The statistic shows the 20 countries with the lowest fertility rates in 2024. All figures are estimates. In 2024, the fertility rate in Taiwan was estimated to be at 1.11 children per woman, making it the lowest fertility rate worldwide. Fertility rate The fertility rate is the average number of children born per woman of child-bearing age in a country. Usually, a woman aged between 15 and 45 is considered to be in her child-bearing years. The fertility rate of a country provides an insight into its economic state, as well as the level of health and education of its population. Developing countries usually have a higher fertility rate due to lack of access to birth control and contraception, and to women usually foregoing a higher education, or even any education at all, in favor of taking care of housework. Many families in poorer countries also need their children to help provide for the family by starting to work early and/or as caretakers for their parents in old age. In developed countries, fertility rates and birth rates are usually much lower, as birth control is easier to obtain and women often choose a career before becoming a mother. Additionally, if the number of women of child-bearing age declines, so does the fertility rate of a country. As can be seen above, countries like Hong Kong are a good example for women leaving the patriarchal structures and focusing on their own career instead of becoming a mother at a young age, causing a decline of the country’s fertility rate. A look at the fertility rate per woman worldwide by income group also shows that women with a low income tend to have more children than those with a high income. The United States are neither among the countries with the lowest, nor among those with the highest fertility rate, by the way. At 2.08 children per woman, the fertility rate in the US has been continuously slightly below the global average of about 2.4 children per woman over the last decade.

The average for 2022 based on 196 countries was 18.19 births per 1000 people. The highest value was in the Central African Republic: 45.42 births per 1000 people and the lowest value was in Hong Kong: 4.4 births per 1000 people. The indicator is available from 1960 to 2023. Below is a chart for all countries where data are available.

In 2024, Monaco was the European country estimated to have the highest fertility rate. The country had a fertility rate of 2.1 children per woman. Other small countries such as Gibraltar or Montenegro also came towards the top of the list for 2024, while the large country with the highest fertility rate was France, with 1.64 children per woman. On the other hand, Ukraine had the lowest fertility rate, averaging around one child per woman.

The total fertility rate of the world has dropped from around 5 children per woman in 1950, to 2.2 children per woman in 2025, which means that women today are having fewer than half the number of children that women did 75 years ago. Replacement level fertility This change has come as a result of the global demographic transition, and is influenced by factors such as the significant reduction in infant and child mortality, reduced number of child marriages, increased educational and vocational opportunities for women, and the increased efficacy and availability of contraception. While this change has become synonymous with societal progress, it does have wide-reaching demographic impact - if the global average falls below replacement level (roughly 2.1 children per woman), as is expected to happen in the 2050s, then this will lead to long-term population decline on a global scale. Regional variations When broken down by continent, Africa is the only region with a fertility rate above the global average, and, alongside Oceania, it is the only region with a fertility rate above replacement level. Until the 1980s, the average woman in Africa could expect to have 6-7 children over the course of their lifetime, and there are still several countries in Africa where women can still expect to have 5 or more children in 2025. Historically, Europe has had the lowest fertility rates in the world over the past century, falling below replacement level in 1975. Europe's population has grown through a combination of migration and increasing life expectancy, however even high immigration rates could not prevent its population from going into decline in 2021.

In the Cook Islands in 2024, the population decreased by about 2.24 percent compared to the previous year, making it the country with the highest population decline rate in 2024. Of the 20 countries with the highest rate of population decline, the majority are island nations, where emigration rates are high (especially to Australia, New Zealand, and the United States), or they are located in Eastern Europe, which suffers from a combination of high emigration rates and low birth rates.

In 2024, the average number of children born per 1,000 people in China ranged at ****. The birth rate has dropped considerably since 2016, and the number of births fell below the number of deaths in 2022 for the first time in decades, leading to a negative population growth rate. Recent development of the birth rate Similar to most East-Asian countries and territories, demographics in China today are characterized by a very low fertility rate. As low fertility in the long-term limits economic growth and leads to heavy strains on the pension and health systems, the Chinese government decided to support childbirth by gradually relaxing strict birth control measures, that had been in place for three decades. However, the effect of this policy change was considerably smaller than expected. The birth rate increased from **** births per 1,000 inhabitants in 2010 to ***** births in 2012 and remained on a higher level for a couple of years, but then dropped again to a new low in 2018. This illustrates that other factors constrain the number of births today. These factors are most probably similar to those experienced in other developed countries as well: women preferring career opportunities over maternity, high costs for bringing up children, and changed social norms, to name only the most important ones. Future demographic prospects Between 2020 and 2023, the birth rate in China dropped to formerly unknown lows, most probably influenced by the coronavirus pandemic. As all COVID-19 restrictions were lifted by the end of 2022, births figures showed a catch-up effect in 2024. However, the scope of the rebound might be limited. A population breakdown by five-year age groups indicates that the drop in the number of births is also related to a shrinking number of people with child-bearing age. The age groups between 15 and 29 years today are considerably smaller than those between 30 and 44, leaving less space for the birth rate to increase. This effect is exacerbated by a considerable gender gap within younger age groups in China, with the number of females being much lower than that of males.

