Women’s Status in Bangladesh and Its Impact on Fertility

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Women’s Status in Bangladesh and Its Impact on Fertility

Chapter: One

Introduction

1.1 Background of the study:

Bangladesh is the ninth most populous country in the world. According to the 2001 population Census, the country had a population of over 130 million people, increasing at an annual growth rate of around 1.54 percent. Today, the country has an estimate population of around and fifty million.

The scarcity of resources and subsistence-level economic conditions characterize the Bangladesh economy. Bangladesh is predominantly dependent on land, with agriculture as its primary industry; however, increasing population pressure on the land is continually decreasing the land-man ratio from 4 decimals in 151 to 20 decimals in 1991. Although high yielding variety (HYV) technology has expanded since the early 1960s, covering one quarter of cultivable land area the per hectares yield is among the lowest in the world.

Socio-economically, Bangladesh is comparatively disadvantaged interms of such key indicators as per capita income (US$ 750 in 2010), proportion living below the poverty line (40.9% of total population and 40% of rural population), etc. Consequently, the Bangladesh economy is characterized by extremely low in savings and investments. Both the per capita food production index and daily calorie supply as percentages of requirements (83%) are quite low in Bangladesh. The overall literacy rate is only 37% -male 40% and female 23%. Female school attendance is low, and there is an uneven ratio of male/female school enrollment, especially beyond the primary level.

Despite pervasive poverty and underdevelopment, Bangladesh has achieved considerable decline infertility. Bangladesh indeed represents’ an apparent anomaly for a significant decline in fertility, despite the absence of conditions believed to b necessary for such a reproductive change. Bangladesh is the only country among the twenty poorest countries in the world where such a change occurred.

The purpose of this paper is to examine the nature fertility transition in Bangladesh. The paper begins by looking at the tends in contraceptive use and fertility , and then examines the major factors which might have accounted for the fertility transition in Bangladesh ,despite its poor socio-economic conditions Two sets of factors may account for the fertility decline:

(a) Positive factors which encourage eligible couples to contraceptive for spacing and/ or limiting births; and

(b) Negative factors which compel women to contraceptive for spacing and/ or limiting births.

Positive factors include education, female education; female employment; modernization, access to media; and ideational changes; decline in child mortality, etc. Negative factors include landlessness, impoverishment, and reduced employment opportunities, which affect economic value of children, etc.

1.2 Review of the literature:

The concept of fertility is the beginning of the study of population dynamics. It refers to the number of births that occur in a population or to an individual. Human fertility offers an interesting and challenging area of scientific inquiry. In recent years viewing the reduction of population growth experienced in most of the developing countries and wide variations in the levels of fertility observed within many high fertility countries, identification of the factors contributing to fertility decline received great importance. Because high fertility in the modern world may be seen as a symptom of lack of access: lack of access to health services, which would reduce the need to insure against infant child and child mortality by having many births; lack of access to education, which could also broaden a woman’s outlook and give her some degree of control over her life; lack of access to social security and forms of insurance for old age, including landownership, that might replace children; lack of access to consumer goods and social opportunities that compete with childbearing; lack of access to the media, which promote such goods and often support modern values and the idea of personal control; and lack of access to family planning service3s, which provide the means to limit births.

Since fertility decline and population control cannot be explained by a single factor, research on fertility control invariability looks for a wide range of explanations at the macro and micro levels. However a relatively recent area of interest in explanations of fertility decline is the crucial aspect of women’s empowerment and its impact on reproductive decisions. Most research on the empowerment explanation of fertility behavior assumes that a greater degree of autonomy in important decisions in the family may lead to a higher degree of influence in fertility decisions.

In recent years considerable attention has been focused on the need for raising the status of women. This has been highlighted by the Chinese slogan “break the thousand year old chains, which have bound them tradition and custom to an inferior role in society and reassure them that they too can hold up of the heaven.” According to the United Nations, the status of women in society can be ascertained by the extent of control over her own life derived from access to knowledge, economic resources and the degree of autonomy enjoyed in the process of decision making and choice at crucial points in her life cycle.

Bangladesh has achieved considerable decline in fertility, with the total fertility rate dropping 6.3 in 1971-75 to 2.7 in 2007. The sharp decline in fertility has attracted the attention of population expert’s around the world. Some authors argued that the decline in fertility level in Bangladesh has been achieved due to successful family planning program. During the 1970s and 1980s, researchers documented repeatedly by using the cross sectional data from representative surveys’, consistent empirical association between various commonly used proxies for women’s status such as education and working status their fertility, in wide range of developing countries from different regions. Comprehensive studies on fertility have revealed that improved educational and formal employment opportunities for women world would lead to greater number of women participation in modern-sector employment.

Recent studies have suggested that the status of women may be the single most important element in explaining the fertility transition (Mitra, 1978; Dyson and Moore, 1983). While there are some empirical support, particularly at the macro level, for a relationship between women’s status indicator and both the shift toward controlled fertility and transition from high to low fertility, the mechanism through the status of women effect changes in fertility are not clear(Mason,1948)

Three types fertility behavior directly determine fertility outcomes: marriage timing, breastfeeding duration, and the practice of contraception and abortion. These behaviors may be affected directly through population policies and programs, including family planning programs that change the socio-economic characteristics of households, and therefore the propensities and decisions of their members with regard to each type of behavior.

