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Fertility Paraguay
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  • SOURCE OF INFORMATION   I have to say that in felt lucky because surprisingly about this topic, fertility, there are good amount of data, quite high quality. It is unusual in my country, where you know there is a lack of reliable data.   My principal source was the National Survey of Demography and Reproductive and Sexual Health.   It has been conducted each 4 years from 1990 by a non-profited organization with assistance of the CDC.   The last one was published one month ago. Almost 8.000 women participated.  
  • TRENDS IN FERTILITY   Paraguay has had an important and constant decline in the Total Fertility Rate (TFR) in last 10 years.   The total fertility rate was around 4 children per woman between year 1990 and 1998, but in 2004 it was estimated in 2.9.   Last survey conducted in 2008 confirms this trend.   In 2008 the total fertility rate was estimated in 2,5. This represents a decrease of 50% in a period of 20 years.
  • Age specific fertility rate   During years 2001 – 2004 the estimated TFR was significantly lower than it was during 1992–95 or 1995–98.   The recent drop in fertility is evidenced also in age specific rates.   In particular, the most reproductively active women, those aged 20–29, show lower fertility estimates, contributing to the overall low in this most recent period.     As you can see the drop in rates has been continuous trough the time. Fertility in adolescent women decrease 19,2%   In age group of 20 to 24 the decrease was 19% and in the group of woman aged 25 to 29 the drop was 15.8%   The most important drop was registered in woman 35 to 39 years old. The decrease was of 51%
  • An average woman in the beginning of the ’90 has around 4 children. Today the expected number of children per woman is 2 of 3.
  • As you can see the decrease in fertility has been continuous through the time but it become most pronounced from 1998.
  • This surprising decrease does that the validity of data has been questioned by both international and domestic policymakers.   I found out a study that assess the quality of data collected and explore the possible determinants of Paraguay’s recent TFR decrease . It conclude that data were properly gathered.
  • The principal question was: ¿Why such a dramatically decrease in just one decade if…   There is no substantial changes in Paraguay during the past decade in other development indicators Same child mortality Same socioeconomic levels No political agenda for family planning programs
  •   EDUCATIONAL LEVEL   The percentage of women with 12 years or more education almost doubled in one decade. It increased from 21% to 39,1% between 1998 and 2008. The percentage with less than 3 years of education decreased from 8% to 4% .
  • OTHER DEMOGRAPHIC FACTORS   All surveys show important differences in fertility by residence, educational attainment, socioeconomic status and language usually spoken in the home   I do not if these are proximate determinate of fertility according to whom theory because the authors don’t justify the election of these variables, but I will show you the differences:
  • RESIDENCE   Women in Asuncion has 2 children compared with women in some rural areas; where the TFR is 3,1 children per woman.   The most important drop occurs in rural areas . Two decades ago the rate was 6 children per woman. Now it is 3.  
  • LANGUAGE SPOKEN The language spoken at home was strongly associated with both fertility and contraceptive use. Thirty percent of respondents normally speaks guaraní in the household 36% speak both guaraní and spanish 31% speak only spanish in the household 3% speak other languages   Women in Guarani-speaking homes reported a higher mean number of children, a higher mean ideal number of children, and a lower rate of contraceptive use than did women in Spanish-speaking homes.   If only guaraní is usually spoken in the home , the TFR is 3.3 versus 2.2 in homes where only spanish is spoken.   This suggests that cultural elements may foster a preference for a higher fertility level. This issue have not been well investigated in Paraguay  
  • AGE OF FIRST MARRIAGE   Also contributing to the decline in fertility is the later age of marriage.   The proportion of women who married before 20 years of age has declined from 44% of 40-44 year old women to 33% of 20-24 year olds.
  • CONTRANCEPTIVE USE   Contraceptive prevalence among married women is 72.8 percent.
  • This finding represents over a 90% increase in prevalence since 1987 when contraceptive prevalence was 37.6%.  
  • Contraceptive use is the most important factor in the fertility decline   Total Fertility Rates and Contraceptive Prevalence Rates are closely and inversely correlated   The size of the decrease in TFR over time is positively associated with the size of the increase in contraceptive prevalence.
