Urban Rural differentials in the use of Fertility and Contraceptive use in Bangladesh

Research Paper (postgraduate), 2017

16 Pages, Grade: 1.00





3.1 Urban rural differentials in fertility through Parity Progression ratio
3.2 Urban Rural differentials in the use of contraception

4. Conclusions



Bangladesh is the seventh most populous country in the world. The population this country has reached 142.319 million with a density of 964 per square kilometre. The annual population growth rate is 1.34 (BBS 2011). The official target of the replacement level of fertility is not yet obtained. Every decade of delay in achieving replacement level of fertility, an additional 20-50 million people will be added to the country’s eventual population (World Bank and BCAS, 2003). At the current rate of population growth, the population projected to reach the whopping number of 208 million by 2025. In 2050, the population will be over 231 million. The overwhelming population is placing a tremendous economic, social and environmental strain on the country’s development. In spite of development successes in the last three decades, with fertility declining from 6.3 to 2.7 children/women (BBS, 2009) Bangladesh is still facing chronic poverty, wide spread illiteracy, negligible potential of meeting basic need, high maternal and infant mortality and morbidity, high incidence of communicable diseases, severe malnutrition.

In order to ease mounting pressure of large population development policies of Bangladesh had to take strategies to reduce the population growth rate. The strategies have lead Bangladesh in achieving impressive gains in some indicators related to population and family planning. The total fertility rate was 6.3 with an annual growth rate 2.3 in 1970-1975. With a 60% decline in fertility Bangladesh become able to reduce the population annual growth rate to 1.34 (BBS 2011). However, there is a discrepancy between rural and urban areas, with women in rural areas bearing one more child on average (3.5) than their counterpart in urban areas (2.5).

Family planning programme in Bangladesh was the main responsible factor for declining fertility even in the absence of rapid economic development and social change (Bairagi and Datta, 2001, Cleland et al., 1994). Several studies have also shown that the only factor contributing much to the recent fertility decline was the proper use of contraceptive methods (Amin et al., 1994). Modern contraceptive methods are generally more effective in preventing pregnancy compared to traditional methods, although effectiveness varies with the quality of practice (Trussel and Kost, 1987). While more effective modern methods users in some countries have shifted toward greater use of other methods viz., rhythm, withdrawal, abstinence and foam (Palmore and Bulatao, 1989). There exist a direct relationship between fertility behaviour and place of residence (Androka, 1978: Li and Wang 1994; Findley 2005). Contraceptive is also significantly varied according to the place of residence (Ria et al., 2009). Several factors contributing in this rural urban gap in contraceptive use (Uddin et al, 1985). Therefore this study has taken an attempt to explore the fertility differentials in Bangladesh according to place of residence and try to identify those factors responsible for urban-rural differentials in contraceptive use.


The data extracted from most recent nationwide survey of Bangladesh demographic and health survey, 2007 (BDHS-2007) and was based on responses from a sample of 10,996 ever-married women aged 10-49. Parity Progression Ratio (PPR) is used to explore the urban rural differential in fertility in Bangladesh and linear logistic regression is used to identifying the factors that that make urban rural differential in contraceptive use in Bangladesh.


3.1 Urban rural differentials in fertility through Parity Progression ratio

Parity Progression Ratio (PPR) is the chance that a woman after delivering ith child will ever precede to the next parity. If this progression is recorded to cohort like year of marriage, year of birth of mothers etc., then it is termed as cohort parity progression ratio (CPPR) and if it is recorded for a specific period, say, one calendar year then it is called period parity progression ratio (PPPR).

To see the level of fertility Cohort Parity Progression Ratio (CPPR) is used by taking cohort of women who got married during 1971-1973.Table 1 shows the level of fertility through Cohort Parity Progression Ratio. CPPRs are estimated for the transitions M→ 1 (marriage to first birth), 1→2 (first birth to second birth), 2→3, 3à4, 4à5, 5→6 and 6→7+ (six to seven or higher order birth). In rural area among those who marry, the likelihood of progressing to first birth is 97 percent. Among those who had a first birth, the likelihood of progressing to second birth is 95 percent. A considerable reduction (about 9 percent) is observed in proceeding to third parity, indicating that many women stopped childbearing by getting two children. The progression ratios beyond third birth dropped off further. In urban area a consistent decline of CPPRs are also observed. CPPRs in rural areas are higher than in urban areas at each parity transition. By place of residence, there is a little variation in progression ratios at parity transitions M→1, 1→2 and 2→3. Among women who marry, nearly all have a first, second and third child irrespective of their place of residence. For each parity transition beyond parity three, progression ratios for rural women are considerably higher than those for urban women (Table 1 and Figure 1).

Table 1: Cohort Parity Progression Ratio by place of residence from BDHS 2007

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Figure 1: Cohort Parity Progression Ratio

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Table 2 shows Period Parity Progression ratio (PPPR) by place of residence. Based on Period Parity Progression Ratio, TFR is computed for the year 2007 considering reproductive age (15-49) of women in the year. Result for the 2007 may be speculative. Reason being that a large number of women who got married at the end of 2007 may be included in the analysis that did not get sufficient time of exposure to give birth (Table 2 and Figure 2).

