Analyzing Regional and Urban-Rural Differences in Total Children Ever Born Using Generalized Poisson-Regression Model

Abstract

 Fertility remains a key demographic indicator with implications for population growth and socio-economic development. This study investigates the demographic, socio-economic, and regional determinants of fertility among women of reproductive age in Bangladesh using data from the 2022 Bangladesh Demographic and Health Survey (BDHS 2022). We analyzed data from 19,987 women aged 15–49 years. The outcome variable was the total number of children ever born (TCEB). A Generalized Poisson Regression Model (GPRM) was employed to count data distribution and estimate incidence rate ratios (IRRs) with 95% confidence intervals (CIs). Age was the strongest predictor of fertility, with IRRs increasing steadily across older age groups, reaching 6.34 (95% CI: 5.89–6.82) for women aged 45–49. Higher education levels were significantly associated with reduced fertility; women having higher education had 37% fewer children compared to those with no education (IRR = 0.63, 95% CI: 0.60–0.66). Muslim women, those from rural areas, and currently married or widowed women exhibited significantly higher fertility. Regional disparities were evident as Sylhet and Chattogram had experienced almost 14% higher fertility, while Khulna and Rajshahi had significantly lower rates. Although contraceptive use was positively associated with TCEB, this may indicate reverse causality, where contraception is adopted after reaching the desired family size. The study highlights significant socio-demographic and regional differences in fertility behavior in Bangladesh. These findings emphasize the need for targeted policy interventions that improve access to education and reduce regional fertility disparities, ultimately supporting national and global development objectives.