Khalifa (1986) studied the determinants of fertility in Sudan Fertility Survey data 1979. In his study he found that fertility of Sudanese population was close to natural. Prolonged lactational amenorrhea was found to be the main inhibitor of fertility.

The effect of the intermediate fertility variables on marital fertility in Kenya was examined by Kaula Sabti (1984) and in his findings he suggested that variations in the proportion married among population, level of contraception and post-partum lactational infecundebility could account for much but not all of the observed fertility differentials. From the National Survey in Nepal, 1987 it was found that the most important factor, resulting in reduction of about six children per women. The temporary separation of spouse’s use to emigration was conjecture to be the most important fertility inhibiting factor, not explicitly accounted for in the standard model.

1.3 Objective of the study:

This studies the relationship between the certain aspect of female status such as their education, working experience age at marriage women’s mobility and autonomy and consequently their affect on their fertility preference. This study deals with general context within which discrimination arises and its implications for women’s attitudes to high fertility norms. This study also assesses the contraceptive behavior among adolescent and adult married women.

The specific objective is to examine:

1. Trends in the recent fertility.

2. The socio-demographic characteristics of women in Bangladesh and its impact on their fertility preference.

3. Contraceptive behavior among the women and contraceptive prevalence among the adolescent and adult.

4. To identify significant factors influencing fertility using appropriate multivariate analysis.

1.4 Organization of the study

This study has been organized in six chapters.

The first chapter contains introduction, background of the study, literature review and objective of the study.

The second chapter describes the data sources and methodology.

The third chapter depicts the recent trends in fertility.

Chapter four discusses the determinant of fertility.

Chapter five is the discussion of status of women in Bangladesh.

Chapter six is designed with the discussion of contraceptive behavior among adolescent and adult married women.

Findings of the study, conclusion & recommendation are discussed in chapter seven.

Besides these list of references used in this study is given at the end of the study.

Chapter: Two

Data and Methodology

2.1 Introduction:

In the study attempt has been made to explore the motive of women’s participation in decision-making activities. To serve the purpose of the study quantitative analysis has been made. To complete the analysis, secondary data source, the 2007 Bangladesh Demographic and Health Survey (BDHS) has been used.

2.2 Sources of data:

The Bangladesh Demographic and Health Survey (BDHS) are intending to serve as a source of population and health data for policymakers and the research community. In general, the aims of the BDHS are to:

(a) Provide information to meet the monitoring and evaluation needs of health and family

Planning programs, and

(b) Provide program managers and policy makers involved in these programs with the

Information they need to plan and implement future interventions.

The 2007 BDHS survey was conducted under the authority of the National Institute for

Population Research and Training (NIPORT) of the Ministry of Health and Family Welfare. The survey was implemented by Mitra and Associates, a Bangladeshi research firm located in Dhaka. Macro International Inc., a private research firm located in Calverton, Maryland, USA, provided technical assistance to the survey as part of its international Demographic and Health Surveys program. The U.S. Agency for International Development (USAID)/Bangladesh provided financial assistance.

2.3 Sample design:

The 2007 BDHS employs a nationally representative sample that covers the entire population residing in private dwelling units in Bangladesh. The survey used the sampling frame provided by the list of census enumeration areas (EAs) with population and household information from the 2001 Population Census. Bangladesh is divided into six administrative divisions. In turn, each division is divided into zilas, and each zila into upazilas. Rural areas in an upazila are divided into union parishads (UPs), and UPs are further divided into mouzas. Urban areas in an upazila are divided into wards, and wards are subdivided into mahallas. These divisions allow the country as a whole to be easily divided into rural and urban areas. EAs from the census were used as the Primary Sampling Units (PSUs) for the survey, because they could be easily located with correct geographical boundaries and sketch maps were available for each one. An EA, which consists of about 100 households, on average, is equivalent to a mauza in rural areas and to a mohallah in urban areas.

The survey is based on a two-stage stratified sample of households. At the first stage of sampling, 361 PSUs were selected. The selection of PSUs was done independently for each stratum and with probability proportional to PSU size, in terms of number of households. The 361 PSUs selected in the first stage of sampling included 227 rural PSUs and 134 urban PSUs. A household listing operation was carried out in all selected PSUs from January to March 2007. The resulting lists of households were used as the sampling frame for the selection of households in the second stage of sampling. On average, 30 households were selected from each PSU, using an equal probability systematic sampling technique. In this way, 10,819 households were selected for the sample. However, some of the PSUs were large and contained more than 300 households. Large PSUs were segmented, and only one segment was selected for the survey, with probability proportional to segment size. Households in the selected segments were then listed prior to their selection. Thus, a 2007 BDHS sample cluster is either an EA or a segment of an EA.

The survey was designed to obtain 11,485 completed interviews with ever-married women age 10-49. According to the sample design, 4,360 interviews were allocated to urban areas and 7,125 to rural areas. All ever-married women age 10-49 in selected households were eligible respondents for the women’s questionnaire.

