Agency in Fertility Decisions in Western Europe During the Demographic Transition: A Comparative Perspective

Did the 1918 influenza pandemic cause a 1920 baby boom? Demographic evidence from neutral Europe

In 1919-20, the European countries that were neutral in the First World War saw a small baby bust followed by a small baby boom. The sparse literature on this topic attributes the 1919 bust to individuals postponing conceptions during the peak of the 1918-20 influenza pandemic and the 1920 boom to recuperation of those conceptions. Using data from six large neutral countries of Europe, we present novel evidence contradicting that narrative. In fact, the subnational populations and maternal birth cohorts whose fertility was initially hit hardest by the pandemic were still experiencing below-average fertility in 1920. Demographic evidence, economic evidence, and a review of post-pandemic fertility trends outside Europe suggest that the 1920 baby boom in neutral Europe was caused by the end of the First World War, not by the end of the pandemic.

Fertility and contraception: The experience of Spanish women born in the first half of the twentieth century

New data based on retrospective interviews with older informants enable us to review the history of contraceptive use among Spanish women over much of the twentieth century. This source is unique because it includes cohorts of women whose reproductive lives took place before, during, and after the baby boom. Traditional contraceptive methods (withdrawal and periodic abstinence) were central to the experience of the first set of women, while the last set made full use of modern as well as some traditional methods. For the first cohorts, traditional methods spearheaded the historic decline in fertility, while among the last set of women modern methods led to a precipitous decline towards the below-replacement fertility that continues in Spain today. There is no evidence that the modest increases in fertility during the baby boom in Spain were the result of a decline in the use of contraception among married women.

mHealth in Sub-Saharan Africa and Europe: Context of current health, healthcare status, and demographic structure

Introduction

The advent of digital systems and global mobile phone availability presents an opportunity for better healthcare access and equity. However, the disparity in the usage and availability of mHealth systems between Europe and Sub-Saharan Africa (SSA) has not been explored in relation to current health, healthcare status, and demographics.

Objective

This study aimed to compare mHealth system availability and use in SSA and Europe in the above-mentioned context.

Methods

The study analyzed health, healthcare status, and demographics in both regions. It assessed mortality, disease burden, and universal health coverage. A systematic narrative review was conducted to thoroughly assess available data on mHealth availability and use, guiding future research in the field.

Results

SSA is on the verge of stages 2 and 3 in the demographic transition with a youthful population and high birth rate. Communicable, maternal, neonatal, and nutritional diseases contribute to high mortality and disease burden, including child mortality. Europe is on the verge of stages 4 and 5 in the demographic transition with low birth and death rates. Europe's population is old, and non-communicable diseases (NCDs) pose major health challenges. The mHealth literature adequately covers cardiovascular disease/heart failure, and cancer. However, it lacks approaches for respiratory/enteric infections, malaria, and NCDs.

Conclusions

mHealth systems in SSA are underutilized than in Europe, despite alignment with the region's demographics and major health issues. Most initiatives in SSA lack implementation depth, with only pilot tests or small-scale implementations. Europe's reported cases highlight actual implementation and acceptability, indicating a strong implementation depth of mHealth systems.

Consistency of the determinants of achieving fertility desires in Ghana: insights from 2003, 2008 and 2014 Ghana Demographic and Health Survey data sets

Sub-Saharan Africa has entered the early stage of the demographic transition with differences in and between countries. The relation between fertility preference and actual fertility is at the core of the demographic changes during the demographic transition in sub-Saharan Africa. At the current pace of the demographic transition, overachieved fertility (actual fertility being higher than fertility preference) is more prevalent in sub-Saharan Africa although some women do achieve their fertility preference. Our aim is to assess the trends and identify factors that consistently influence women with completed fertility to achieve their fertility desires in Ghana over a 10-year period. We used secondary data from the 2003, 2008 and 2014 Ghana Demographic and Health Surveys for the analysis. The sample size was restricted to currently married/living in union women aged 45–49 years. The results indicate that underachieved fertility has increased from 25.1% in 2003 to 35.8% in 2014. Similarly, achieved fertility has also increased from 23.8% in 2003 to 26.0% in 2014. On the contrary, overachieved fertility has decreased from 51.1% in 2003 to 38.2% in 2014. The most persistent determinants of achieved fertility relative to overachieved fertility in Ghana during the last three rounds of the Ghana Demographic and Health Surveys are child survival status, ethnicity and couple’s fertility preference. The study provides support for programmatic interventions targeting improving child survival and regulating men’s fertility preference.

Rethinking the Fertility Transition in Rural Aragón (Spain) Using Height Data

Based on an analysis of the life trajectories of 2510 conscripts and their families from a Spanish rural area in the period 1835–1977, this paper studies the development of the fertility transition in relation to height using bivariate analyses. The use of heights is an innovative perspective of delving into the fertility transition and social transformation entailed. The results confirm that the men with a low level of biological well-being (related to low socio-economic groups) were those who started to control their fertility, perhaps due to the effect that increased average family size had on their budget. The children of individuals who controlled their fertility were taller than the children of other families. Therefore, the children of parents who controlled their fertility experienced the largest intergenerational increase in height (approximately 50% higher). This increase could be due to the consequence of a greater investment in children (Becker’s hypothesis) or a greater availability of resources for the whole family (resource dilution hypothesis).

