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FERTILITY LEVELS, TRENDS, AND DIFFERENTIALS 4Dudu Dlamini4.1 INTRODUCTIONThis chapter looks at a number of fertility indicators, including levels, patterns, and trends in bothcurrent and cumulative fertility; the length of birth intervals; and the age at which women initiatechildbearing. Information on current and cumulative fertility is essential in monitoring population growth.The data on birth intervals are important since short intervals are strongly associated with childhoodmortality. The age at which childbearing begins can also have a major impact on the health and wellbeingof both the mother and the child.Data on fertility were collected in several ways. Each woman was asked about all of the births shehad had in her lifetime. To ensure completeness of the responses, the duration, the month and year oftermination, and the result of the pregnancy were recorded for each pregnancy. In addition, questionswere asked separately about sons and daughters who live with the mother, those who live elsewhere, andthose who have died. Subsequently, a list of all births was recorded along with name, age if still alive, andage at death if dead. Finally, information was collected on whether women were pregnant at the time ofthe survey.4.2 CURRENT FERTILITYThe level of current fertility is one of the most importanttopics in this report because of its direct relevance to populationpolicies and programmes. Current fertility can be measured usingthe age-specific fertility rate (ASFR), the total fertility rate (TFR),the general fertility rate (GFR), and the crude birth rate (CBR). TheASFR provides the age pattern of fertility, while the TFR refers tothe number of live births that a woman would have had if she weresubject to the current ASFRs throughout the reproductive ages (15-49 years). The GFR is expressed as the number of live births per1,000 women of reproductive age, and the CBR is expressed as thenumber of live births per 1,000 population. The measures of fertilitypresented in this chapter refer to the period of three years prior to thesurvey. This generates a sufficient number of births to providerobust and current estimates.Table 4.1 depicts measures of current fertility for the threeyears preceding the survey for the country as a whole and by urbanand rural residence. These are the total fertility rate (TFR), generalfertility rate (GFR), and crude birth rate (CBR). The survey resultsindicate that the TFR for Swaziland for the three years preceding the2006-07 SDHS survey is 3.8 births per woman. As expected,fertility is considerably higher in rural areas (4.2 births per woman)than in urban areas (3.0 births per woman). As the ASFRs show, thepattern of higher rural fertility is prevalent in all age groups exceptage 40-49. The urban-rural difference in fertility is more pronouncedTable 4.1 Current fertilityAge-specific and total fertility rate, thegeneral fertility rate, and the crude birthrate for the three years preceding thesurvey, by residence, Swaziland 2006-07ResidenceAge group Urban Rural Total15-19 89 118 11120-24 163 219 20225-29 124 184 16530-34 113 182 15935-39 83 105 9940-44 31 30 3045-49 0 5 4TFR 3.0 4.2 3.8GFR 110 146 136CBR 31.9 31.0 31.1Note: Age-specific fertility rates are per1,000 women. Rates for age group 45-49may be slightly biased due to truncation.Rates are for the period 1-36 months priorto interview.TFR: Total fertility rate expressed perwomanGFR: General fertility rate expressed per1,000 womenCBR: Crude birth rate expressed per 1,000populationFertility Levels, Trends, and Differentials | 49
for women in the age group 30-34 (113 births per 1,000 women in urban areas versus 182 births per 1,000women in rural areas). The overall age pattern of fertility as reflected in the ASFRs indicates thatchildbearing begins early. Fertility is low among adolescents and increases to a peak of 202 births per1,000 among women age 20-24 and declines thereafter.The CBR in Swaziland is 31.1 births per 1,000 population. The overall GFR is 136 and is higherin the rural areas than in urban areas (146 and 110 births per 1,000 women, respectively).Compared with other south-east African countries that have participated in the DHS programme,the TFR in Swaziland is the same as that in Zimbabwe and slightly higher than in Namibia and Lesotho.Figure 4.1 Total Fertility Rates for Selected Countriesin Southeast Africa8Births per woman76.766.065.95.75.554.9433.8 3.83.6 3.5210Uganda2006Malawi2004Zambia Tanzania2001-02 2004Mozambique2003Kenya2003ZimbabweSwaziland Namibia2005-062006-07 2006-07Lesotho2004SDHS 2006-074.3 FERTILITY DIFFERENTIALSFertility is known to vary by residence, educational background, and other backgroundcharacteristics of a woman. Table 4.2 shows several different indicators of fertility, mainly the totalfertility rate, mean number of births to women age 40-49, and the percentage currently pregnant. Themean number of births to women age 40-49 is an indicator of cumulative fertility; it reflects the fertilityperformance of older women who are nearing the end of their reproductive period. If fertility remainsstable over time, the two fertility measures, total fertility rate (TFR) and children ever born (CEB), tend tobe very similar. The percentage pregnant provides a useful additional measure of current fertility,although it is recognized that it may not capture all pregnancies in an early stage.Table 4.2 indicates that there are variations in the TFR by residence, region, education, andwealth quintile. Fertility is highest in the Shiselweni region with a TFR of 4.3 births per woman andlowest in Hhohho at 3.6 births per woman. TFR decreases gradually with increasing level of education;better educated women have fewer children than less educated women. Women with no education haveon average 4.9 children compared with 2.4 children for women with tertiary education. Fertility varies50 | Fertility Levels, Trends, and Differentials