2.4 Questionnaire:

The 2007 BDHS used five questionnaires:

(a) A Household Questionnaire

(b) A Women’s Questionnaire

(c) A Men’s Questionnaire

(d) A Community Questionnaire and

(e) A Facility Questionnaire.

Their contents were based on the MEASURE DHS Model Questionnaires. These model questionnaires were adapted for use in Bangladesh during a series of meetings with a Technical Task Force (TTF) that included representatives from NIPORT, Mitra and Associates, ICDDRB: Knowledge for Global Lifesaving Solutions, the Bangladesh Rural Advancement Committee (BRAC), USAID/Dhaka, and Macro International (see Appendix E for a list of members). Draft questionnaires were then circulated to other interested groups and reviewed by the BDHS Technical Review Committee (see Appendix E). The questionnaires were developed in English and then translated and printed in Bangla.

The Household Questionnaire was used to list all the usual members of and visitors to selected households. Some basic information was collected on the characteristics of each person listed, including age, sex, education, and relationship to the head of the household. The main purpose of the Household Questionnaire was to identify women and men who were eligible for individual interviews. In addition, the questionnaire collected information about the dwelling unit, such as the source of water, type of toilet facilities, flooring and roofing materials, and ownership of various consumer goods. The Household Questionnaire was also used to record height and weight measurements of all women age 10-49 and all children below six years of age.

The Women’s Questionnaire was used to collect information from ever-married women age 10- 49. Women were asked questions on the following topics:

1. Background characteristics, including age, residential history, education, religion, and media exposure,

2. Reproductive history,

3. Knowledge and use of family planning methods,

4. Antenatal, delivery, postnatal, and newborn care,

5. Breastfeeding and infant feeding practices,

6. Vaccinations and childhood illnesses,

7. Marriage,

8. Fertility preferences,

9. Husband’s background and respondent’s work,

10. Awareness of AIDS and other sexually transmitted diseases,

11. Knowledge of tuberculosis, and

12. Domestic violence.

2.5 Data collection period:

Data collection process commenced on April 16 and ended on August 31, 2007.

2.6 Methodology

In this study initially univariate analysis is performed to examine the background characteristics of ever married women and discuss fertility-inhibiting effects of the proximate determinants of fertility. Then bivariate analysis is executed to find the association between socio-economical characteristics or status of women and fertility. A multivariate analysis is also executed by using logistic regression to show the affect of various factors on women’s status and its impact on fertility.

2.7 Multivariate analysis:

Bivariate analysis only provides unadjusted results. An empirical association between two variables doesn’t necessarily imply a causal relationship between them. The relative importance of all the variables has to be examined simultaneously by multivariate statistical techniques. Multivariate analysis is the simultaneous analysis of two or more variables. Multivariate analysis is also used to test the join effects of two or more variables upon a dependent variable. Different multivariate techniques can be used to predict a dependent variable from a set of independent variables. The logistic regression model is one of the multivariate techniques which are used to estimate the probability that an event occurs.

Logistic regression analysis:

There are many multivariate statistical techniques. Two important multivariate techniques are multiple regressions and discriminate analysis. Sometimes it is difficult to apply these techniques when the dependent variables are categorized (dichotomous and polygamous). In such situation it is better to fit linear logistic regression (Cox’s, 1970, Schlesslelman, 11082). Since, it does not require distribution assumption, unlike many other multivariate techniques (for example that the variable\s are normally distributed with equal variances), so it can appropriately handle situation in which the independent variables are qualitative or measured in normal or ordinal scales. It can be used to identify risk factors as well as predict the probability of ‘success’ (Pi), to ‘failure (1-Pi)’ and relating it to the independent variables, the logistic parameter can easily be interpreted in terms of odds and odds ratio, relative odds can be estimated for the categories of each independent categorical variables or combination of such variables.

Logistic regression model:

A brief description of the model is given below. Suppose that there are individual, some of them are called ‘success’ and other are ‘failure’.

Let, Yi denote the dependent variable for the ith observation and let,

Yi = 1, if the ith individual is a success and

Yi = 0, if ith individual is a failure.

Suppose for each of the n individuals, ‘p’ independent variables, Xi1, Xi2… Xip are measured.

In this model, the dependence of the probability of success on independent variables is assumed to be

Where, X10 = 1 and’s unknown coefficients.

Equations (1) and (2) look complicated, however, the logarithm of the ratio of Pi and (1-Pi) which we called logit of Pi turns out to be a simple linear function of Xij.

We define

The logit is the logarithm of the odds of success, that is, the logarithm of the ration of the probability of success to the probability of failure. It is also called the logistic transform of success of Pi and equation 3 is a linear logistic model. Thus the linear logistic model relates to the independent variables to the transform of Pi or the log odds.

In logistic regression, the parameters of the model are estimated using the maximum likelihood estimation procedure. That is the coefficients that make our observed results most ‘likely’ are selected. Since the logistic model is nonlinear, an iterative algorithm is necessary for parameters estimation. To understand the interpretation of the logistic coefficients, consider a re-arrangement of the equation for the logistic model. The logistic model can be re-written in terms of the odds of an event occurring. It has several nice properties. First, as Pi increases, so does logit (Pi). Second, logit (Pi) varies over the whole real line, where as Pi bounded only between o and 1. We see that logistic regression model can be expressed in two equivalent ways. First we can fit a linear model in the logit scale (in terms of the log odds).