Background : Substantial differences between countries were observed in terms of Covid-19 death tolls during the past two years. It was of interest to find out how the epidemiologic and/or demographic history of the population may have had a role in the high prevalence of the Covid-19 in some countries. Objective : This observational study aimed to investigate possible relations between Covid-19 death numbers in 39 countries and the prepandemic history of epidemiologic and demographic conditions. Methods : We sought the Covid-19 death toll in 39 countries in Europe, America, Africa, and Asia. Records (2019) of epidemiologic (Cancer, Alzheimer's disease) and demographic (natality, mortality, and fetility rates, percentage of people aged 65 and over) parameters as well as data on alcohol intake per capita were retrieved from official web pages. Data was analysed by simple linear or polynomial regression by the mean of Microsoft Excell software (2016). Results : When Covid-19 death numbers were plotted against the geographic latitude of each country, a bell-shaped curve was obtained for both the first and second years (coefficient of determination R2=0.38) of the pandemic. In a similar manner, bell-shaped curves were obtained when latitudes were plotted against the scores of (cancer plus Alzheimer's disease, R² = 0,65,), the percentage of advanced age (R² = 0,52,) and the alcohol intake level (R² = 0,64,). Covid-19 death numbers were positively correlated to the scores of (cancer plus Alzheimer's disease) (R2= 0.41, P= 1.61x10-5), advanced age (R2= 0.38, P= 4.09x10-5) and alcohol intake (R2= 0.48, P= 1.55x10-6). Instead, inverted bell-shaped curves were obtained when latitudes were plotted against the birth rate/mortality rate ratio (R² = 0,51) and the fetility rate (R² = 0,33). In addition, Covid-19 deaths were negatively correlated with the birth rate/mortality rate ratio (R2= 0.67) and fertility rate (R2= 0.50). Conclusion : The results show that the 39 countries in both hemisphers in this study have different patterns of epidemiologic and demographic factors, and that the negative history of epidemiologic and demographic factors of the northern hemisphere countries, as well as their high alcohol intake, were very correlated with their Covid-19 death tolls. Hence, also nutritional habits may have had a role in the general health status of people in regard to their immunity against the coronavirus.

