Stability and change in fertility intentions in response to the COVID-19 pandemic in Kenya

Linnea A Zimmerman; Celia Karp; Mary Thiongo; Peter Gichangi; Georges Guiella; Alison Gemmill; Caroline Moreau; Suzanne O Bell

doi:10.1371/journal.pgph.0000147

Stability and change in fertility intentions in response to the COVID-19 pandemic in Kenya

PLOS Glob Public Health. 2022 Mar 8;2(3):e0000147. doi: 10.1371/journal.pgph.0000147. eCollection 2022.

Authors

Linnea A Zimmerman¹, Celia Karp¹, Mary Thiongo², Peter Gichangi^{2

3

4}, Georges Guiella⁵, Alison Gemmill¹, Caroline Moreau^{1

6}, Suzanne O Bell¹

Affiliations

¹ Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
² International Centre for Reproductive Health Kenya (ICRH-K), Mombasa, Kenya.
³ Technical University of Mombasa, Mombasa, Kenya.
⁴ Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
⁵ Institut Supérieur des Sciences de la Population (ISSP/University of Ouagadougou), Ouagadougou, Burkina Faso.
⁶ Soins et Santé Primaire, CESP Centre for Research in Epidemiology and Population Health U1018, Inserm, Villejuif, France.

Abstract

Fertility intentions are expected to decline due to the COVID-19 pandemic but limited empirical research on this topic has been conducted in sub-Saharan Africa. Longitudinal data from Kenya, with baseline (November 2019) and follow-up (June 2020) data, were used to 1) assess the extent to which individual-level fertility intentions changed, and 2) examine how security, specifically economic and health security, affected fertility intentions. The final sample included 3,095 women. The primary outcomes were change in quantum and timing. Exploratory analyses described overall changes within the sample and logistic regression models assessed sociodemographic and COVID-19 related correlates of change, specifically income loss at the household level, food insecurity, and ability to socially distance. Approximately 85% of women reported consistent fertility intentions related to both the number and timing of childbearing. No COVID-19-related factors were related to changing quantum intentions. Women who reported chronic food insecurity had 4.78 times the odds of accelerating their desired timing to next birth compared to those who reported no food insecurity (95% CI: 1.53-14.93), with a significant interaction by wealth. The COVID-19 pandemic did not lead to widespread changes in fertility intentions in Kenya, though the most vulnerable women may have accelerated their childbearing intentions.

Copyright: © 2022 Zimmerman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Grants and funding

This work was supported, in whole, by the Bill and Melinda Gates Foundation through a grant (INV 009466). Under the grant conditions of the Foundation, a Creative Commons Attribution 4.0 Generic License has already been assigned to the Author Accepted Manuscript version that might arise from this submission. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.