From, equation (3) we see that the coefficient can be interpreted as the change in the log odds associated with a one unit change in the independent variable. Since it is easier to think of odds, rather log odds, the logistic equations can terms of odds as

The exponential rose to the power is the factor by which the odds change when jth independent variable increases by one unite. If is positive, the factor will be greater than 1, which means that the odds are decreased. If is 0, the factors equal 1, which leaves the odds unchanged.

Second, it is almost equivalent to modeling the logit of the probability of success a linear function of the independent variables, as given equation (1). The equation (1) express in the model as in the S-shaped curve in the original probability scale. Equation (1) and equation (3) are equivalent. Besides in many ways, equation (3) is the model for normally distributed data.

In the logistic regression, just as in linear regression, the codes for independent variables must be meaningful. We have coded all of our two-categorical independent variable as either 0 or 1. This is called dummy variable or indicator variable coding. For variables more than two categories, we have created new variables to represent the categories. The number of new variables required to represent a categorical variable is one less that of categories. The logistic regression procedure will automatically create new variables for categorical variables.

To fit a best regression model, we have considered a full model with all independent variables at a time. The on the basis of odds ratio and it will be decided which variables are significant or not.

2.7 Software used for analysis:

A well known statistical package SPSS16 & R was used to analyze the data and to prepare the thesis paper. SPSS16 for windows is a comprehensive and flexible statistical analysis and data management system. Besides SPSS, another well known application software such as MS word, MS excel are used to complete the thesis.

Chapter: Three

Fertility trends in Bangladesh

3.1 Introduction:

At the beginning of the 20th century, the total population of Bangladesh was less than 30 million. The annual growth rate of the population was less than 1 percent until 1951, when the population reached about 44 million (Bangladesh bureau of statistics, 1998). From the early 1950’s, mortality started to decline while fertility remained high until the 1970s. owing to the changes in fertility and mortality rates, from the 1950’s the population started to grow at an unprecedented rate, reaching an all time high (about 2.5% per year) in the 1960s and 1970s. The growth rate then started to decline in the 1980s and is currently about 1.2% per year. The Bangladesh population policy indicates that the population should stabilize at 210 million by 2060, if replacement level fertility is reached by 2010. This estimates of future population science is reasonably consistent with the World Bank projection from 1994 (BOS et al., 1994), and the UN projections 1996 revisions (UN 1996), both of which estimated on mid 21st century population of 210 millions. The main source behind the decline in the population growth rate of Bangladesh in the 1980s and 1990s was a remarkable decrease in fertility during the period. In the early 1970s, the TFR was about 7 children per woman, and an estimated 2.7 children per woman obtained by BDHS 2007. The TFR is so surprisingly low that quality of the data is being questioned. The aim of the chapter is to unmark genuine trends from the BDHS 2007 data. Its aim is to reach the firmest possible conclusions about the timing, magnitude, and nature of fertility decline in Bangladesh.

3.2 Lifetime fertility:

Trends in fertility in Bangladesh since early 1970s can be examined by observing a time series of estimates produced from demographic surveys filled over the last 2 and half decades, beginning with the 1975 BFS in 1978, the government of Bangladesh declared population pressure as the leading problem of the country. Since then, the government as well as non-governmental private and international organizations has undertaken several programs to solve population problems. Some success in different areas has been achieved.

Table: 3.2: cumulated number of children ever born to all women, by age group, various sources

Source 15-19 20-24 25-29 30-34 35-39 40-44 45-49 All ages
Census 1961 0.7 2.2 3.3 4.6 5.2 5.5 5.7 3.15
BRSFM 1974 0.6 2.3 4.2 5.7 6.7 7.1 6.7 3.79
CPS 1981 0.5 2.0 3.7 5.4 6.4 7.3 7.6 3.63
CPS 1983 0.6 2.2 3.8 5.5 6.5 7.4 7.5 3.74
CPS 1985-86 0.4 2.0 3.6 5.1 6.5 7.4 7.2 3.54
BFS 1989 0.4 1.7 3.1 4.7 5.9 6.6 7.3 3.14
CPS 1989 0.4 1.8 3.3 4.7 5.9 7.0 7.5 3.32
CPS 1991 0.4 1.7 3.2 4.5 5.7 6.7 7.4 3.5
BDHS 1993-94 0.3 1.6 2.9 4.1 5.2 6.4 6.9 3.0
BDHS 1996-97 0.4 1.5 2.8 3.9 4.8 5.6 6.4 2.8
BDHS 1999-00 0.4 1.4 2.6 3.6 4.3 5.1 6.1 2.6
BDHS 2004 0.4 1.4 2.6 3.4 4.1 4.7 5.6 2.5
BDHS 2007 0.3 1.3 2.3 3.2 3.8 4.3 4.9 2.3

For example, female field workers, known as Family Welfare Assistants (FWAs), have established a well-designed net work for providing door-to-door family planning services. As a result, a substantial increase contraceptive use and remarkable decline in fertility have been achieved in the past two decades. The Bangladeshi family planning program is therefore now considered a model for less developed countries. However, despite these achievements, the present TFR is far above the replacement level and the population problem remains leading problem in the country. A convenient starting point for the discussion of fertility is a cohort analysis of cumulative number of children ever born. Table 3.2 displays the relevant information from all major sources over the last 30 years. At first glance, there appears to be no obvious pattern to the results.