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12.1.3 Prompt Treatment of Fever in
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Table 3.5.1 Employment status: Wome
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Table 13.8.1 Multiple sexual partne
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Figure 16.1 Number of Decisions in
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PREFACEThis detailed report present
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FAMILY PLANNINGKnowledge of family
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Page 33 and 34: Because of the anonymous nature of
Page 35 and 36: HOUSEHOLD POPULATION AND HOUSING2CH
Page 37 and 38: given. Households in Swaziland are
Page 39 and 40: Table 2.3.2 Educational attainment
Page 41 and 42: Table 2.4 shows that for both boys
Page 43 and 44: The dropout rates are higher for bo
Page 45 and 46: 2.4.2 Household Sanitation Faciliti
Page 47 and 48: Table 2.8—ContinuedHousingHouseho
Page 49 and 50: Table 2.10 Household possessionsPer
Page 51 and 52: Table 2.11 presents the percentage
Page 53 and 54: Table 3.1.1 Background characterist
Page 55 and 56: 3.2 EDUCATIONAL ATTAINMENT BY BACKG
Page 57 and 58: Table 3.3.1 Literacy: Women 15-49Pe
Page 59 and 60: Table 3.3.4 Literacy: Older adults
Page 61 and 62: Table 3.4.2 Exposure to mass media:
Page 63 and 64: The pattern of exposure to mass med
Page 65 and 66: Table 3.5.1 Employment status: Wome
Page 67 and 68: Table 3.5.2 Employment status: Men
Page 69 and 70: 3.6 OCCUPATIONRespondents who were
Page 71 and 72: Table 3.6.3 shows the percent distr
Page 73: Six in ten women and 72 percent of
Page 77 and 78: Nonetheless, the results in Table 4
Page 79 and 80: 4.6 BIRTH INTERVALSA birth interval
Page 81 and 82: Overall, 6 percent of women age 25-
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Page 87 and 88: 62 | Family PlanningTable 5.3.1 Eve
Page 89 and 90: Table 5.3.2 Ever use of contracepti
Page 91 and 92: Figure 5.2 compares the modern cont
Page 93 and 94: 9080706050403020100Figure 5.3 Contr
Page 95 and 96: Table 5.7 Number of children at fir
Page 97 and 98: consistent, asking informants in th
Page 99 and 100: Table 5.13 Informed choiceAmong cur
Page 101 and 102: 5.14 PREFERRED METHOD OF CONTRACEPT
Page 103 and 104: Table 5.17.2 Exposure to family pla
Page 105 and 106: Table 5.19 Husband/partner's knowle
Page 107 and 108: OTHER PROXIMATE DETERMINANTS OF FER
Page 109 and 110: Table 6.2 Polygyny: Women and men a
Page 111 and 112: Table 6.4 Age at first marriage: Wo
Page 113 and 114: Eleven percent of women age 25-49 h
Page 115 and 116: The data for men show a different p
Page 117 and 118: Table 6.10.2 Recent sexual activity
Page 119 and 120: Women who gave birth three years pr
Page 121 and 122: FERTILITY PREFERENCES 7Dudu Dlamini
Page 123 and 124: Table 7.2.1 Desire to limit childbe
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Overall, unmet need does not vary i
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7.5 MEAN IDEAL NUMBER OF CHILDREN B
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The total wanted fertility rate and
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Tables C.4-C.6 in Appendix C can be
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Figure 8.2 Neonatal, Postneonatal,
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Table 8.3 Early childhood mortality
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common single high-risk category is
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Table 9.1 Antenatal care providerPe
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Table 9.3 Components of antenatal c
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While older women of higher parity
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Table 9.6 Assistance during deliver
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Table 9.7 Timing of first postnatal
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accessing health services. Other li
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10.2.1 Collection of DataThe 2006-0
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PercentFigure 10.1 Trend in Vaccina
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Table 10.4 presents the proportions
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Table 10.5 Prevalence of diarrhoeaP
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Antibiotics and other medications a
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10.5 KNOWLEDGE OF ORS PACKETSAs dis
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NUTRITION OF CHILDREN AND ADULTS 11
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Table 11.1—ContinuedBackgroundcha
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during the first three days after b