ABSTRACT Background : The Covid-19 pandemic associated with the SARS-CoV-2 has caused very high death tolls in many countries, while it has had less prevalence in other countries of Africa and Asia. Climate and geographic conditions, as well as other epidemiologic and demographic conditions, were a matter of debate on whether or not they could have an effect on the prevalence of Covid-19. Objective : In the present work, we sought a possible relevance of the geographic location of a given country on its Covid-19 prevalence. On the other hand, we sought a possible relation between the history of epidemiologic and demographic conditions of the populations and the prevalence of Covid-19 across four continents (America, Europe, Africa, and Asia). We also searched for a possible impact of pre-pandemic alcohol consumption in each country on the two year death tolls across the four continents. Methods : We have sought the death toll caused by Covid-19 in 39 countries and obtained the registered deaths from specialized web pages. For every country in the study, we have analysed the correlation of the Covid-19 death numbers with its geographic latitude, and its associated climate conditions, such as the mean annual temperature, the average annual sunshine hours, and the average annual UV index. We also analyzed the correlation of the Covid-19 death numbers with epidemiologic conditions such as cancer score and Alzheimer score, and with demographic parameters such as birth rate, mortality rate, fertility rate, and the percentage of people aged 65 and above. In regard to consumption habits, we searched for a possible relation between alcohol intake levels per capita and the Covid-19 death numbers in each country. Correlation factors and determination factors, as well as analyses by simple linear regression and polynomial regression, were calculated or obtained by Microsoft Exell software (2016). Results : In the present study, higher numbers of deaths related to Covid-19 pandemic were registered in many countries in Europe and America compared to other countries in Africa and Asia. The analysis by polynomial regression generated an inverted bell-shaped curve and a significant correlation between the Covid-19 death numbers and the geographic latitude of each country in our study. Higher death numbers were registered in the higher geographic latitudes of both hemispheres, while lower scores of deaths were registered in countries located around the equator line. In a bell shaped curve, the latitude levels were negatively correlated to the average annual levels (last 10 years) of temperatures, sunshine hours, and UV index of each country, with the highest scores of each climate parameter being registered around the equator line, while lower levels of temperature, sunshine hours, and UV index were registered in higher latitude countries. In addition, the linear regression analysis showed that the Covid-19 death numbers registered in the 39 countries of our study were negatively correlated with the three climate factors of our study, with the temperature as the main negatively correlated factor with Covid-19 deaths. On the other hand, cancer and Alzheimer's disease scores, as well as advanced age and alcohol intake, were positively correlated to Covid-19 deaths, and inverted bell-shaped curves were obtained when expressing the above parameters against a country’s latitude. Instead, the (birth rate/mortality rate) ratio and fertility rate were negatively correlated to Covid-19 deaths, and their values gave bell-shaped curves when expressed against a country’s latitude. Conclusion : The results of the present study prove that the climate parameters and history of epidemiologic and demographic conditions as well as nutrition habits are very correlated with Covid-19 prevalence. The results of the present study prove that low levels of temperature, sunshine hours, and UV index, as well as negative epidemiologic and demographic conditions and high scores of alcohol intake may worsen Covid-19 prevalence in many countries of the northern hemisphere, and this phenomenon could explain their high Covid-19 death tolls. Keywords : Covid-19, Coronavirus, SARS-CoV-2, climate, temperature, sunshine hours, UV index, cancer, Alzheimer disease, alcohol.

Native Hawaiian and Pacific Islander women had the highest fertility rate of any ethnicity in the United States in 2022, with about 2,237.5 births per 1,000 women. The fertility rate for all ethnicities in the U.S. was 1,656.5 births per 1,000 women. What is the total fertility rate? The total fertility rate is an estimation of the number of children who would theoretically be born per 1,000 women through their childbearing years (generally considered to be between the ages of 15 and 44) according to age-specific fertility rates. The fertility rate is different from the birth rate, in that the birth rate is the number of births in relation to the population over a specific period of time. Fertility rates around the world Fertility rates around the world differ on a country-by-country basis, and more industrialized countries tend to see lower fertility rates. For example, Niger topped the list of the countries with the highest fertility rates, and Taiwan had the lowest fertility rate.

BackgroundThe birth rate is an important indicator of the health of the population. However, persistently low birth rate has become a pressing demographic challenge for many countries, including China. This has significant implications for sustainable population planning.MethodsThis study applied hot spot analysis and the spatiotemporal geographically weighted regression (GTWR) modeling, used panel data of 286 cities in China from 2012 to 2021 to explore the spatiotemporal heterogeneity of the relationship between the socioeconomic development and birth rate.ResultsThe research has found that 2017 was an important turning point in China’s demographic transition. The hot spot analysis reveals that the birth rate hot spots are characterized by a multipolar kernel distribution, shifting from spatial diffusion to convergence, with the cold spots mainly located in the northeast. And the GTWR modeling found that the relationship between socioeconomic development and birth rate varies and change dynamically over space and time. Key findings include: (1) the negative impact of GDP per capita on birth rates has intensified; (2) housing prices exhibit both wealth and crowding-out effects on birth rates, and there are obvious regional differences between the north and the south; (3) fiscal education expenditure on birth rates has the most pronounced income effect in the eastern region.ConclusionThis study adopts spatiotemporal perspective to reveal the spatiotemporal heterogeneity of the association between socioeconomic development and birth rate. It provides new evidence on the influence of macro factors on fertility in China. And emphasizes the importance of incorporating regional variations into population policy design.

