The complex factors involved in family fertility decisions

Culture, religious beliefs, gender relations and low child survival rates – all play a critical role in very personal decisions about reproduction and hence overall fertility levels and trends. It is not always about ‘supply side’ factors or economic barriers- that is availability of family planning services – the number of children women have is a very personal decision.

Various factors determine the number of children families have including: i) Desire for large families – own desires, family desires, social norms (including old age security); ii) Prevalent child mortality – replacement and hoarding/insurance; iii) Knowledge – knowledge on the reasons to use family planning, available options, side effects and mitigation measures, available services and locations, and costs; and (iv) Access to quality family planning services.