Abstract
BACKGROUND: Women's high-risk fertility behavior, marked by short birth intervals, higher birth order, and early maternal age at childbirth, has been scientifically proven to have detrimental health effects on both the mother and child. Despite the recognized consequences, there is a limited body of research examining the factors that contribute to high-risk fertility behavior in Tanzania. Hence, this study seeks to identify the prevalence of high-risk fertility behavior and associated factors among women of reproductive age within the Tanzanian context. METHOD: This study analyzed data from the 2022 Tanzania's Demography and Health Survey, focusing on 11,380 women of childbearing age. To deal with the survey's clustered structure and the binary nature of the outcome variable, a multi-level mixed-effect generalized linear model (Poisson regression with robust error variance) was employed. The Statistical significance of the predictor was assessed using adjusted prevalence ratios (aPR) with 95% confidence intervals. RESULTS: The prevalence of high-risk fertility behavior among Tanzanian women was 71.55% (95% CI = 70.71, 72.37). Women's educational levels, Age of women, wealth index, media exposure, decision-making autonomy, contraceptive use, and rural residence were found to be predictors of high-risk fertility behavior. CONCLUSION: a considerable number of women in Tanzanian have encountered High-risk fertility Behaviors. This is a significant concern, posing a notable challenge to the healthcare system. Addressing this issue requires a comprehensive and coordinated approach that involves all stakeholders. Policymakers should consider developing programs that take into account predictors like wealth, education, and residence, which contribute to women's vulnerability to high-risk fertility behavior. Focusing on women residing in areas with a high prevalence of high-risk fertility behavior could be instrumental in tackling the root causes of the problem.