Adolescent fertility behavior: Trends and determinants in Northeastern Brazil

Context: Much of the recent decline in Brazil's total fertility rate has been observed among women in the middle of their reproductive years. In contrast, the contribution of adolescent fertility (among 15-19-year-olds) to the total fertility rate is increasing over time. This trend is particularly accentuated in the country's Northeast region. Methods: Data from three Demographic and Health Surveys conducted in Northeastern Brazil in 1986, 1991 and 1996 are used to examine trends and determinants of fertility behavior among adolescents in the region. Discrete-time hazard models are used to estimate the probability of a woman having a first birth during adolescence, and to evaluate individual and environmental factors that may influence personal fertility choices. Results: A young woman's level of education is the factor most strongly and consistently associated with the probability of giving birth during adolescence. In particular, an adolescent with no more than primary schooling is more than twice as likely to have had a first birth than an adolescent with at least a secondary education, even after the analysis is controlled for age, time period and other characteristics. Religious affiliation and mass media exposure did not consistently affect adolescent fertility over time in the multivariate analysis. Conclusions: The promotion of education may be the most effective means of encouraging delayed childbearing among adolescents in Northeastern Brazil. There is a need for greater research into the impact of community facilities on teenage fertility notably health and family planning programs, that target adolescents.