T.A. Obembe1, K.O Odebunmi2 and A.D Olalemi3
- Department of Health Policy and Management, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan
- Department of Hospice and Palliative Care, University College Hospital, Ibadan.
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan.
Abstract
Background: Fertility, particularly as it pertains to the role of men as decision makers is important with respect to demographic transition theory. Studies have explored fertility preferences of men but very little has been done with regard to fertility preferences amongst men from the slums. The aim of this study was to investigate drivers of family sizes among the urban slum households in Ibadan of South-West Nigeria.
Methods: A cross-sectional survey design was conducted among 362 men in selected urban slum communities in Ibadan, Oyo State using multi-stage sampling. Data was collected using pre-tested, semi-structured, interviewer-administered questionnaires. Data were analysed using descriptive statistics, Chi square test and binary logistic regression with level of significance set at 5%.
Results: Age of respondents was 41.1 ± 7.56 years. Over a third have completed tertiary education (35.9%) and were civil servants (47.0%). Ethnicity, educational status, sex distribution of children and number of children were significantly associated with desire for more children (p<0.05). Marginally over half (54.4%) of respondents with 2 or less children wanted to continue child bearing compared to other respondents (p<0.001). Men with female only children were almost 3 times more likely to desire more children than men with male only children (p<0.001; OR= 2.798; 95% CI = 1.53 – 5.13). Igbos also were 52.8% less likely to desire more children compared to Yorubas (p=0.047; OR = 0.472; 95% CI = 0.225 – 0.991).
Conclusion: Programmes targeted at slum dwellers to improve their education on childbearing and family planning are required to assist the country progress through the stages of demographic transition.
Keywords: Slum dwellers, Health disparities, Urban slum, Urban poor, Demographic transition
Correspondence:
Dr. T.A. Obembe
Dept. of Health Policy and Mgt,
Faculty of Public Health,
College of Medicine,
University of Ibadan,
Ibadan
Introduction
The demographic transition theory states that for societies to experience modernization, there must be progress from a pre-modern regime of high fertility and high mortality to a post-modern one in which fertility and mortality are both low.1 It postulates a progression through 4 stages with the last stage comprised of low birth rates and low death rates. The three main components driving this transition “fertility, mortality and migration”, have consequences on one another and on the overall size and/or structure of the population.2 Bloom et al opined that the age structure, a key indicator of the stage of demographic transition possesses a critical influence on the economic performance of any nation.3 In his stance, nations with a high proportion of children are likely to devote a high proportion of resources to their care that invariably influences the pace of economic growth and ultimately the health status of a society. Thus, policy makers try to ensure that countries attain quickly the optimum stage of low natality and low mortality, a stage believed to bring about modest amount of health and economic benefits to any society.
However, the situation in most developing countries especially in Africa is that most are fixed in the second stage of the transition (high birthrates and a drop in mortality) instead of progressing to the next stage of demographic transition.4,5 The stagnancy of most African countries in the second stage of transition (i.e. high natality and a drop in mortality) has been perpetuated by the patriarchal dominance6,7 rooted in most African cultures and their desire for male children.8
Evidence towards this is observed in the fact that although decline in fertility rates have been noticed in some metropolitan areas and selected communities in the sub-continent, a drop in fertility is not yet witnessed in the many parts of sub-Saharan Africa.9 While initial efforts revolved mainly around the woman and understanding her role in reproduction, researchers’ interests in male issues has been recently aroused on how it influences the dynamics of fertility. For instance, it has been observed that couples may not have the same opinions about fertility and due to the cultural and socio-demographic characteristics peculiar to Africa, the decision of whether to bear more children or not in most instances lies with the man and not the woman.10
Research on the role of men in deciding the fertility rates of their partners, has shown that the desire for the male child proves to be one of the main factors behind the desire for continued childbirth among Nigerian women.11,12 Even though, the importance of demographic transitions in societies, especially on the socio-economic status of the population has been documented in varying conditions, studies have not explored the influence of birth and fertility preferences among men from slums within the Nigerian context. This becomes vital, as research has shown that fertility rates differ in different segments of the society. For instance, studies in some African countries have demonstrated that a lack of education as well as poorer socioeconomic status are linked with increased fertility rates.13,14 Furthermore, Stewart et al. observed that the populations in low and middle income countries (LMICs) are becoming rapidly urbanized, with the urbanization accompanied by increasing poverty levels among such migrants. The importance of examining this effect within the context of urban slums is of vital importance as the population of slums from increasing urbanization is on the increase daily.15,16 “United Nations (UN) projections estimate that by 2030, Nigeria’s urban population will reach 162 million whereas the rural population will be only about half the number of urban residents”.17 Urban slums, that arise in the process, account for 43.0% of the population in the developing world as compared to 32.0% of total world’s population.18 These slums in spite of their significant proportion are disadvantaged in terms of access to proper health care, good water supply, and proper sanitation.19 This study thus sought to investigate drivers of family sizes among the urban poor households in slums of Ibadan capital in South- West Nigeria.