During the first two year of the Covid-19 pandemic, deaths tolls differed from a country to another. In a previous research work on 39 countries, we have found that some population’s characteristics were either negatively (birth rate/mortality rate, fertility rate) or positively (cancer score, Alzheimer disease score, percent of people above 65 years old, levels of alcohol intake) correlated with Covid-19 mortality. We also found that low levels of climate factors (average annual temperature, average hours of sunshine, average annual level of UV index) were positively correlated with Covid-19 deaths numbers as well. In the present study, we have developped an anti-Covid Capacity index that takes into account all the above mentioned parameters. The polynomial analysis of the anti-Covid Capacity and its corresponding geographic latitude of each country has generated a bell-shaped curve, with a high coefficient of determination (R2= 0.78). Lower anti-Covid capacity values were recorded in countries of low and high latitudes, respectively. Instead, plotting covid-19 deaths numbers against geographic latitude levels has generated an inverted bell-shaped curve, with higher deaths numbers at low and high latitudes, respectively. The analysis by a simple linear regression has shown that Covid-19 deaths numbers were significantly (p= 2,40 x 10-9) and negatively correlated to the anti-Covid Capacity index values. Our data demonstrate that the negative prepandemic human conditions, and the low scores of both annual temperature and UV index in many countries were the key factors behind high Covid-19 mortality, and they can be expressed as a simple index of anti-Covid capacity of a country that can predict the death-associated severity of Covid-19 disease, and thus, according to a country’s geographic latitude.

The main reasons for the negative consequences of demographic changes are: natural increase in the life span of the population, decline in fertility and emigration of unusual dimensions.

This statistic shows the 20 countries with the highest population growth rate in 2024. In SouthSudan, the population grew by about 4.65 percent compared to the previous year, making it the country with the highest population growth rate in 2024. The global population Today, the global population amounts to around 7 billion people, i.e. the total number of living humans on Earth. More than half of the global population is living in Asia, while one quarter of the global population resides in Africa. High fertility rates in Africa and Asia, a decline in the mortality rates and an increase in the median age of the world population all contribute to the global population growth. Statistics show that the global population is subject to increase by almost 4 billion people by 2100. The global population growth is a direct result of people living longer because of better living conditions and a healthier nutrition. Three out of five of the most populous countries in the world are located in Asia. Ultimately the highest population growth rate is also found there, the country with the highest population growth rate is Syria. This could be due to a low infant mortality rate in Syria or the ever -expanding tourism sector.

ABSTRACT Background : The Covid-19 pandemic has caused very high death tolls across the world in the last two years. Geographic latitude, climate factors, and other human related conditions such as epidemiologic and demographic history are taught to have played a role in the prevalence of Covid-19. Objective : This observational study aimed to investigate possible relations between geographic latitude-associated climate factors and Covid-19 death numbers in 29 countries. The study also aimed to investigate the relationship between geographic latitude and the history of epidemiologic (cancer, Alzheimer's disease) and demographic factors (birth rate, mortality rate, fertility rate, people aged 65 and over), as well as alcohol intake habits. And finally, the study also aimed to evaluate the relationships between epidemiologic and demographic factors, as well as alcohol intake habits with Covid-19 deaths. Methods : We sought the Covid-19 death toll in 29 countries in Europe, Africa, and the Middle East (located in both hemispheres and between the meridian lines "-15°" and "+50°"). We obtained the death numbers for Covid-19 and other geographic (latitude, longitude) and climate factors (average annual temperature, sunshine hours, and UV index) and epidemiologic and demographic parameters as well as data on alcohol intake per capita from official web pages. Based on records of epidemiologic and demographic history, and alcohol intake data, we have calculated a General Immune Capacity (GIC) score for each country. Geographic latitude and climate factors were plotted against each of Covid-19 death numbers, epidemiologic and demographic parameters, and alcohol intake per capita. Data was analysed by simple linear regression or polynomial regression. All statistical data was collected using Microsoft Excell software (2016). Results : Our observational study found higher death numbers in the higher geographic latitudes of both hemispheres, while lower scores of deaths were registered in countries located around the equator line and low latitudes. When the Covid-19 death numbers were plotted against the geographic latitude of each country, an inverted bell-shaped curve was obtained (coefficient of determination R2=0.553). In contrast, bell-shaped curves were obtained when latitude was plotted against annual average temperature (coefficient of determination R2= 0.91), average annual sunshine hours (coefficient of determination R2= 0.79) and average annual UV index (coefficient of determination R2= 0.89). In addition, plotting the latitude of each country against the General Immune Capacity score of each country gave an inverted bell-shaped curve (coefficient of determination R2=0.755). Linear regression analysis of the General Immune Capacity score of each country and its Covid-19 deaths showed a very significant negative correlation (coefficient of determination R² = 0,71, p=6.79x10-9). Linear regression analysis of the Covid-19 death number plotted against the average annual temperature temperature and the average annual sunshine hours or the average annual UV index gave very significant negative correlations with the following coefficients of determination: (R2 = 0.69, p = 1.94x10-8), (R2 = 0.536, p = 6.31x10-6) and (R2 = 0.599, p = 8.30x10-7), respectively. Linear regression analysis of the General Immune Capacity score of each country plotted against its average annual temperature temperature and the average annual sunshine hours or the average annual UV index gave very significant negative correlations, with the following coefficients of determination: (R2 = 0.86, p = 3.63x10-13), (R2 = 0.69, p = 2.18x10-8) and (R2 = 0.77, p= 2.47x10-10), respectively. Conclusion : The results of the present study prove that at certain geographic latitudes and their three associated climate parameters are negatively correlated to Covid-19 mortality. On the other hand, our data showed that the General Immune Capacity score, which includes many human related parameters, is inversely correlated to Covid-19 mortality. Likewise, geographic location and health and demographic history were key elements in the prevalence of the Covid-19 pandemic in a given country. On the other hand, the study points to the possible protective role of UV light against Covid-19. The therapeutic potential of UV light against the Covid-19 associated with SARS-Cov-2 is discussed.