  • PROJECTION INTO THE FUTURE   To predict the future trend in fertility and to evaluate if women are having successful in achieving their fertility desires here has been considered the proportions of births that were reported as wanted, mistimed, or unwanted. Despite the increase in contraceptive prevalence, the proportions of both mistimed and unwanted births increased for all the age groups of women.   This finding suggests that the demand for contraceptives may continue to increase and fertility rate may continue to decrease.
  • Actually a projection made in 2005 by the census department estimated that TFR in 2050 will be below 2 children per woman . This estimation may even be conservative if you considered that the TFR for 2008 was supposed to be 3 children per woman but in reality it was smaller, it was 2,5 children per woman.  

Transcript

  • 1. 2009 Trends in fertility in Paraguay Patricia Lima Pereira Europubhealth - Jagiellonian University Medical College Krakow, November 2009
  • 2. Content
    • Sources of Information
    •   Trends in Fertility - Age Specific Fertility Rate
    •   Assessing Validity of Data
    • Improvement in Education
    •   Demographic Factors: Residence, Education, Language Spoken, Age of Fist Marriage
    •   Contraceptive Use Prevalence
    •   Projection into the Future
    •   Remaining Questions
  • 3. 1
  • 4. Sources of information 1 Survey each 4 years From 1990 to 2008 With assistance of the CDC
  • 5. 2
  • 6. Trends in fertility 2 Evolution of Total Fertility Rate (TFR)
  • 7. Trends in fertility Age specific fertility rate, in three periods of time 2 19,2% 16% % 19% % 51% %
  • 8. 1990 2008 2004
  • 9. Trends in fertility Sources: 1960–72: Census 1972. 1977: Encuesta de Prevalencia de Anticonceptivos (1977). 1979: Encuesta Nacional de Fecundidad (1979). 1982: Census 1982. 1987: Encuesta Nacional de Planificación Familiar (1987). 1990: Encuesta Nacional de Demografía y Salud (1990). 1995: Encuesta Nacional de Demografía y Salud Reproductiva (1995–96). 1998: Encuesta Nacional de Salud Materno Infantil (1998). 2004: Encuesta Demográfica y de Salud Materna Infantil (2004). 2
  • 10. 3
  • 11.
    • “ Fertility Decline in Paraguay” Kanako Ishida, Paul Stupp, and Mercedes Melian (Studies in Family Planning 2009; 40[3]: 227–234)
    Assessing validity of data 3
  • 12.
    • Why such a dramatically decrease in just one decade?
    • if…
    • There is no substantial changes in Paraguay during the past decade in other development indicators
    • Same child mortality
    • Same socioeconomic levels
    • No political agenda for family planning programs
    Assessing validity of data 3
  • 13.
    • They conclude that this decline is inversely related to
    • a significant increase in the education level of Paraguayan women
    • and increase in the prevalence of modern methods of contraception .
    Assessing validity of data 3
  • 14. 4
  • 15. Educational level of women 4
  • 16. 5
  • 17. Other demographic factors 5 Total Fertility Rate, according to residence, education level and lenguage spoken in the household. 2008
  • 18. 5 Residence
  • 19. Education level 5
  • 20. Language spoken in the home 30% GUARANI 36% SPANISH AND GUARANI 5 31% SPANISH
  • 21. Age of first marriage 5 married before 20 years of age Aged 40 – 44 44% Aged 20 - 24 33%
  • 22. 6
  • 23. Contraceptive prevalence 6 72,8% among married women
  • 24. 6 Contraceptive prevalence rate Contraceptive Prevalence Rates among married women over time
  • 25. Total Fertility Rates and Contraceptive Prevalence Rates are closely and inversely correlated
  • 26. 7
  • 27. Will this trend of fertility decline continue? 7
  • 28. Reproductive Preference and Projection into the Future 7
  • 29. Proyección de la Población Nacional por Sexo y Edad, 2000-2050. DGEEC 2005 7
  • 30. Remaining questions
    • What factors determinate that contraceptive use became widely accepted by the various sectors of the Paraguayan population?
    • Why women in Guarani-speaking homes report such higher mean number of children?
    8
  • 31. Thanks you