Determinants of Fertility Preferences Among Nepali Women at Karnali Province

Abstract

Background: Fertility preferences that is, individual wishes about the number of children and the timing to have them are probably very critical factors in determining reproductive behaviour as well as the shape of demographic transitions in low and middle income countries. This study looks for to establish the socio-demographic determinants of fertility preferences among women of reproductive age in Karnali Province.

Methods: This study used cross-sectional data extracted from Nepal Demographic and Health Survey (NDHS) focusing on women aged between 15 - 49 years. A stratified two-stage cluster sampling approach was used to ensure that the representation was accurate across the subgroups. Descriptive statistics, chi-square tests, and multivariable logistic regression analyses while adjusting for sampling weights, clustering, and stratification to explore relationships between fertility preference and the explanatory variables.

Results: The strongest predictor of fertility preference emerged to be age, with the greatest inclination among younger women toward desiring having more number of children. Beyond the age of 25 years, the odds of having fertility preference decline steeply (aOR for 25–29 = 0.072; 30–34 = 0.032; 35–39 = 0.003; p < 0.001). Partner's education also remained the significant factor in the adjusted model (adjusted odds ratio for secondary education = 0.136, p < 0.05), pointing towards the significance of spousal influence. Education and wealth of women seemed to be associated with fertility preference in the unadjusted models but lost significance when controlling other variables. Media exposure had a positive association in crude but not adjusted model.

Conclusion: It is influencing areas regarding fertility preferences of women in Karnali Province are age, education of the partner under individual level factors, while wealth or caste is much less likely to be imposing. Reproductive health policies should be proposed in further strengthening youth-focused, couple-based education and increasing access to services.