Fertility and the family

Fertility: Production of a live birth (natality) measured by number of children born to a woman. Parity: Number of children born alive to a woman. Gravidity: Number of pregnancies a woman has had whether or not they produce a live birth.

Fecundity Physiological ability to bear children, that is, the ability to deliver a child. Sterility : Inability of a woman to conceive a pregnancy.

FACTORS AFFECTING FERTILITY Age at marriage. Duration of marriage. Spacing of children. Education. Economic status. Religion and Culture. Breastfeeding. Preference for males.

Fertility Measurement: Sources of Data 1- Censuses 2- Vital registration systems 3- Nationally representative sample surveys 4- World Fertility Surveys (WFS), 5- Demographic and Health Surveys

Fertility Measures 1- The child/women ratio = Child aged 0-4 X 1000 C/W ratio = Women aged 15-49 From the table below C/W ratio = 71 + 70 X 1000 48 + 41 + 32 + 29 + 22 + 19 + 11

Females(000) Males (000) Age Groups 70 71 0-4 61 64 5-9 50 55 10 - 14 48 51 15 - 19 41 43 20 - 24 32 37 25 - 29 29 31 30 - 34 22 28 35 - 39 19 21 40 - 44 11 15 45 - 49 10 More 50

=698.01/100 Disadvantages 1- It relates births to all women aged 15-49 irrespective of being married. 2- Does not allow for differences in the fertility of women of different ages.

3- Affected by mortality 3- Affected by mortality. Numerator included only surviving children with number affected by mortality. Advantage: 1- Simple to calculate. It requires only data about the age and sex structure of the population under study.

2- Crude Birth Rate (CBR): Births in year X 1000 = CBR Population at mid-year

Country Crude birth rate Total fertility rate   Per 1000 Saudi Arabia 22.1 3.03 Yemen 38.6 5.48 Palestine 35.9 4.65 Iraq 36.6 4.86 Bahrain 20.7 2.63 Emirates 14.0 2.36 Oman 22.2 2.52 Qatar 14.1 1.92 Jordon 4.1 3.27

Age specific fertility rate Saudi Arabia Age specific fertility rate   1,000 15 - 19 11.6 20 - 24 70.9 25 - 29 217.5 30 - 34 122.4 35 - 39 106.0 40 - 44 53.0 45 - 49 23.7

Example: For a region: The total population at the mid year 1427 H was 763000. The number of women (15-49) was 149000 The total live births during the same year was 36000 child 36000 X 1000 = 47.2/ 1000 = CBR 763000

Disadvantages: 1- All the population included in the denominator is not exposed to the risk of pregnancy 2- are not necessarily comparable through time, because of the influence of changing age structure.

However, it is useful in 1- making annual comparisons 2- to detect trends in fertility in a given country and 3- in comparing different populations.

Factors affecting the CBR: Factors affecting the Live births Number of females specifically those 15-49 years The age of marriage Level of infant and preschool mortality rates Socioeconomic level of the country

Economic value of children and lower expenses of rearing children Cultural and religious factors Knowledge, attitudes and motives for adopting or rejecting family planning.

Crude Birth Rate for Saudi Arabia (2000 – 2011)

Fertility rate differs by social variable: 1- Religious group 2- Social class: lower class have higher fertility. 3- Region: People in rural area tend to have lower fertility. 4- Country: people in poor countries tend to have higher fertility.

Fertility rates can be affected by: 1- Public policy: Governments pressure couples to have fewer kids. 2- Culture: Religion and contraception 3- Economics: Expense of having kids in industrial versus agricultural societies.

4- Technology: Availability of effective contraceptives. Fertility and Health 1- Higher fertility can increase maternal mortality. 2- Continuous child-bearing can have negative impact on maternal health.

4- Closely spaced births ( less than 18 months apart) and low birth weight babies (less than 2.5 kg) at higher risk. 5- Problems of marriage at young age.

Rate of natural increase (RNI): Births – deaths in a year RNI = X 1000 Population at mid-year In the previous example, let number of deaths in the region be 30,000. Then: 36000 – 30,000 =7.86/1000 RNI = 763000

Thus, the rate of natural increase is 8 per thousand. The world’s population had a rate of natural increase estimated at 14/1000, but there were great differences between countries. The more developed countries had rates of only 1 per thousand compared to 16/1000 for the developed countries.