Means number of children fluctuate erratically between 3.1 and 3.8 births. The oscillation reflects differential completeness of reporting between surveys as, for instances, have occurred in surveys conducted 1981. The problem is not clearly seen with regard to the differences between the census 1961 and the BFS a year later. A detailed evolution in these years suggests strongly that appreciable omission of children occurred among older age groups (Blacker 1977). The adjusted means are close to those reported in the 1975 BFS.

When attention is confined to the more reliable sources, a pattern emerges. Starting in 1983, the CPS has been conducted by Mitra and associates under contract to USAID, employing high standards of fieldwork supervision. A comparison of three most recent Contraceptive Prevalence Surveys reveals a decline in fertility among all age groups except the oldest. Similarly, comparison of the two Bangladesh fertility surveys both of which laid particular stress on accuracy of measurements shows an appreciable decline. The overall standardized mean changes from 3.79 births in 1975 to 3.14 in 1989, a fall of 17 percent. While deterioration in completeness of birth reporting or discrepancies in sample design could account for both the CPS and BFS comparisons, a genuine decline in fertility is a more likely explanation.

A comparison of the mean of number of children ever born reported in the 2004 BDHS and various other surveys does not highlights recent changes in fertility, but rather is an indication of the cumulative changes in fertility over the decades preceding the 2004 BDHS. Despite the fluctuations between surveys, the data generally show only modest declines until the late 1980s. Between 1985 and 1989, the decline in the mean number of children gain declined considerably between 1991 and 1993-1994 and 1999-2000 at all ages except 15-19. The most recent data showed a decline in the mean number of children between 1999-2000 and 2007 among women age 30and above.

3.3 Fertility levels and trends:

Bangladesh has been cited a remarkable decline in fertility that has begun in 1980s this is the main force behind the decline in the population growth rate of Bangladesh during this period. In the early 1970s the TFR was about seven children and women in the first demographic and Health Survey 94. TFR remained almost unchanged at 3.3 children per woman in the next two DHSs conducted in 1996-97 and 1999-2000. (Mitra and others, 1997, BDHS 2000). According to the BDHS 2007, the estimated TFR is 2.7. This shows a very small change in TFR in recent years. The following table also represents the trends in current fertility.

Table: 3.3.1: Trend in current fertility according to national survey:

Year 1975 (BFS) 1989 (BFS) 1991 (BDHS) 1993-94 (BDHS) 1996-97 (BDHS) 1999-00 (BDHS) 2004 (BDHS) 2007

(BDHS)

TFR 6.3 5.1 4.3 3.4 3.3 3.3 3.0 2.7

This unexpected halt in TFR naturally raises questions about the factors of fertility dynamics and the future prospect of fertility decline in Bangladesh and has created concern among planner and policy marks.

Other predictors of fertility are the age at first birth. The onset of childbearing has a direct effect on fertility. Early initiation into childbearing lengthens the reproductive period and subsequently increases fertility. In many countries, postponement of first births reflects an increase in the age at first marriage has an important role to decline fertility. Early childbearing involves substantial risks to the health of both the mother and child and restrict educational and economic opportunities for women. The following table gives the relevant evidence from the 1989 BFS and 2007 BDHS in terms of median age at 1st birth:

Table: 3.3.2: Age t 1st birth according to the 1989 BFS and 2007 BDHS:

Current Age
Age at 1st birth Survey 20-24 25-29 30-34 35-39 40-44 45-49
BFS 1989 18.0 17.6 17.3 17.2 17.0 16.9
BDHS 2007 19.0 18.1 17.8 18.2 17.8 17.6

The median age at first birth, is about 18.2 years across all age cohorts, except for women age 45-49 years, whose median age at 1st birth 18 years, indicating a slight change in the age at first birth. This light increases in age at 1st birth is reflected in the smaller proportion of younger women whose 1st birth occurred before age 15, 18% of women in their late forties report having had their 1st birth before age 15,compared with only 6 percent of women age 15-19. Comparison of data from the 1999-2000 BDHS and the 2007 BDHS shows little change in the median age at first birth for women age 20-49. At this point, it is useful to introduce a different type of evidence to buttress the emerging conclusion that Bangladesh indeed has experienced a recent, large fertility decline. In successive surveys, currently married woman have been asked whether or not they are pregnant. As an indicator of fertility, current pregnancy data have one great virtue compared to birth data: they do not suffer from misdating problems. However, it is well known that understatement occurs, partly out of shyness but mainly because women are often uncertain about their status in the first trimester of pregnancy (Goldman and West off 1980). Nevertheless, it is likely that the degree of understatement is constant over time and to the extent that this proposition is valid, trends in the proportions pregnant can be interpreted in a straightforward manner. These proportions are given in the table 3.3.3

The prevalence of reported pregnancy is slightly lower in 1975 than in the subsequent 3 surveys; probably because of an effect on fertility of the severe 1974 famine (The Matlab data series shows a marked fertility response to the famine). Percentage of currently married women who reported that they were pregnant, 1975 and 2007 BDHS.