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SDHS by asking mothers about the fo
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Table 11.4 Median duration and freq
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The results in Table 11.5 document
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Figure 11.2 Percentage of Children
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years and above. Severe anaemia, wh
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Table 11.8.2—ContinuedBackgroundc
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Table 11.9 Micronutrient intake amo
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iodized salt. Manzini had the lowes
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directly related to household wealt
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The results in Table 11.12.2 indica
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11.12 MICRONUTRIENT INTAKE AMONG MO
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MALARIA AND OTHER HEALTH ISSUES 12A
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Tables 12.2 and 12.3 provide inform
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Table 12.4 provides information on
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12.1.4 Indoor Residual SprayingIndo
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Slightly less than two-thirds of me
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Table 12.9.2 Health insurance cover
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Table 12.10.2 Knowledge and attitud
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HIV/AIDS-RELATED KNOWLEDGE, ATTITUD
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Table 13.2 Knowledge of HIV prevent
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Table 13.3.1 Comprehensive knowledg
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Table 13.4 shows that a relatively
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Table 13.5.2 Accepting attitudes to
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13.6 ATTITUDES TOWARDS CONDOM EDUCA
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Table 13.8.2 Multiple sexual partne
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Consistent use of condoms requires,
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Table 13.11.2 Coverage of prior HIV
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Table 13.13 Pregnant women counsell
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100Figure 13.1 Women and Men Seekin
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administered injections with a syri
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13.11.2 Knowledge of Condom Sources
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Table 13.20 Condom use at first sex
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Table 13.22.1 Higher-risk sexual in
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wealth quintile, especially among w
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13.11.9 HIV Testing and Counselling
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Table 14.1 Coverage of HIV testing
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Table 14.2 Coverage of HIV testing
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Looking at the age pattern, Table 1
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The HIV epidemic also exhibits some
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Table 14.6.1 HIV prevalence by demo
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As expected, men who sleep away fro
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Table 14.7.2 HIV prevalence by sexu
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Table 14.7.3 HIV prevalence by sexu
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The uptake of HIV testing in Swazil
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Table 14.11 HIV prevalence by backg
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14.6 HIV PREVALENCE AMONG COUPLESBo
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Of the 25,594 siblings reported in
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The results in Table 15.3 indicate
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“no” to this question were aske
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Older women and women with more chi
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Table 16.3 Women's control over the
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Figure 16.1 Number of Decisions in
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Differentials by region and wealth
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Table 16.7.1 Attitude toward refusi
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There are small differences by back
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Table 16.9 Current use of contracep
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Table 16.11 Reproductive health car
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ORPHANS AND VULNERABLE CHILDREN 17A
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Table 17.2 Orphans and vulnerable c
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There is only a minor difference in
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Table 17.6 Underweight orphans and