SPSS Data File Used in Analyses for Studies 1 and 2Related Publication: Li, N.P., Lim, A.J.Y., Tsai M.H. (2015) Too Materialistic to get Married and have Children? PLoS ONE 10(5): e0126543. http://dx.doi.org/10.1371/journal.pone.0126543. Full text available in InK: http://ink.library.smu.edu.sg/soss_research/1676/We developed new materials to induce a luxury mindset and activate materialistic values, and examined materialism’s relationship to attitudes toward marriage and having children in Singapore. Path analyses indicated that materialistic values led to more negative attitudes toward marriage, which led to more negative attitudes toward children, which in turn led to a decreased number of children desired. Results across two studies highlight, at the individual level, the tradeoff between materialistic values and attitudes toward marriage and procreation and suggest that a consideration of psychological variables such as materialistic values may allow for a better understanding of larger-scale socioeconomic issues including low fertility rates among developed countries. We discuss implications and describe how psychological factors relating to low fertility fit within evolutionary mismatch and life history theory frameworks.

The COVID-19 pandemic has been a major health concern in Bangladesh until very recently. Although the Bangladesh government has employed various infection control strategies, more targeted Non-Pharmaceutical interventions (NPIs), including school closure, mask-wearing, hand washing, and social distancing have gained special attention. Despite significant long-term adverse effects of school closures, authorities have opted to keep schools closed to curb the spread of COVID-19 infection. However, there is limited knowledge about the impact of reopening schools alongside other NPI measures on the course of the epidemic. In this study, we implemented a mathematical modeling framework developed by the CoMo Consortium to explore the impact of NPIs on the dynamics of the COVID-19 outbreak and deaths for Bangladesh. For robustness, the results of prediction models are then validated through model calibration with incidence and mortality data and using external sources. Hypothetical projections are made under alternative NPIs where we compare the impact of current NPIs with school closures versus enhanced NPIs with school openings. Results suggest that enhanced NPIs with schools opened may have lower COVID-19 related prevalence and deaths. This finding indicates that enhanced NPIs and school openings may mitigate the long-term negative impacts of COVID-19 in low- and middle-income countries. Potential shortcomings and ways to improve the research are also discussed.

Baby Formula Fat Market Outlook

The global baby formula fat market size is experiencing a significant expansion, with a projected increase from USD 15 billion in 2023 to approximately USD 25 billion by 2032, reflecting a robust compound annual growth rate (CAGR) of 6.5%. This remarkable growth trajectory is driven by a multitude of factors, chief among them being the rising awareness about infant nutrition and the increasing consumer inclination towards high-quality baby food products. The demand for baby formula fat is bolstered by the necessity to provide essential nutrients that mimic the nutritional profile of breast milk, which is critical during the early stages of an infant's development. The marketÂ’s expansion is also augmented by technological advancements in food science, enabling the production of more sophisticated formula compositions that cater to the diverse dietary needs of infants around the globe.