Table 3.3.3: Percent of pregnant in 1989 and 2004

Survey Percent pregnant
BFS 1975 12.5
CPS 1979 13.2
CPS 1981 14.1
CPS 1983 13.2
CPS 1985-86 10.5
BFS 1989 9.3
CPS 1991 10.7
BDHS 1993-94 8.7
BDHS 1996-97 7.7
BDHS 1999-00 7.8
BDHS 2004 6.6
BDHS 2007 6.1

After that declining trend has started and stalled around 6.1 percent. The above table gives a detailed comparison of the 1975 and 2007survey results. At younger ages, the fall in proportions pregnant is modest, but the difference widens among older women, comparison of the total pregnancy rate reveals on overall fall of 47 percent. The conclusion can be drawn that a large decline in marital fertility has occurred, in response to increased birth control in the later stages of marriage.

The above discussion revealed the factors behind the fertility decline in Bangladesh. There is another important factor which has important role in this decline the contraception prevalence which is discussed in later.

Chapter: Four

Direct determinants of fertility

4.1 Introduction:

In the previous chapter, fertility trends and patterns were reviewed. In this section, attention turns to the direct or physiological determinants of fertility. The factors that determine fertility can be placed into major categories – biological and social. The biological component refers to the capacity to reproduce, usually called fecundity.

Cultural and economic factors do not affect fertility directly; they influence another set of variables that determine the rate and the level of childbearing. One of the major demographic advances of the last 15 years has been the development of a crude but simple method to express the fertility reducing impact of the major direct determinants of fertility. (See, e.g. Bongaarts 1982). These are:

· Exposure to sexual intercourse

· Marriage

· Postpartum infecundity

· Brest feeding]

· Contraception

· Induced abortion

To be sure, there are many other physiological determinants, but they are thought to be relative invariant over space-time. Largely, therefore, differences in the fertility of the large population changes over time can be explained by references to the four main determinants listed here. Each of them will be considered to now.

4.2 Marriages:

The legal union of two persons of opposite sex dually solemnized by certain religious norms for the purpose of leading conjugal life, production of offspring and establishment of family is defined as marriage. Marriage is essentially a reproductive union and in most societies, reproduction is normatively restricted to married couples only. From the demographic point of view marriage is the event that marks the beginning of the potential period of childbearing. The age at which women enter into stable sexual unions (through marriage) determines the lengths of reproductive life span and hence number of children women potentially can bear.

In most populations, actual fertility of women is substantially lower than the potential fertility. Marriage contributes significantly to this reduction in potential fertility. A study using data from World Fertility Survey (WFS) showed that martial exposure is one means through which substantial reductions in potential fertility are achieved in all groups of countries covered in most cases, 35-40 percent of the total reduction is due to this source (UN 1987). Nuptiality has received relatively less attention in terms of its effect on fertility than contraception. This arises partially from the fact that on most Thirds World countries family planning programs were directed towards married couples with the aim of reducing marital fertility (Freeman, 1979). In Bangladesh, as in most Asian countries, childbearing outside of marriage is very rear, thus the age at which men and women marry, the proportions who remain single and the frequently of divorce widowhood are all potentially powerful influences on fertility level.

East Bengal has a long tradition of very early and universal marriage for female, together with a large age difference between husband and wife. The precocity of marriage has been a subject of concern for successive governments, which have legislated against young marriages with little success. For instances, the Child Marriage Act of 1929 banned unions below age 14. Thirty years later, the mean age of marriage was still below this legal minimum. As we shall see, changing ideas and economic forces have largely succeeded where legislation failed. The main sources of information on age at marriage are censuses. Censes data on marital status by age group can be converted into indicators of mean marriage age using the method proposed by Hajnal (1953). The results, given in the table 4.2 reveals a longstanding upward drift in age at marriage for both men and women, with a slight attenuation of the large age differences between bride and groom. The mean age at marriage for women has increased from bout 14 year in the 1950s and 1960s to about 18 years in 1989 and 20 years in 2006

This table shows a very large decrease in the proportions reporting consummation of first marriage before the age of 15: from 68 percent among women age 45to 49 in 1989 to 37 percent among those ages 20-24. There is a parallel decrease in the proportion of marriage that starts before menarche, a particularly welcome change.