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17.8 WIDOWS DISPOSSESSED OFPROPERTY
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17.10 EXTERNAL SUPPORT FOR ORPHANS
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18.1 CAREGIVERTable 18.1 shows the
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Some parents or guardians take the
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Girls and boys age 12-14 were asked
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Figure 18.2 shows the percentage of
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Table 18.7 Exposure to information
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Table 18.9 Places for information a
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18.7 KNOWLEDGE OF HIV/AIDS HELP LIN
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When asked if they had discussed th
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REFERENCESAuvert, B., D. Taljaard,
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SAMPLE IMPLEMENTATIONAppendix ATabl
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Table A.3 Sample implementation: Gi
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Table A.5 Sample implementation: Wo
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ESTIMATES OF SAMPLING ERRORSAppendi
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Sampling errors are analyzed for tw
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Table B.1—Continued--------------
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DATA QUALITY TABLESAppendix CTable
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Table C.3 Completeness of reporting
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EFFECT OF NONRESPONSE ON THESDHS HI
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PERSONS INVOLVED IN THE 2006-07SWAZ
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Mr. Musa DlaminiMr. Patrick Makhubu
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2006 SWAZILAND DEMOGRAPHIC AND HEAL
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LINENO.IF AGE 18-59YEARSIF AGE 0-17
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LINENO.IF AGE 5 YEARS OR OLDERIF AG
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NO. QUESTIONS AND FILTERS CODING CA
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1ST SICK PERSON 2ND SICK PERSON 3RD
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NAME 1ST DEATH NAME 2ND DEATH NAME
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405 RECORD NAMES, LINE NUMBERS AND
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CONSENT STATEMENT FOR ANAEMIA FOR C
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CHILD 4 CHILD 5 CHILD 6502 LINE NUM
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CHILD 4 CHILD 5 CHILD 6502 LINE NUM
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CONSENT STATEMENT FOR ANAEMIA TEST
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WEIGHT, HEIGHT, HAEMOGLOBIN MEASURE
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WOMAN 4 WOMAN 5 WOMAN 6524 LINE NUM
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We are asking children like you to
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WEIGHT, HEIGHT, HAEMOGLOBIN MEASURE
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MAN 1 MAN 2 MAN 3544 LINE NUMBER LI
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211 Now I would like to record the
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SECTION 3. CONTRACEPTION301 Now I w
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SECTION 4. PREGNANCY, POSTNATAL CAR
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LAST BIRTH NEXT-TO- SECOND-FROM-LAS
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SECTION 5. IMMUNIZATION, HEALTH, AN
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LAST BIRTH NEXT-TO-LAST BIRTH SECON
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SECTION 6. MARRIAGE AND SEXUAL ACTI
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LASTSEXUAL PARTNERSECOND-TO-LASTSEX
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SECTION 9. HIV/AIDSNO. QUESTIONS AN
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SECTION 10. OTHER SEXUALLY TRANSMIT
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SECTION 12. MATERNAL MORTALITYNO. Q
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INSTRUCTIONS:ONLY ONE CODE SHOULD A
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SECTION 3. CONTRACEPTION301 Now I w
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LASTSEXUAL PARTNERSECOND-TO-LASTSEX
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SECTION 5. FERTILITY PREFERENCESNO.
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INTERVIEWER'S OBSERVATIONSTO BE FIL
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SECTION 1. RESPONDENT'S BACKGROUNDI
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SECTION 2. CARE AND PROTECTIONNO. Q
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SECTION 4. KNOWLEDGE OF AIDSNO. QUE
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SECTION 1. RESPONDENT'S BACKGROUNDI
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SECTION 4. HIV/AIDSNO. QUESTIONS AN
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SECTION 5. OTHER SEXUALLY TRANSMITT
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