High fertility desires are often one of the primary cause of fast population growth and it play a predominant role in explaining current fertility trends [19, 43]. Therefore, it's critical to concentrate on issues linked to the fertility desire to have a child in order to predict fertility behavior and restrict population growth [20]. Hence, in midst of a rapid increase in the population of Ethiopia, this study determined and identified the determinants of fertility desire to have a child among reproductive-age married or cohabiting women in Ethiopia thereby generating up to date national level evidence to preserve such rapid population growth.
Accordingly, nationally, fertility desire to have a child is closer to three-fourths 74.1% (95% CI; 71.5–76.6%), while 25.9% (95% CI; 23.4–28.5%) of women reported that they desire not to have any more children. This finding is comparable to Senegal 74.1%, Cote d’Ivoire 75.8%, Burkina Faso 72.8%, Congo DR 72.8%, and Comoros 72.2% in the previous study conducted on SSA countries [35]. However, it is found to be higher than the results reported in other studies conducted in Ethiopia, Uganda, Nigeria, and Ghana [26, 30, 36–38, 41, 52], and it is also lower than studies conducted in Niger and other SSA countries [35, 53]. Multiple possible explanations may account for this disparity in each study. However, differences in outcome variable measurement, study period, sample size, and categories of the outcome variable might be related from the study setting perspective. Existing conditions, such as differences in sociocultural norms and expectations regarding family size, differences in economic conditions, government policies related to family planning, and disparities in access to contraception services and health care infrastructure, may also contribute to these differences [54–56].
The analysis indicated that fertility desire to have a child is associated with the woman's and her partner's age in Ethiopia. As indicated in this study, older women (aged 40–49) were found to have lower odds to desire to have a child than their younger (aged 15–19) counterparts; similarly, women who reported a partner age greater than 45 were found to have less odds to desire to have a child. Such difference in fertility desires might be linked to several conditions. Biological reasons play a role, since fertility reduces with age, and older women and older partners may prioritize their health and vitality, and they may prefer to focus on their existing family’s needs rather than extending it. Economically, raising children involves expenses related to school, healthcare, and other essentials [57]. Older women and older partners may emphasize their current family’s well-being and may have fulfilled their desired family size or concentrated on other life priorities. Additionally, studies conducted on the effect of advanced paternal age on fertility showed that advanced paternal age is associated with reduced fertility and a higher risk of genetic abnormalities in offspring [58, 59]. This finding is in line with studies in Uganda, Niger, Ghana, Nigeria, Guatemala, and Ethiopia [26, 30, 35–38, 41, 52, 53, 60, 61].
In line with studies [35, 53, 61, 62], parity was found a lower odds of fertility desire to have a child. Women who have had three or more live births were likely to have reduced fertility desire to have a child compared to women who had two or fewer live births. Similarly, having a family size of more than five individuals reduces the likelihood of desiring to have a child compared to families with one to five members. This is in line with a study conducted in Asia [63] and a qualitative study conducted in South Africa and Malawi [22]. The possible explanation for such results could be that women who have experienced multiple pregnancies may be more aware of the physical and emotional challenges associated with childbirth and may choose to limit further pregnancies. With each additional pregnancy, women may face increased physical discomforts such as nausea, fatigue, and stiffness [64]. Additionally, such women may have reached or exceeded their desired family size and might be worried about parental resources such as time, energy, and financial stability, which will become more pronounced with each additional child. As a result, women who have had three or more live births may feel overwhelmed and less inclined to have an additional child.
Furthermore, it was found that women who have ever used family planning are less likely to desire to have a child. This confirms earlier research [26, 35, 36, 38, 44, 56, 65]. The probable explanation is that women who are using family planning might not desire to give birth to additional children, may be at different stages in their lives with different priorities and goals, and would adopt several mechanisms to achieve this goal, including the use of family planning. John Bongaarts (2020) also identified that family planning programs can reduce desired fertility, which implies and suggests that their impact can be significant [55]. Similarly, Caldwell (2005) also indicates that one of the causes of Asian fertility decline was strong government family planning programs [66].
It is noticed that women who have more than a secondary level of education have increased odds of fertility desire to have a child. It could result from both better-favorable positions among secondary-plus educated people and a lack of resources among individuals with no education [67]. Women who have more than a secondary plus level of education may be more likely to prioritize their career or educational goals at an earlier age, leading them to delay having children. They may, however, be more ready to start a family if they achieve stable employment or complete their educational objectives. Similarly, they may have greater awareness of the biological limitations of fertility and the potential risks associated with delaying childbirth. Consequently, they may feel a sense of urgency to have children before the decline in fertility due to old age becomes worrying.
Testa (2014), in her article on the positive correlation between education and fertility intentions in Europe, argued that women in Europe who spent more resources on human capital do not necessarily plan to have fewer children than their less educated counterparts [65, 68]. Hashemzadeh M. (2021), in his systematic review, stated that in nations where there are more options for women to acquire high levels of education, other structural conditions impacting fertility are also available, for example, life satisfaction, feelings of well-being, and levels of trust [69]. Accordingly, studies conducted in Guatemala, Ethiopia, and Uganda also reported similar findings [26, 30, 38, 41, 60]. However, these results contrast earlier studies on this point that higher education is associated with lesser fertility desire [19, 35–37]. The discrepancy might be attributed to the difference in the study population, design, and measurement; meanwhile, further study is required to examine the association between level of education and fertility desire in this population group.
Consistent with the literature, women's religion was found to be associated with fertility desire [19, 36, 38, 52, 61, 70]. The likelihood of fertility desire to have a child was higher among women of Muslim religion. According to social identity theory, an individual’s sense of identity is shaped by their membership in social groups, such as religious or cultural communities [71]. A recent qualitative analysis done by Abdi et al. [72] in two Muslim communities in Kenya indicated that Muslim women prefer the desire for more children since they have the belief that children are a blessing from God and a source of joy. Cranney (2015) also identified that religion is positively associated with fertility desire, and more religious people tend to have higher desire than non-believers [73].
Other factors that were found to significantly increase fertility desire to have a child were age at first sex and forced pregnancy. There is an expectation or preference to delay the age of entry into sexual intercourse and childbearing until certain milestones, such as completion of education, marriage, or employment, have been reached in most Ethiopian cultures and social contexts [74]. Women who adhere to these norms by delaying age at entry into sexual intercourse may also be more likely to express a desire to have children when they feel it aligns with societal expectations or personal aspirations. Similarly, women who delay their sexual debut may be more selective in choosing their partners and establishing committed relationships. They can prioritize partners who share their values and family formation goals, making them more likely to express a desire for children in the context of stable and supportive relationships [75, 76].
Women who are forced into pregnancy may have limited autonomy and control over their own reproductive decisions. It can indicate a significant power imbalance within the relationship. This imbalance may extend to other aspects of the relationship, where the partner exerts control over the woman's reproductive choices. In such cases, a partner's pressure may influence the woman's desire to have a child rather than her own preferences [25, 34, 77]. A qualitative study conducted in Malawi and South Africa revealed that women in both cultures expressed the assumption that all marriages produce babies, and married women generally reported being unable to oppose a husband’s ambition and request for sex or pregnancy [22].
The study is effective since it utilizes nationwide datasets and uses a multi-stage sampling technique to choose participants. Therefore, the findings may be generalized to all Ethiopian women of reproductive age. Despite these strengths, it is impractical to show the trend and impossible to include the Tigray region because of the existing conflict.