Table 4.2 Simulate mean age at marriage, census and survey data:

Source Males Females Age difference
1951 census 22.4 14.4 8.0
1961 census 22.9 13.9 9.0
1974 census 23.9 15.9 8.0
1981 census 23.9 16.6 7.3
1989 BFS 25.5 18.0 7.5
BDHS 2004 27.5 20.0 7.5
BDHS 2007 23.63 15.47 8.16

Rising age, a t marriage has been almost universal features of demographic change in Asia over the last 20 years, and Bangladesh clearly no exception. Increased female education and employment opportunities, together with changing ideas about choice of a spouse, are usually proposed as the underlying causes. In Bangladesh, such socioeconomic influences may be less important than inherently demographic forces. As a reflection of rapid population growth, younger cohorts are considerably larger than older cohorts are. Because of the tradition in Bangladesh that women marry men much older than they marry themselves, there is a numerical shortage of eligible bridegrooms. For instance, 4 million females age 15-19 were enumerated in the 1981 census compares to only 3.24 million men age 20-24 a ratio of 123 females to 100 males.

This imbalance represents an unfavorable marriage market for women. Parents face problems in finding suitable husbands for their daughters. Marriages are thus delayed. Another consequence is a shift in marriage transactions whereby the bridegroom’s family demands a large dowry. Both anecdotal and empirical evidence indicates that this is happening (Lindenbaum 1981)

4.3 Contraception:

The modern methods of contraception are in fact technologies, which apparently gave women the ‘right’ to control her reproductive behavior. Women in the early twentieth century launched births control. This demand was certainly radical from the feminist point of view and perhaps genuine in those times. Nevertheless, it is also true that women have demanded reproductive rights before they could gain recognition in the society as human being or as a person. They did not fight enough to establish themselves in the society and against the patriarchal oppression. The society responded to their demands by offering various methods of birth control to be used by women were happy to get it and thought that they have gained “reproductive rights”. In the context of western society, perhaps this, a reproductive right bears some meaning, but it has no meaning at all to the majority of women in Bangladesh. The processes of poverty and underdeveloped have reduced their life to margin thinly above death by chronic starvation. For the minority of middle and upper class women, the acceptance of modern methods of contraception was somewhat an imitation of the west without having the reproductive rights.

4.4 Breast-feeding:

Breast-feeding is the focus of rapidly growing interest in the developing countries because of its important implications not only for health of children, who are breastfeed, but also on fertility levels. Recent research has documented the benefits of breastfeeding as an inexpensive and appropriate source of nutrients and to stimulate strong emotional relationship between mother and child, breast milk provides immunological protection against common childhood illness and it has a significant impact on reducing infant and child mortality (Hacht, Da Vanzo and Butz, 1989, Cunningham. 1988).

Aside from these major roles, breastfeeding is equally important in controlling fertility in developing countries. It is well known by both researchers and mothers that the process of breast-feeding can affect the probability to conceive Demographic analysis have demonstrated that in populations without access to modern form of contraception, birth intervals are determined principally by the duration of breast-feeding. (Bongaarts and Potter, 1983). In Asia and Africa, breast-feeding has been shown to inhibit an average of four potential births (representing 25percent of the total fecundity) per women (Thapa, Short and Potts; 1988).

Following a pregnancy a women remains infecundable (i.e., unable to conceive until the normal pattern of ovulation and menstruation is restored. The duration of the period of infecundability is a function of the duration and intensity of lactation. A number of recent investigators have clarified the physiological mechanism through whish breast-feeding influence ovulation. The period in which normal pattern of ovulation and menstruation is absent due to child’s birth is known to as postpartum amenorrhea. Without breastfeeding, the average amenorrhea period duration of amenorrhea increases to some extent, but not at a constant rate. Additional month of breastfeeding may therefore extend the period of no exposure to the risk of conception and thereby declines fertility.

Breast-feeding is almost universal in Bangladesh. Evidence suggests that the pattern has changed very little in the recent years (Islam et al., 1997). In Bangladesh, the average duration of breast-feeding is over two years, one of the longest in the world (Kabir and Rab, 1990). This long duration of breast-feeding has substantial impact on fertility through postpartum amenorrhea.

4.5 Induced abortion:

Any practice that deliberately interrupts the normal course of gestation is considered as indeed abortion. Induced abortion is one of the oldest methods of fertility regulations and one of the most widely used methods of fertility control in many countries. It is well established fact that induced abortion is play an important role in fertility decline in many countries. Induced abortion is practices in remote rural societies and in large modern urban centers. Although detailed statistical information on induced abortion is scarce and trends to be incomplete, it is evident that induced abortions are performed in both developed and developing countries.

Abortion is illegal in most of the countries, except some cases where it is permitted to save women’s life. In countries, where abortion illegal and widely available, abortion poses a minimum threats to women’s health. Where abortion is legal, however and widely available, abortion poses a minimum threat to women’s health. Where abortion as legal, however abortions are usually performed in substandard and unsanitary conditions, leading to a high incidence of complications and resulting chronic morbidity and often death.

Very little information is available on the prevalence of abortion in Bangladesh. Except in very few circumstances’, such an s pregnancy from rape or threat to the mother’s life, abortion is illegal in Bangladesh. Due to these legal complications, hospitals do not keep correct or complete records on abortion related services of treatment.

Anecdotal evidence suggests that abortion is common in rural areas of Bangladesh. However, lack of data makes it impossible to estimate the true rate. In rural areas, indigenous practitioners who refuse to identify themselves to investigators due to legal and social constraints, thus making the data gathering process even more difficult, perform abortion. In cases where these practitioners have been interviewed, the information provided is incomplete because none keeps ant records of the number of abortions each has performed.

