Fertility preference among refugees and native women of reproductive age in Kigoma region Tanzania.A comparative study

Abstract

ABSTRACT Background: The displacement of people can impact fertility preferences, leading to either an increase or decrease in the desire for children. This can be influenced by factors such as the desire to replace lost family members or limited resources. The higher desired family size in the Kigoma region compared to the national level or surrounding regions underscores the need to study fertility differences between immigrant and native populations. Objective: This study aimed to determine and compare the fertility preferences among refugee and native women of reproductive age in the Kigoma Region, Tanzania. Methodology: The study was cross-sectional analytical and applied a quantitative approach. Stratified sampling was used to select participants. Data were collected through a structured interview form. The outcome variable was the desired number of children used as a proxy for fertility preference. Data analysis was performed using SPSS version 25. Categorical variables were summarized using percentage and continuous data as mean and standard deviation. Linear regression analysis was used to examine the association between the desired number of children and selected independent variables. The F-test was performed to assess the strength of the association. The significance level was set at p<0.05. Ethical clearance and informed consent were obtained before data collection. Result: The study included 401 natives and 403 refugees. The mean age of participants was 28.2 (SD = 7.4) years and 26.8(SD=7) for natives and refugees respectively, ranging from 16 to 46 years. While 172 (42.6%) of the refugees had no formal education, 262 (65.3%) of the native women had at least primary education. Family planning use was significantly higher among natives 326 (81.3%) as compared to refugees 235 (58.3%) (χ2=50.349; p<0.001). The median desired family size was significantly higher among refugees than among natives; eight than five respectively, (p<0.01). For native women, the number of living children was significantly associated with desired family size (p<0.001). For refugee women, none of the individual-level factors were significantly associated with the desired family size. Health-related factors like the use of family planning and fear of side effects were significant for natives but not for refugees. Facility-related factors such as distance to the nearest health facility showed a weak but significant negative association with fertility desire among both groups. Conclusion: Refugee women of reproductive age have elevated family size desires than their counterparts. Family planning users among refugees are significantly lower. Factors associated with desired family size among natives include the number of living children distance to health facilities and fear of side effects when using family planning among refugees. The study emphasizes the necessity for further research in the Kigoma region to gain a deeper understanding, especially of the cultural and socioeconomic factors associated with reproductive health choices.