Epidemiological revision of high fertility behaviors among mothers in Mosul city, Iraq

  • Asma A. Aljawadi Department of Family and Community Medicine, College of Medicine, University of Mosul, Nineveh, Iraq
  • Hajir H. Al-Ridhwany Nineveh Health Directorate, Nineveh, Iraq
  • Muthanna S. Abduljawad Nineveh Health Directorate, Nineveh, Iraq
Keywords: Epidemiological, Fertility, Behaviors, Prevalence, Mothers


Background and objective: Collective high fertility behaviors is a term that refers to mothers who had got married during their teenage and having parity of five or more living children with less than 24 months apart. The present study aimed to estimate the prevalence of collective high fertility behaviors among mothers in Mosul city, Iraq.

Methods: A cross-sectional study was carried out using a multi-stage stratified sampling method. Inclusion criteria included mothers in child-bearing age who had at least two living children. The required data were collected by filling an especially structured questionnaire in the eligible primary health care centers over a period of ten months, from April, 1st 2011 to the end of January 2012.

Results: Among 1302 participants, the prevalence of high fertility behaviors was 17.7% within all age groups. The prevalence was significantly higher among Muslim, low social classes (P ˂0.001), nuclear family structure (P ˂0.001), consanguineous marriage (P ˂0.001) and low educated mothers and husbands (P ˂0.001).

Conclusion: The study found that collective high fertility behaviors are prevalent among almost two out of ten mothers of all age groups in Mosul city. Thus, effective engagement of all human resources is recommended for constructing healthy fertility behaviors and confirming the non-reproductive role of women.


United Nations. Manual X: Indirect techniques for demographic estimation. New York: Department of International Economic and Social Affairs: Population Studies no. 81; 1983.

Gatarayiha JP, Rukundo A, Karema C, Nkusi E, Ngabo F, Ilibagiza D, et al. editors. Rwanda: Interim Demographic and Health Survey 2007-08. Rwanda: Ministry of Health of Rwanda, National Institute of Statistics of Rwanda and ICF Macro Calverton, Maryland, USA; 2009.

Mahjabeena T Khanb IA. Analyzing Bongaarts model and its applications in the context of Bangladesh. 19th International Congress on modeling and simulation; 2011 Dec 12-16; Perth (Australia). 2011

Mesleh RA, Al-Aql AS, Kurdi AM. Teenage Pregnancy. Saudi Med J 2001; 22(10):864–7.

Strobino DM, Grason H, Minkovitz C. Charting a course for the future of women’s health in the united states: concepts, findings and recommendations. Soc Sci Med 2002; 54(5):839–48

Singh S, Darroch JE. Adolescent pregnancy and childbearing: Levels and trends in developed countries. Fam Plann Perspect 2000; 32(1):14–23.

Casterline JB, Lazarus RT. Determinants and consequences of high fertility: a synopsis of the evidence. Ohio: Department of Sociology. Ohio State University; 2010.

Daniel WW. Biostatistics, a foundation for analysis in the health sciences. 8th ed. Georgia State (USA): Wiley (John Wiley & Sons, Inc); 2005.

Jakel JF, Elmore JG, Katz DL. Common research design used in epidemiology. In: Epidemiology, biostatistics and preventive medicine; 1996.

Chadha VK. Sample size determination in health studies. NTI Bulletin 2006; 42(3):55–62.

Bartlett JE, Kotrlik JW, Chadwick CH. Determining organizational research: determining appropriate sample size in survey research appropriate sample size in survey research. ITLPJ 2001; 19(1):43–50.

WHO. Sampling Methods and Sample Size. In: Health research methodology: a guide for training in research methods. 2nd Ed. Manila: Regional Office for the Western Pacific; 2001.

Greenberg R, Daniels S, Flanders W, Eley J, Boring J. Medical epidemiology. 4th ed. Lange Basic Science; 2004.

I-WISH 2011. Complete survey for social and health indicators of Iraqi women. A summary report. Iraq: Ministry of Planning, Central Bureau of Statistics; 2011.

Fuster V. Inbreeding pattern and reproductive success in a rural community from Galicia (Spain). J Biosoc Sci 2003; 35(1):83–93.

Helgason A, Palsson S, Gudbjartsson DF, Kristjansson T, Stefansson K. An association between the kinship and fertility of human couples. Science 2008; 319(5864):813–6.

Al-Abdulkareem AA, Ballal SG. Consanguineous marriage in an urban area of Saudi Arabia: rates and adverse health effects on the offspring. J Community Health 1998; 23(1):75–83.

Tadmouri GO, Nair P, Obeid T, Al Ali MT, Al Khaja N, Hamamy HA. Consanguinity and reproductive health among Arabs. Reprod Health 2009; 6:17.

Conde-Agudelo A, Rosas-Bermúdez A, Kafury-Goeta AC. Birth Spacing and Risk of Adverse Perinatal Outcomes: A Meta-analysis. JAMA 2006; 295(15):1809–23.

Makinwa-Adebusoye P, Kritz MM. Reproductive decision-making in Nigeria: An overview. Union for African Population Studies. Afr Popul Stud 1997; 12(1).

Mutharayappa R, Choe MK, Arnold F, Roy TK. Son preference and its effect on fertility in India. India: National Family Health Survey Subject Reports Number 3; 1997.

Abbasi-Shavazi MJ, Morgan SPh, Hossein-Chavoshi M, McDonald P. Family change and continuity in the Islamic republic of Iran: Birth control use before the first pregnancy. Iran: National Institute of Child Health and Human Development; 2007.

Grant JC, Bittles AH, Sullivan SG, Hussain R. Does inbreeding lead to decreased human fertility? Ann Hum Biol 2002; 29(2):111–30.

Vahidnia F. Case study: fertility decline in Iran. Popul Environ 2007; 28(4-5):259–66.

Burner B. Religiousness and fertility among Muslims in Europe, does Islam influence fertility? Oslo: Oslo and Akershus University College of Applied Sciences, Faculty of Social Sciences Oslo and Akershus University College Oslo; 2012.

Karim M. Changes in fertility rates among Muslims in India, Pakistan, and Bangladesh [on line]. Washington (USA): Population Reference Bureau; 2009. (Accessed November 5, 2018 at http://www.prb.org/Articles/2009/karimpolicyseminar.aspx).

Khraif RM. Fertility in Saudi Arabia: levels and determinants. King Saudi University. Salvador (Brazil): XXIV General Population Conference; 2001.

León A. The effect of education on fertility: Evidence from compulsory schooling laws. Department of Economics, University of Pittsburgh, Pittsburgh; 2004.

Ayoub AS, Tuman JP, Johnson DR. The Effects of Education on Fertility in Colombia and Peru: Implications for Health and Family Planning Policies. Glob Health Gov 2007; 1(2):1–13.

How to Cite
Aljawadi, A., Al-Ridhwany, H., & Abduljawad, M. (2019). Epidemiological revision of high fertility behaviors among mothers in Mosul city, Iraq. Zanco Journal of Medical Sciences (Zanco J Med Sci), 23(1), 90-99. https://doi.org/10.15218/zjms.2019.012
Original Articles