The Geography of Fertility Rates in Low and Middle-Income Countries: Analysis of Cross-Sectional Surveys from 74 Countries
Victor A. Alegana, WorldPop, Geography and Environment, University of Southampton
Alessandra Carioli, WorldPop, Geography and Environment, University of Southampton
Sophie E. Hanspal, WorldPop, Geography and Environment, University of Southampton
Graeme M. Hornby, Flowminder Foundation, Stockholm
William H.M. James, WorldPop, Geography and Environment, University of Southampton
Zoe Matthews, Division of Social Statistics and Demography and Centre for Global Health, Population, Poverty and Policy, University of Southampton
Kristine Nilsen, WorldPop, Geography and Environment, University of Southampton
Carla Pezzulo, Flowminder Foundation, Stockholm
Corrine W. Ruktanonchai, Flowminder Foundation, Stockholm
Alessandro Sorichetta, Flowminder Foundation, Stockholm
Andrew J. Tatem, Flowminder Foundation, Stockholm
Natalia Tejedor-Garavito, GeoData, University of Southampton
Together with mortality and migration, fertility is a crucial indicator for describing the status of a country in terms of its population, its opportunities for development, future population growth, and women’s reproductive health. Policies and programs aiming to understand the distribution and patterns of age specific fertility rates (ASFRs) and total fertility rates (TFRs) usually rely on national estimates, masking underlying heterogeneity in fertility levels within countries. Understanding the geographic variation in the distribution of ASFRs and TFRs within and between countries, and by background characteristics, is relevant for planning and implementing for safer maternal and newborn health strategies and for targeting programs on sexual and reproductive health care in a more effective way (SDG 3). In this work, we collected subnational age specific fertility rates (ASFRs) and total fertility rates (TFRs) from the most recent nationally representative surveys (Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS)) between 2005 and 2016 for 74 low, lower and upper middle-income countries, resulting in a total of circa 1,000 subnational areas. Using descriptive analysis, we investigated geographic disparities in the in the age pattern of fertility within the subnational areas both within and between countries. Moreover, we also investigated fertility age patterns for the subnational areas by background characteristics such as urban and rural areas of residence, macro-region and income level and fertility level. This work aims to (i) highlight the subnational geographic variation in the distribution of fertility rates (ASFRs and TFRs) within and between countries included in the analysis, with a particular focus on adolescent fertility, and (ii) describe patterns in the distribution of fertility by age by country background characteristics. These findings have important implications on Sustainable Development Goal (SDG) targets, particularly SDG 3, ensuring the health and wellbeing of all.