A significant growth factor for the baby formula fat market is the increasing global birth rates in developing regions. Countries in Asia and Africa, for instance, are experiencing demographic booms that are contributing to a higher demand for infant nutrition products. Moreover, the growing number of working mothers worldwide is necessitating the use of convenient and reliable alternatives to breastfeeding, further propelling the demand for high-quality baby formula. As urbanization and modernization sweep across various parts of the globe, families are increasingly seeking nutritionally complete, convenient solutions that cater to the evolving needs of their infants. This shift towards formula feeding is not solely driven by necessity but also by the rising disposable income, allowing parents to invest in premium baby formula products.

Another crucial factor contributing to the market growth is the increasing number of product innovations and investments in research and development. Manufacturers are focusing on enhancing the nutritional content of baby formulas by incorporating beneficial fats that are vital for brain development and overall health. This includes fortifying formulas with omega-3 and omega-6 fatty acids, which are critical for the development of the central nervous system. Furthermore, the market is also witnessing a surge in organic and non-GMO baby formula fat products, aligning with the global trend towards healthier and more sustainable food choices. These innovations are not only catering to the nutritional needs of infants but also addressing parental concerns regarding food safety and quality.

Regionally, Asia Pacific holds a substantial share in the baby formula fat market, driven by high birth rates and a burgeoning middle class. Countries like China and India are at the forefront, with increased consumer spending on infant nutrition products. North America and Europe also represent significant markets, with a steady demand for premium and specialized baby nutrition solutions. The demand in these regions is fueled by a well-informed consumer base that values nutritional content and quality. Meanwhile, markets in Latin America and the Middle East & Africa are emerging, with improving economic conditions and growing awareness about infant health advancing market growth in these regions.

In recent years, the role of Transfat in baby formula has been a topic of considerable discussion among nutritionists and health experts. Transfats, which are often found in processed foods, have been scrutinized for their potential negative health impacts. However, in the context of baby formula, manufacturers are increasingly focused on eliminating or significantly reducing Transfats to ensure the health and safety of infants. This shift aligns with the broader industry trend towards healthier, more natural ingredients. By minimizing Transfats, baby formula producers aim to provide a product that supports optimal infant growth and development, while also addressing parental concerns about food safety and nutrition.

Product Type Analysis

The baby formula fat market is segmented into various product types, including cow milk-based, soy-based, protein hydrolysate-based, and other formulations. Cow milk-based formulas are the most dominant segment, traditionally favored due to their close resemblance to human milk in terms of nutrient profile. This segment benefits from decades of research and development that have fine-tuned the formulation to support infant growth effectively. However, the cow milk-based segment is facing increasing competition from alternative formul

