High-risk fertility behavior, defined by early maternal age, closely spaced births, high birth order, or pregnancies after the age of 34, poses serious health risks to both mother and child. In Tanzania, this pattern remains a widespread concern, with over 70% of women of reproductive age exhibiting at least one high-risk fertility behavior. These behaviors significantly strain the healthcare system and have long-term implications for maternal and child health.
Analysis of data from the 2022 Tanzania Demographic and Health Survey reveals that education, socioeconomic status, media exposure, contraceptive use, autonomy in health-related decision-making, and place of residence all play critical roles in influencing women’s fertility behaviors. Among these, educational attainment is one of the strongest protective factors. Women with higher education levels are more likely to delay childbearing, access reproductive health services, and make informed choices about family planning. As education increases, the prevalence of high-risk fertility behavior decreases significantly.
Economic status also influences fertility behavior. Women from middle and high-income households tend to exhibit lower levels of high-risk fertility patterns compared to those from poorer households. Financial resources provide better access to healthcare services, contraception, and health education. These women are more likely to receive antenatal care, plan pregnancies, and manage the spacing of their children, contributing to healthier outcomes for themselves and their families.
Contraceptive use is another important determinant. Women who use modern contraceptive methods are less likely to engage in high-risk fertility behavior. These methods help manage the timing and number of pregnancies, reduce unplanned births, and extend the period between successive pregnancies—factors that lower the risk of maternal and neonatal complications.
Decision-making autonomy, particularly in healthcare matters, significantly reduces the likelihood of high-risk fertility behavior. When women have control over their reproductive choices, they are more empowered to seek medical advice, adopt contraception, and delay or plan pregnancies. Conversely, limited autonomy can leave women vulnerable to societal pressures and fertility choices driven by external influences, such as family or cultural norms.
Media exposure plays a pivotal role in shaping fertility behaviors. Women who regularly access information through television, radio, newspapers, or the internet are better informed about reproductive health and the consequences of early or closely spaced pregnancies. Awareness promoted through media helps counter myths, shifts cultural expectations, and supports women in making healthier reproductive choices.
Place of residence also impacts fertility behavior. Rural women are more likely to engage in high-risk fertility behavior than those living in urban settings. In rural areas, factors such as early marriage, lower access to education, limited availability of family planning services, and traditional gender roles contribute to higher fertility risks. Addressing these issues requires tailored interventions that consider geographical disparities in healthcare access and educational outreach.
Despite the strengths of using nationally representative data and robust statistical modeling, it is important to note that the study’s cross-sectional design limits the ability to draw causal inferences. Nevertheless, the findings underscore the urgent need for multi-sectoral strategies targeting the root causes of high-risk fertility behavior.
Addressing this challenge requires not only improvements in access to healthcare and education but also community-level initiatives aimed at shifting cultural attitudes, increasing women’s empowerment, and ensuring widespread dissemination of reproductive health information. By prioritizing these areas, Tanzania can make meaningful progress in improving maternal and child health outcomes.