Hospital records also suggest that abortions are common in rural Bangladesh. (Obaidullah 1981) estimated that approximately 17 percent of total pregnancies were terminated by induced abortion during the year 1978-80. According to the authors, they provide the estimated abortion is low since the information they were able collect was incomplete awing to abortions illegally, ethical unacceptability and cultural reasons.

In a recent study, Ahmed et.al. (1996) observed that during the period 1982-1991, there were 1183 induced abortion among 22500 women of reproductive age over a nine years period in Matlab comparison area. Using this information about induced abortion, Islam teal (1996) estimated the total induces abortion rate as 0.18, which they argued that due to likely under reporting, this estimate should be taken as a lower bound of the total abortion rate in Bangladesh.

In Bangladesh, the ministry of health and family planning promotes Menstrual Regulation (MR) services as a method of menstrual regulation. In recent years, several government and nongovernment clinics have been providing MR services. Some private clinic perform abortion in cover MR and despite the restrictive laws every years a considerable number of women in Bangladesh. Tale reason to pregnancy termination (Khan Et. al.1986). Records of clinics suggest a rising trend of MR in Bangladesh.

Therefore, induced abortion is not negligible in Bangladesh. The incidence of induced abortion play substantial role in fertility decline and for this reason it attracts the attentions of researchers.

Chapter: Five

Status of women in Bangladesh

5.1 Introduction:

Women’s status is often described in terms of their legal rights, education, economic independency, and empowerment, age at marriage, health, and fertility, as well as the roles she plays in her family and society. The status of women implies a comparison with the status of men, and is therefore a significant reflection of the level of social justice in the society.

Over the last decade, much concern has been shows about the need to empower women so that they can make their own decisions about childbearing and about other areas of their lives. Lack of power over their own decision-making has long been recognized as a barrier to improve women’s sexual and reproductive health. Many NGOs have been demonstrating the link between women’s development and successful family planning program and were responsible for introducing innovative women’s programs in the 1980s. The 1980s saw a number of schemes that trued to combine income generation or literacy or some other aspects of improving women’s status with family planning in order to give women more control over their lives. The role of women in development and as agents of changes as mothers, producers, and as environment managers- also came to be much more widely recognized during this period.

Women’s status as reflected in their legal rights, age at marriage, education, employment is low in Bangladesh. The women here do not have equal access to resources within the household and that their direct role in the process of reproduction gives them some influences over its outcome.

In the following section an overview of the status of women in Bangladesh about their education, employment, mobility etc. are discussed and the relationships between different factors that affect their status are assessed by logistic regression.

5.2 Status of Women in Bangladesh:

In the male dominant society women’s are in a disadvantageous position. Women, in custom and practice, remained subordinate to male in almost all aspect of their lives; greater autonomy was the privilege of the rich or the necessity of the very poor. Most women’s lives remained centered on their traditional roles and they had limited access to markets, productive services, education, health care, and local government. At the household level, the girl child often has unequal access to nutrition, health care and education compare to boy child. Many discriminatory practices arise out of some deep-rooted socio-cultural factors. Women still earn less than men earn and are mostly occupied in low paid jobs. They often do not have easy access to credit and other income generation opportunities, and are still under represented at management and policy levels.

The lack of opportunities contributed to high fertility patterns, which diminished family well-being contributed to the malnourishment and generally poor health of children and frustrated educational and other national development goals. In fact, acute poverty at the margin appeared to be hitting hardest at women. As long as women’s access to health care, education and training remained, limited and prospect for improved productivity among the female population remained poor in our country.

In the 1980’s women’s status in Bangladesh remained inferior to that of men. About 80 percent of women lived in rural areas in the late 1980’s. The majority of rural women, most probably seventy percent, were in small cultivator; tenant and landless households, many of them worked as laborers part time or seasonally, usually during the post harvest and received payment in kind or in meager cash wages. Another twenty percent, mostly in poor landless households, dependent on the casual labor, gleaning, begging and other irregular sources of income, typically their income was essential to household survival. The remaining ten percent of women were in household mainly in the professional, trading, or large-scale landowning categories, and they usually did not work outside the home.

The economic contribution of women was substantial, but largely unacknowledged. Their contribution in agricultural sector and manufacturing jobs, especially in the ready-made garment industry is remarkable. Despite the fact that women constitute half of our citizenry, they continue to face persistent disadvantages and exclusion, evident in gender differentials for various indicators of health. One of the most telling indicators of the disparity between male and female can be found in child mortality. Though following global norms in Bangladesh infant mortality is higher for males than females, soon after birth the mortality rates start to reverse. For example, post neonatal mortality among males is twenty-seven per thousand births versus thirty-one among females and child mortality among male is twenty-eight per thousand births versus thirty-eight among females. These disparities clearly indicate the neglect of girl children in terms of nutrition and access to health care.

The factors that determine the status as well as the fertility of women in Bangladesh are education, and empowerment, occupation of husband, residence and possession of items and religious beliefs and norms.

5.3 Educatio