Analysis of Fertility and its effects on Health among Mothers and Children in Tanzania.

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Lihawa, Robert Michael
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ABSTRACT Health is an important socioeconomic component as it promotes the national welfare and fosters economic prosperity. Tanzania has made significant strides with regards to investments in its health sector by developing major health policies meant to enhance sustainability of the health status of its populace. , Significant efforts have been directed towards reduction of disability, morbidity and mortality, further nutritional status and improving life expectancy. However, despite the government's effort to improve access to health services across Tanzania, poor maternal and child nutritional health statuses are still a challenge to date. On the other hand, fertility rate in Tanzania is higher than the global average that poses serious challenges for sustainable development. The core objective of this study was to examine the relationship between fertility, maternal health and child health outcomes in Tanzania. Specifically, the study examined the effects of socioeconomic factors on fertility in Tanzania. Subsequently, the study sought to examine the effect of fertility on child health outcomes using height-for-age Z-score (HAZ) and the probability of a child being stunted as dependent variables. The study also examined the effect of fertility on maternal health status using Body Mass Index (BMI) and the probability of a mother being underweight as dependent variables. Cross-sectional data from Tanzania Demographic Health Surveys for 2010 was used for the analysis. The study used Zero Inflated Poisson regression model to estimate the effect of socioeconomic factors on fertility. Subsequently, Ordinary Least Square (OLS), Probit, Instrumental Variable IVProbit and IVregression models and the Control Function Approach (CFA) were employed for the analysis of the effect of fertility on maternal and child health outcomes while controlling for the endogeneity and heterogeneity problems. Based on the study's findings, the age of the mother and marital status significantly affect the number of children in Tanzania. On the other hand, maternal education, mother's employment, contraceptive use, awareness of family planning, access to media and place of residence were associated with significant changes in fertility. Again, fertility significantly lowered the height-for-age z-score (HAZ) and increased the probability of a child being stunted. On the maternal health status, high fertility reduces the women's welfare by reducing the Body Mass Index (BMI) and consequently increasing the probability of a mother being underweight. Results further indicate a presence of heterogeneity arising in the maternal health model. Based on the finding of this study, promotion of family planning is recommended. The study also recommends investing in women's education as a way of rooting out illiteracy on matters related to family planning. There is also a need for the government to increase the proportion of women in the labor force and boost their participation in the same as a means of enhancing their well-being as well as that of their families.
A thesis submitted in partial fulfillment of the requirements or the award of the degree of doctor of Philosophy in Economics in the school of Economics of Kenyatta University. November, 2016