Rate of natural increase Country Natural increase   1,000 Saudi Arabia 18.39 Yemen 28.40 Palestine 23.73 Iraq Bahrain 14.15 Emirates 11.6 Oman 18.89 Qatar 9.13 Jordon 19.65 Kuwait 14.14 Rate of natural increase

Rate of population growth Crude Birth Rate - Crude Death Rate = crude rate of natural increase. This rate is based on naturally occurring events – births and deaths.

For example if the CBR=46, CDR=18 per 1000 population and population size of 25,460 in 1998, then: Crude rate of natural increase = 46 - 18 = 28 per 1000 = 2.8% per year. The net effect of migration is assumed to be zero.

Population at mid-year for General Fertility Rate (GFR): Live births in year = GFR Population at mid-year for females aged 15-49 36000 = GFR X 1000 = 241.6/1000 149000 The range of possible values is from 50 to 300.

That means: Every 1000 women in the reproductive age add 242 live birth.

Disadvantages: 1- More data is needed to calculate GFR than CBR, since we have to know the age composition of the female population between 15-49. 2- Can not be used for comparison between populations due to the substantial variation within the reproductive age range.

Women at the reproductive Age Specific Fertility Rate (ASFR) Live births for women at the reproductive age X ASD = X 1000 Women at the reproductive age x at mid-year The below table shows the distribution of Saudi women according to live birth during the past year, SFHS 1996, Calculate the ASFR and the TFR

ASBR Births Women Age Groups 49.9/1000 246 4928 15 - 19 201/1000 621 3088 20 - 24 269.9/1000 679 2516 25 - 29 263.8/1000 511 1937 30 - 34 191.3/1000 350 1830 35 - 39 103.1/1000 114 1106 40 - 44 67.7/1000 54 798 45 - 49

For example, ASBR for the interval (20 – 24), can be calculated as: Live births to women aged 20-24 ASFR20-24 = X 1000 Mid-year population for Women aged 20-24 621 = 201/1000 X 1000 3088

Uses: For comparisons in fertility behavior at different ages For comparison of fertility at different ages over time For comparison of fertility across countries/populations

Total Fertility Rate (TFR) Calculated from the set of age-specific fertility rates. A major advantage of the TFR it produces a single summary figure from seven age-specific fertility rates. It measures “average family size”

Total fertility rate (TFR): Sum of ASFRs x 5 = TFR 1000 Note that: 1- Each ASFR usually relates to 5 years. It can be though of as the average of the rates for each of the 5 years. It is necessary to multiply the

Using the previous table, TFR is: Five-year rate by 5. 2- The TFR is always expressed per woman, where as ASFRs are often expressed per 1000. Then it is necessary to divide by 1,000. Using the previous table, TFR is: (49.9 + 201 + 269.9 + 263.8 + 191.3 + 103.1 + 67.7) x 5 1000 = 5.73

Meaning The average number of children that would be born to a woman by the time she ended childbearing if she were to pass through all her childbearing years and bear children in accordance with current age-specific fertility rates. In our example, the average number of children or family size is 6.

The number, which ranges from more than 7 children per woman in developing countries in Africa to around 1 child per woman in Eastern European and highly-developed Asian countries. and bear children in accordance with current age-specific fertility rates.

Total Fertility Rate Saudi Arabia (2000-2011)

Gross Reproduction Rate For TFR we considered population replacement in terms of total children born. Proliferation of people is measured by number of female births because they represent the generation that bears the responsibility of reproduction in the future.

The gross reproduction rate resembles the TFR, except it measures the number of daughters per woman, instead of the total number of children. Calculation of GRR = = GRR Sum of ASFRs for daughters x 5 X1000 1000

ASFRs daughters 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 Female births Women Age Groups 24.6/1000 121 4928 15 - 19 98.1/1000 303 3088 20 - 24 131.6/1000 331 2516 25 - 29 128.5/1000 249 1937 30 - 34 93.4/1000 171 1830 35 - 39 50.6/1000 56 1106 40 - 44 32.6/1000 26 798 45 - 49

= GRR (24.6 + 98.1 + 131.6 + 128.5 + 93.4 + 50.6 + 32.6) x 5 1000 2797 = 2.797 = 1000

Gross reproduction rate Mean age of child bearing Country Gross reproduction rate Net reproduction rate Mean age of child bearing Saudi Arabia 2.13 2.26 30.46 Yemen 3.09 2.59 34.16 Palestine 2.99 2.84 31.78 Iraq 2.60 2.10 32.40 Bahrain 1.7 31.20 Emirates 2.22 Oman 3.05 2.96 34.24 Qatar 2.40 Jordon 1.83 1.72 30.22 Kuwait 2.38 2.35 29.95