The 2003 Nigeria Demographic and Health Survey (2003 NDHS) is the third national Demographic and Health Survey conducted in Nigeria. The 2003 NDHS is based on a nationally representative sample of over 7,000 households. All women age 15-49 in these households and all men age 15-59 in a subsample of one-third of the households were individually interviewed. The survey provides up-to-date information on the population and health situation in Nigeria. The 2003 NDHS was designed to provide estimates for key indicators such as fertility, contraceptive use, infant and child mortality, immunization levels, use of family planning, maternal and child health, breastfeeding practices, nutritional status of mothers and young children, use of mosquito nets, female genital cutting, marriage, sexual activity, and awareness and behaviour regarding AIDS and other sexually transmitted infections in Nigeria. MAIN RESULTS FERTILITY Fertility Levels, Trends, and Preferences. The total fertility rate (TFR) in Nigeria is 5.7. This means that at current fertility levels, the average Nigerian woman who is at the beginning of her childbearing years will give birth to 5.7 children by the end of her lifetime. Compared with previous national surveys, the 2003 survey shows a modest decline in fertility over the last two decades: from a TFR of 6.3 in the 1981-82 National Fertility Survey (NFS) to 6.0 in the 1990 NDHS to 5.7 in the 2003 NDHS. However, the 2003 NDHS rate of 5.7 is significantly higher than the 1999 NDHS rate of 5.2. Analysis has shown that the 1999 survey underestimated the true levels of fertility in Nigeria. On average, rural women will have one more child than urban women (6.1 and 4.9, respectively). Fertility varies considerably by region of residence, with lower rates in the south and higher rates in the north. Fertility also has a strong negative correlation with a woman's educational attainment. Most Nigerians, irrespective of their number of living children, want large families. The ideal number of children is 6.7 for all women and 7.3 for currently married women. Nigerian men want even more children than women. The ideal number of children for all men is 8.6 and for currently married men is 10.6. Clearly, one reason for the slow decline in Nigerian fertility is the desire for large families. FAMILY PLANNING Knowledge of Family Planning Methods. About eight in ten women and nine in ten men know at least one modern method of family planning. The pill, injectables, and the male condom are the most widely known modern methods among both women and men. Mass media is an important source of information on family planning. Radio is the most frequent source of family planning messages: 40 percent of women and 56 percent of men say they heard a radio message about family planning during the months preceding the survey. However, more than half of women (56 percent) and 41 percent men were not exposed to family planning messages from a mass media source. Current Use. A total of 13 percent of currently married women are using a method of family planning, including 8 percent who are using a modern method. The most common modern methods are the pill, injectables, and the male condom (2 percent each). Urban women are more than twice as likely as rural women to use a method of contraception (20 percent versus 9 percent). Contraceptive use varies significantly by region. For example, one-third of married women in the South West use a method of contraception compared with just 4 percent of women in the North East and 5 percent of women in the North West. CHILD HEALTH Mortality. The 2003 NDHS survey estimates infant mortality to be 100 per 1,000 live births for the 1999-2003 period. This infant mortality rate is significantly higher than the estimates from both the 1990 and 1999 NDHS surveys; the earlier surveys underestimated mortality levels in certain regions of the country, which in turn biased downward the national estimates. Thus, the higher rate from the 2003 NDHS is more likely due to better data quality than an actual increase in mortality risk overall. The rural infant mortality rate (121 per 1,000) is considerably higher than the urban rate (81 per 1,000), due in large part to the difference in neonatal mortality rates. As in other countries, low maternal education, a low position on the household wealth index, and shorter birth intervals are strongly associated with increased mortality risk. The under-five mortality rate for the 1999-2003 period was 201 per 1,000. Vaccinations. Only 13 percent of Nigerian children age 12-23 months can be considered fully vaccinated, that is, have received BCG, measles, and three doses each of DPT and polio vaccine (excluding the polio vaccine given at birth). This is the lowest vaccination rate among African countries in which DHS surveys have been conducted since 1998. Less than half of children have received each of the recommended vaccinations, with the exception of polio 1 (67 percent) and polio 2 (52 percent). More than three times as many urban children as rural children are fully vaccinated (25 percent and 7 percent, respectively). WHO guidelines are that children should complete the schedule of recommended vaccinations by 12 months of age. In Nigeria, however, only 11 percent of children age 12-23 months received all of the recommended vaccinations before their first birthday. WOMEN'S HEALTH Breastfeeding. Breastfeeding is almost universal in Nigeria, with 97 percent of children born in the five years preceding the survey having been breastfed. However, just one-third of children were given breast milk within one hour of birth (32 percent), and less than two-thirds were given breast milk within 24 hours of birth (63 percent). Overall, the median duration of any breastfeeding is 18.6 months, while the median duration of exclusive breastfeeding is only half a month. Complementary Feeding. At age 6-9 months, the recommended age for introducing complementary foods, three-quarters of breast-feeding infants received solid or semisolid foods during the day or night preceding the interview; 56 percent received food made from grains, 25 percent received meat, fish, shellfish, poultry or eggs, and 24 percent received fruits or vegetables. Fruits and vegetables rich in vitamin A were consumed by 20 percent of breastfeeding infants age 6-9 months. Maternal Care. Almost two-thirds of mothers in Nigeria (63 percent) received some antenatal care (ANC) for their most recent live birth in the five years preceding the survey. While one-fifth of mothers (21 percent) received ANC from a doctor, almost four in ten women received care from nurses or midwives (37 percent). Almost half of women (47 percent) made the minimum number of four recommended visits, but most of the women who received antenatal care did not get care within the first three months of pregnancy. In terms of content of care, slightly more than half of women who received antenatal care said that they were informed of potential pregnancy complications (55 percent). Fifty-eight percent of women received iron tablets; almost two-thirds had a urine or blood sample taken; and 81 percent had their blood pressure measured. Almost half (47 percent) received no tetanus toxoid injections during their most recent birth. WOMEN'S CHARACTERISTICS AND STATUS Across all maternal care indicators, rural women are disadvantaged compared with urban women, and there are marked regional differences among women. Overall, women in the south, particularly the South East and South West, received better care than women in the north, especially women in the North East and North West. Female Circumcision. Almost one-fifth of Nigerian women are circumcised, but the data suggest that the practice is declining. The oldest women are more than twice as likely as the youngest women to have been circumcised (28 percent versus 13 percent). Prevalence is highest among the Yoruba (61 percent) and Igbo (45 percent), who traditionally reside in the South West and South East. Half of the circumcised respondents could not identify the type of procedure performed. Among those women who could identify the type of procedure, the most common type of circumcision involved cutting and removal of flesh (44 percent of all circumcised women). Four percent of women reported that their vaginas were sewn closed during circumcision. MALARIA CONTROL PROGRAM INDICATORS Nets. Although malaria is a major public health concern in Nigeria, only 12 percent of households report owning at least one mosquito net. Even fewer, 2 percent of households, own an insecticide treated net (ITN). Rural households are almost three times as likely as urban households to own at least one mosquito net. Overall, 6 percent of children under age five sleep under a mosquito net, including 1 percent of children who sleep under an ITN. Five percent of pregnant women slept under a mosquito net the night before the survey, one-fifth of them under an ITN. Use of Antimalarials. Overall, 20 percent of women reported that they took an antimalarial for prevention of malaria during their last pregnancy in the five years preceding the survey. Another 17 percent reported that they took an unknown drug, and 4 percent took paracetamol or herbs to prevent malaria. Only 1 percent received intermittent preventative treatment (IPT)-or preventive treatment with sulfadoxine-pyrimethamine (Fansidar/SP) during an antenatal care visit. Among pregnant women who took an antimalarial, more than half (58 percent) used Daraprim, which has been found to be ineffective as a chemoprophylaxis during pregnancy. Additionally, 39 percent used chloroquine, which was the chemoprophylactic drug of choice until the introduction of IPT in Nigeria in 2001. Among children who were sick with fever/convulsions, one-third took antimalarial drugs, the majority receiving the drugs

