Perceived ideal number of children among adolescent girls in sub-Saharan Africa: does exposure to family planning messages matter?

Background: Even though evidence shows that fertility transition has begun almost everywhere in sub-Saharan Africa (SSA), the decline has been slower than in other parts of the world. Research shows that there is a positive relationship between fertility levels and fertility preference. Therefore, many countries in the region are implementing family planning education campaigns targeting at influencing reproductive behavior of women. Thus, this study aimed to examine the extent to which exposure to family planning communication influences fertility preferences of adolescent girls in SSA.

Methods: This study used data extracted from the most recent Demographic and Health Survey datasets for 28 countries in SSA. Analyses were conducted on a pooled sample of 87,950 female adolescents' aged 15-19 years who were captured in respective country's survey. Multivariable binary logistic regression model was fitted in Stata version 17 software to examine the association between exposure to family planning communication and fertility preference among adolescent girls in SSA.

Results: The average fertility preference among adolescent girls in SSA was 4.6 children (95% CI: 4.5, 4.7). Findings show that regardless of the country, adolescents who had exposure to family planning messages [aOR = 0.76, 95% CI = 0.72-0.80] were less likely to prefer 4 or more children. On average, fertility preference among adolescents who had exposure to family planning communication was (3.8 children compared to 4.5 children; p < 0.001) among those with no exposure. Furthermore, results show that married adolescents in SSA who had exposure to family planning message had a higher average preferred family size compared to those who were not married (4.8 versus 3.8; p < 0.001).

Conclusion: Exposure to family planning communication has shown the potential to influence adolescents' fertility preference in sub-Saharan Africa. Adolescents with exposure to family planning messages preferred a small family size. Therefore, there is a need to scale-up family planning education programmes in order to reduce fertility further in SSA.