Table 2: Period Parity Progression Ratio by place of residence from BDHS 2007

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Figure 2: Period Parity Progression ratio

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3.1.2 Total fertility rate

According to the BDHS-2007, the total fertility rate for women aged 15-49 is 2.6. In rural area the TFR is 2.7 whereas in urban area the TFR is 2.3 (Table 3). Thus, consistent with the differentials in PPRs by place of residence, rural TFR remains higher, followed by that of urban area. The fertility level varies considerably by Region, from a high of 3.4 children per women in the Sylhet Region to 2.1 in the Khulna Region. The fertility is also particularly high in the Chittagong Region. Rural women have higher fertility than urban women in all regions.

Table 3: Total Fertility Rate (TFR) according to residence by region

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3.2 Urban Rural differentials in the use of contraception

This section deals with identification of the factors that are responsible for urban-rural differentials of current use of contraception considering 9490 currently married non pregnant women aged 15-49 having specified number of living children. The binary logistic regression analysis is used to identify the urban rural differential factor of contraceptive use in Bangladesh. We consider current use of contraceptive methods as a dependent variable and age of women, level of education, region, working status of women, media exposure, wealth index and religion as independent variables. If the respondent is a current user of contraceptive method it takes a value of unity and if the respondent is not a current user of contraceptive methods it takes a value of zero.

Age is an important demographic variable and comes out as a significant factor influencing the use of contraceptive on various studies (Kamal and Mohsena, 2007). In urban area, the likelihood of current use of contraceptive methods is 3.94 times higher among women aged ‘less than 30’ and 3.129 times higher among women aged 30-40 than those women aged above forty with two living children. This may be due to the fact that they completed their family size by the age 40 or above. On the other hand in rural area women aged less than 30 are 1.191 times and women aged 30-40 are 1.028 times more likely to use of contraceptive methods than their counterparts in the reference category (Table 4). We also find a statistically significant association between age and contraceptive use of women having three and four or more living children (Table 5 and Table 6). Women having four or more children in the age level below 30 are about 2.7 times more users of contraceptive methods both in rural and urban area (Table 6). This decrease in use may be due to declining fecundity associated with the older age of higher parity women.

Education is one of the key determinants of the life style for the status of women (Widayatun, 1991). It affects almost all aspects of human life. Educational attainment has strong effects on reproductive behaviour, contraceptive use, fertility, infant and child mortality, morbidity and issues related to family health and hygiene (Mitra et al., 1997). The Table 4 shows that the log-odds of using current contraceptive methods are higher among rural women who have higher education than those with no education across rural areas of Bangladesh. Choe and Tsuya, (1991) concluded that educated women desire fewer children than their less educated counterparts because of the incompatibility between formal-sector employment and childcare. In the other two models indicate that only the primary education level of rural women has a significant effect on contraceptive use. Except the primary education level in 1st model our study does not find any significant association between education and the contraceptive use in urban areas like Kamal and Sloget, 1996 study.

In all the three model (Table 4,Table 5 and Table 6) region is emerge as an factors that has an strong significant effect on current contraceptive use in rural areas in Bangladesh. In all these three models except in Chittagong all the married women in all other regions of rural area are significantly higher user of contraceptive method than those in the Sylhet region. In urban area only women with having three living children belonging to both Dhaka and Rajshahi region are 3.7 times more likely to use contraceptive method than those of the women in Sylhet region. Decision autonomy is a strong significant indicator with both lifetime and current contraceptive use (Saleem, 2005, Cleland et al, 1996). Regions in Bangladesh significantly differ according to mobility and decision making index. Sylhet region showed low figures in these two indexes, next being Barisal. Khulna region showed higher levels of mobility and decision making (Kamal, 2008). Khan and Raeside, 1998 suggested that women of Sylhet and Chittagong divisions are religiously more conservative and have traditional values regarding family planning method. Goni and Saito (2009) shows that literacy rate is lower in Rajshahi, Chittagong and Sylhet divisions than in Dhaka division. Low levels of education and low former- sector employment also identified as the lower performing factors of contraceptive use in Sylhet and Chittagong (Mannan and Beaujot, 2006). Mannan and Beaujot, 2006 also opine that socio-economic scenario of Sylhet division is different from the rest of the country some. They may not have similar views regarding fertility control compared to the other regions of the country. NIPORT (2001) found in their study that family planning programme implemented differently across different region of the country. And Sylhet and Chittagong division are lagging behind others division in terms of family planning service delivery.

Women’s working status is a more powerful predictor of her contraceptive use (Kamal, 2008, Kabir et al, 2000). The regression coefficients for current work status find as highly significant in both urban and rural area for the women having three living children. In urban area we find that women with three living children if they are currently involved with work are 2.063 times more likely to use of contraceptive methods than those of women who are not involved in work. In rural area the odds ratio for the rural working women having three living children is 1.6 (Table 5). Decision making authority and mobility may assist the working women in using contraceptive method. As currently working women have greater mobility and higher authority of decision taking in their conjugal life (Kamal, 2008).


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Urban Rural differentials in the use of Fertility and Contraceptive use in Bangladesh
Shahjalal University of Science and Technology
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Awards/Prizes Won: Book medal: For outstanding result of Honors in Statistics from Shahjalal University of Science and Technology.
urban, rural, fertility, contraceptive, bangladesh
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Musammad Rahima Begum (Author), 2017, Urban Rural differentials in the use of Fertility and Contraceptive use in Bangladesh, Munich, GRIN Verlag, https://www.grin.com/document/380368


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