BackgroundCivil registration and vital statistics (CRVS) systems play a key role in upholding human rights and generating data for health and good governance. They also can help monitor progress in achieving the United Nations Sustainable Development Goals. Although many countries have made substantial progress in strengthening their CRVS systems, most low- and middle-income countries still have underdeveloped systems. The objective of this systematic review is to identify national policies that can help countries strengthen their systems.Methods and findingsThe ABI/INFORM, Embase, JSTOR, PubMed, and WHO Index Medicus databases were systematically searched for policies to improve birth and/or death registration on 24 January 2017. Global stakeholders were also contacted for relevant grey literature. For the purposes of this review, policies were categorised as supply, demand, incentive, penalty, or combination (i.e., at least two of the preceding policy approaches). Quantitative results on changes in vital event registration rates were presented for individual comparative articles. Qualitative systematic review methodology, including meta-ethnography, was used for qualitative syntheses on operational considerations encompassing acceptability to recipients and staff, human resource requirements, information technology or infrastructure requirements, costs to the health system, unintended effects, facilitators, and barriers. This study is registered with PROSPERO, number CRD42018085768. Thirty-five articles documenting experience in implementing policies to improve birth and/or death registration were identified. Although 25 countries representing all global regions (Africa, the Americas, Southeast Asia, the Western Pacific, Europe, and the Eastern Mediterranean) were reflected, there were limited countries from the Eastern Mediterranean and Europe regions. Twenty-four articles reported policy effects on birth and/or death registration. Twenty-one of the 24 articles found that the change in registration rate after the policy was positive, with two supply and one penalty articles being the exceptions. The qualitative syntheses identified 15 operational considerations across all policy categories. Human and financial resource requirements were not quantified. The primary limitation of this systematic review was the threat of publication bias wherein many countries may not have documented their experience; this threat is most concerning for policies that had neutral or negative effects.ConclusionsOur systematic review suggests that combination policy approaches, consisting of at least a supply and demand component, were consistently associated with improved registration rates in different geographical contexts. Operational considerations should be interpreted based on health system, governance, and sociocultural context. More evaluations and research are needed from the Eastern Mediterranean and Europe regions. Further research and evaluation are also needed to estimate the human and financial resource requirements required for different policies.

The European countries which saw the greatest population growth in 2025 were Gibraltar, Kosovo and Iceland. Overall, Europe's population declined by 3.3 percent in 2025, with this varying by region from a 0.19 percent decline in northern Europe to 4.6 percent in southern Europe. All the countries which saw the largest declines in their population in 2025 were central and eastern European countries.