Socio-demographic and cultural determinants of high fertility among women residing in an urban metropolitan slum: a comparative cross-sectional study

Rutuja R. Chavan; Abhiram M. Kasbe

doi:10.18203/2394-6040.ijcmph20264110

Authors

Rutuja R. Chavan Department of Community Medicine, N. C. Medical College and Hospital, Israna, Panipat, Haryana, India
Abhiram M. Kasbe Department of Community Medicine, T. N. M. C. and B. Y. L. Nair Hospital, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20264110

Keywords:

Family planning, High fertility, Maternal education, Socioeconomic determinants, Son preference, Urban slum

Abstract

Background: High fertility (three or more children) remains a public health concern in socioeconomically vulnerable urban populations. This study compared socio-demographic, reproductive, and cultural factors associated with low and high fertility among women residing in an urban metropolitan slum.

Methods: A community-based comparative cross-sectional study was conducted from January 2021 to April 2022 among 322 women in an urban slum of a metropolitan city in India. Women were equally categorized into low-fertility (1-2 children) and high-fertility (≥3 children) groups. Participants were selected by systematic random sampling. Data were collected using a pre-tested structured interview schedule and analysed using Chi-square tests and multivariable logistic regression.

Results: Women with high fertility were more likely to have lower maternal and paternal education, lower socioeconomic status, earlier marriage and first pregnancy, more conceptions, lower mass-media exposure, and greater desire for additional children. Contraceptive use was lower among women with high fertility than those with low fertility (87.5% versus 96.3%). In adjusted analysis, higher paternal education was associated with lower odds of high fertility (AOR 0.52), while an unplanned last pregnancy was associated with higher odds (AOR 3.56). Having a male first child and the husband’s desire for another child were also independently associated with fertility status (AOR 0.27 and 0.22, respectively).

Conclusions: High fertility in this urban slum was associated with gender preference, spousal fertility intentions, pregnancy planning, and lower paternal education. Couple-centred family-planning counselling, male involvement, delayed marriage, improved education, and access to effective modern contraception should be prioritised.

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