ppt fertility concepts and measures

• Factors affecting fertility

  • Nuptiality/union and sexual intercourse
  • Age of menarche
  • Contraception
  • Lactational infecundabililty/ postpartum amenorrhea
  • Induced abortion
  • Duration of fertile period
  • Socio-economic factors
  • Gender and cultural factors
• Fertility measures


  • Crude birth rate (CBR)
  • General fertility rate (GFR)
  • Age specific fertility rate (ASFR)
  • Total fertility rate (TFR)
  • Gross reproduction rate (GRR)
  • Net reproduction rate (NRR)
  • Children ever born (CEB)
  • Child woman ratio (CWR)

  
• Other fertility measures


  • Wanted fertility
  • Contraceptive prevalence rate – percentage of married women aged 15-49 currently using any family planning method
  • Intention to use contraceptives
  • Marital status
  • Age at first marriage
  • Age at first menstruation/ menarche
  • Age at first sexual intercourse
  • Recent sexual activity
  • Postpartum amenorrhea
  • Abstinence
  • Menopause
• Refers to the actual birth performance indicated by live births

  fertility
• Physiological capacity of a woman, man or couple to conceive or reproduce

  fecundity
• The complete expulsion from its mother the product of conception, irrespective of the duration of pregnancy, after expulsion shows evidence of life such as breathing, pulsation, beating of the heart, definite movement of voluntary muscle, whether or not the placenta has been cut or not

  live births
• Union marks the exposure to childbearing, the younger a woman enter into union, the longer the exposure, more frequent sexual intercourse increases chance of pregnancy (especially when there is no contraception), indicated by age at first marriage and marital status

  Nuptiality/union and sexual intercourse
• Menarche marks the onset of woman's capacity to conceive or get pregnant, early onset of menarche coupled with early sexual intercourse heightens the risk of early and unwanted pregnancy, early pregnancy among adolescents poses high risk in pregnancy

  age of menarche
• it helps manage fertility or planning pregnancy, prevents the fertilization of sperm and egg cell thus preventing pregnancy, condom also can help reduce the risk of sexually transmitted diseases

  contraception
• Following a pregnancy a woman remains unable to conceive (i.e. infecund) until the normal pattern of ovulation and menstruation is restored, the infecundity is a function of lactation or breastfeeding

  lactational infecundability/postpartum amenorrhea
• The duration of fertile period is a function of the duration of the viability of the sperm or ovum


  duration of fertile period
• This terminates conception, includes any act of deliberately interrupts the normal course of gestation or pregnancy, it is illegal in the country but with high recorded incidence (more than 470,000 cases in 2008 – Guttmacher study)

  induced abortion
• Cultural barriers to sexual health, sexuality is a taboo, double standard on sexuality, many sexuality and fertility attitude decisions are made by men and disadvantageous to women, higher preference of men for number of children, preference for sons, lack of sensitivity to women'sexual concerns, women has no power or inferior negotiating power to refuse sexual abuses and advances, lack of access to appropriate information and services on sexual and reproductive health


  gender and Cultural Factors
• Education and income is negatively associated with fertility, women with less education and who are poor have higher fertility, education is associated with knowledge on accurate information about pregnancy and family planning, level of income determines access to necessary information and services

  socioeconomic Factors
• A more refined measure than the CBR since it restricts the denominator to women of childbearing age,

  general fertility rate
• GFR FORMULA 


  GFR= Number of births in a given year / Mid-year of population of women aged 15-49 in the same year x 1,000
• The ratio of the number of births during a period (one year) to the total number of persons in the population as of the middle of the same period

  Crude Birth Rate
• CBR FORMULA

  CBR= (B/P) x 1,000, where B = number of births in a given year and P = total mid-year population
• true or false? it is called "crude" because its denominator includes people who are not at risk of giving birth (e.g. women beyond reproductive age and men)

  true
• It depicts variations of fertility by age groups

  age specific fertility rate
• ASFR FORMULA 


  ASFR= Number of births to reproductive women in specific age group / Number of women in the same age group x 1,000
• The number of children a woman would have by the time she reaches age 50 (or during her reproductive age)

  total fertility rate
• TFR FORMULA 


  TFR = 5 Σ ASFRi, where ASFR = age specific fertility rate and 5 = age group interval
• it measures the extent to which a hypothetical cohort of women will replace itself assuming no women die during the childbearing years

  gross reproduction rate
• GRR FORMULA

  GRR = (100/106) x TFR, where TFR = Total fertility rate and 100/106 is the proportion of female among live births
• Derived by asking the women the number of children they ever had, usually tabulated by woman's age yielding cumulative fertility of women up to specified points in their childbearing years, limitations are that it measures past fertility and children you died young might not be remembered

  children ever born
• Number of children/population under age five per 1,000 women of childbearing age in a given year, this is measured as a rough fertility indicator available in the census (population by age group)

  children-woman ratio