Role of conflict in shaping fertility preferences in Rwanda

Conflicts affect the social and economic conditions that could account for the stall in fertility decline in Sub-Saharan Africa. For Rwanda, the total fertility rate decreased very rapidly to 6.1 in the eighties but stalled at that level in the nineties. Part of the stall can be attributed to a lack of fertility control, but the question is whether social upheaval also affects fertility preferences. We identify three mechanisms through which the Rwanda conflict have led to a preference for larger families: mortality experience, modernization and the attitudes of third parties.Using data from DHS, we tested the contribution of these mechanisms to the preference for small, medium or large families. With the exception of sibling mortality, there is a strong impact of these mechanisms on the preference for large families, yet they do not fully account for the shifts in preferences over the years

Changes in Fertility Decline in Rwanda: A Decomposition Analysis

After having stalled in the 1990s, fertility in Rwanda resumed its downward trajectory between 2005 and 2010. The total fertility rate declined from 6.1 to 4.6 and modern contraceptive use increased. However, it is unclear which determinants lay behind the previous stall and the recent strong drop in fertility. This paper contributes to an ongoing debate on the impact of social upheavals on fertility decline. We use a decomposition analysis, focusing on the change in characteristics and reproductive behaviour of women and their contributions to levels of fertility during 1992–2000 and 2000–2010. Results show that due to widowhood and separation the proportion of women who were married decreased between 1992 and 2000, but their fertility increased in the same period due to replacement fertility and an unmet need for family planning. After 2000, postponement of marriage and lower infant mortality contributed to lower fertility, but the most important effect is the overall lower fertility due not only to improved family planning provision but perhaps also to the sensitizing campaigns of the Rwandan government

Attitudes towards vaccines and intention to vaccinate against COVID-19: a cross-sectional analysis - implications for public health communications in Australia

Objective To examine SARS-CoV-2 vaccine confidence, attitudes and intentions in Australian adults as part of the iCARE Study. Design and setting Cross-sectional online survey conducted when free COVID-19 vaccinations first became available in Australia in February 2021. Participants Total of 1166 Australians from general population aged 18-90 years (mean 52, SD of 19). Main outcome measures Primary outcome: responses to question € If a vaccine for COVID-19 were available today, what is the likelihood that you would get vaccinated?'. Secondary outcome: analyses of putative drivers of uptake, including vaccine confidence, socioeconomic status and sources of trust, derived from multiple survey questions. Results Seventy-eight per cent reported being likely to receive a SARS-CoV-2 vaccine. Higher SARS-CoV-2 vaccine intentions were associated with: increasing age (OR: 2.01 (95% CI 1.77 to 2.77)), being male (1.37 (95% CI 1.08 to 1.72)), residing in least disadvantaged area quintile (2.27 (95% CI 1.53 to 3.37)) and a self-perceived high risk of getting COVID-19 (1.52 (95% CI 1.08 to 2.14)). However, 72% did not believe they were at a high risk of getting COVID-19. Findings regarding vaccines in general were similar except there were no sex differences. For both the SARS-CoV-2 vaccine and vaccines in general, there were no differences in intentions to vaccinate as a function of education level, perceived income level and rurality. Knowing that the vaccine is safe and effective and that getting vaccinated will protect others, trusting the company that made it and vaccination recommended by a doctor were reported to influence a large proportion of the study cohort to uptake the SARS-CoV-2 vaccine. Seventy-eight per cent reported the intent to continue engaging in virus-protecting behaviours (mask wearing, social distancing, etc) postvaccine. Conclusions Most Australians are likely to receive a SARS-CoV-2 vaccine. Key influencing factors identified (eg, knowing vaccine is safe and effective, and doctor's recommendation to get vaccinated) can inform public health messaging to enhance vaccination rates