Predictors of underachieved and overachieved fertility among women with completed fertility in Ghana

Background

A woman’s ability to achieve her preferred family size is critical in addressing issues of high fertility in sub-Saharan Africa. The socio-cultural context in sub-Saharan Africa presents some difficulty for the attainment of preferred fertility for many women. Few studies in sub-Saharan Africa have examined the extent to which women are unable to achieve their preferred family sizes. This study, therefore, examines the factors that are associated with the non-attainment of women’s preferred fertility by the end of their reproductive years.

Data and methods

The study analyzed pooled cross-sectional data with a sub-sample of 1,888 currently married women aged 45–49 years from five rounds of the Ghana Demographic and Health Survey, 1993 to 2014. Test of associations and multinomial logistic regression analysis were used to examine the predictors of underachieved and overachieved fertility relative to achieved fertility.

Results

The results indicate that 44 per cent of the women recorded overachieved fertility while about 36 per cent underachieved their fertility. Partner wants more, experiencing child loss and married more than once were significantly associated with overachieved fertility. Nonetheless, increased years of a woman’s education and delaying her at first birth were negatively associated with overachieved fertility. On the other hand, underachieved fertility was significantly associated with having a partner with fewer fertility preference, being of the Islamic faith and ever use of modern contraception.

Conclusion

Partner’s fertility preference, child loss experience, marrying more than once and ever use of modern contraception were important predictors of a woman’s inability to achieve her fertility preference. Policies to regulate men’s fertility behaviour, delaying age at first birth, use of modern contraception, encouraging longer years of education, and reducing infant and child mortality are important strategies to achieve fertility preference in Ghana.

Stop! Go! What Can We Learn About Family Planning From Birth Timing in Settler South Africa, 1835-1950?

We revisit the discussion on family limitation through stopping and spacing behavior before and during the fertility transition with a sample of 12,800 settler women's birth histories in nineteenth- and twentieth-century South Africa. Using cure models that allow us to separate those who stop childbearing from those who continue, we find no evidence of parity-specific spacing before the transition. We do find evidence of non-parity-based birth postponement before the transition. Increased stopping and parity-independent postponement characterized the beginning of the fertility transition, with increased parity-specific spacing following later in the transition phase.

Sibling loss and fertility desires in the high-mortality context of Peru

Despite demographers' long-standing preoccupation with the effects of child mortality on women's fertility desires, scholars continue to know little about the consequences of other pervasive mortality exposures. We use nationally representative data from the high-mortality context of Peru to examine whether the desire to have a(nother) child varies as a function of sibling loss and to assess heterogeneity in this association by women's current number of children and a range of conditions related to siblings' deaths. Women who have experienced sibling bereavement and have two or more children report higher odds of desiring another child. These effects are not contingent on the age or sex of the deceased sibling but are only significant if the sibling died during the respondent's lifetime (not before). These findings highlight the theoretical and empirical import of investigating the relationship between fertility desires and a wider range of familial mortality exposures beyond own child mortality.

Survival and sex composition of offspring: Individual-level responses in the quantum and tempo of childbearing during the demographic transition

Previous studies have documented varying fertility responses to childhood mortality and to the sex composition of the surviving offspring during the demographic transition. We contribute to this literature by applying a mixture cure model to reproductive histories of Estonian women born 1850-99. This model, unlike standard event history models, is capable of separating the effect of the covariates on the propensity of having another birth from their effect on its timing. Child fatalities, not having sons, and to a smaller extent, not having daughters, increased the propensity to have another child and decreased the interval to it. The response was stronger among later cohorts, but only with respect to parity progression. By contrast, the accelerated childbearing response diminished over time. Our findings suggest that behavioural responses in the quantum and tempo of childbearing can occur relatively independently.

Voluntary Associations and Net Fertility During the Swedish Demographic Transition

This study investigates the role of changing social relations for fertility decline during the European fertility transition. The growth of voluntary associations at the end of the nineteenth century entailed a radical shift in the landscape of social relations in Sweden. By combining micro-census data from 1890 to 1900 with local-level membership data for three voluntary association groups, this article assesses the effect of parish-level voluntary association size on net fertility in Sweden using mixed-effects Poisson regression models. The results show that the adoption of fertility limitation during the transition period was associated with the creation and diffusion of the idea of respectability within large social network organisations, an idea that has previously been shown to be connected to fertility limitation. Furthermore, by applying a social network perspective, the results show that the strength of the effect was dependent on the structure of the social networks in terms of size, density, and homogeneity. Voluntary association size had the strongest effect for the free churches, which created dense heterogeneous networks through systems of social control, while the size of the temperance association showed no effect on fertility because the connections between nodes were sparse.