Crude birth rates, age-specific fertility rates and total fertility rates (live births), 2000 to most recent year.

The Demographic and Health Surveys (DHS) are a major source for many demographic and health indicators in developing countries. Although these indicators are well defined in the literature, using survey data to calculate some of these indicators has never been an easy task for data users. This paper presents the DHS.rates software, a user-friendly R package developed to calculate fertility indicators, such as the total fertility rate, general fertility rate, and age-specific fertility rates, and childhood mortality indicators, such as the neonatal mortality rate, post-neonatal mortality rate, infant mortality rate, child mortality rate, and under-5 mortality rate, from the DHS data. The package allows for national and subnational indicators. In addition, the package calculates sampling error indicators such as standard error, design effect, relative standard error, and confidence interval for each demographic indicator. The package can also be used to calculate the same indicators from other population surveys such as the Multiple Indicator Cluster Survey (MICS).

Collective data of Japan's birth-related statistics from 1899 to 2022. Some data are missing between the years 1944 and 1946 due to records lost during World War II.

For use case and analysis reference, please take a look at this notebook Japan Birth Demographics Analysis

Feature Descriptions

• year: The year.
• birth_total: The total number of births.
• birth_male: The total number of male births.
• birth_female: The total number of female births.
• birth_rate: The birth rate. Equation is birth_total / population_total * 1,000
• birth_gender_ratio: The birth gender ratio. Equation is birth_male / birth_female * 1,000
• total_fertility_rate: The average number of children that are born to a woman over her lifetime.
• population_total: The total population.
• population_male: The total male population.
• population_female: The total female population.
• infant_death_total: The total infant deaths.
• infant_death_male: The total male infant deaths.
• infant_death_female: The total female infant deaths.
• infant_death_unknown_gender: The total unknown gender infant deaths.
• infant_death_rate: The infant death rate. Equation is infant_death_total / birth_total * 1,000
• infant_death_gender_ratio: The infant death gender ratio. Equation is infant_death_male / infant_death_female * 1,000
• infant_deaths_in_total_deaths: The infant death ratio among other deaths.
• stillbirth_total: The total number of stillbirths (dead born).
• stillbirth_male: The total number of male stillbirths.
• stillbirth_female: The total number of female stillbirths.
• stillbirth_unknown_gender: The total number of unknown gender stillbirths.
• stillbirth_rate: The stillbirth rate. Equation is stillbirth_total / (birth_total + stillbirth_total) * 1,000
• stillbirth_gender_ratio: The stillbirth gender ratio. Equation is stillbirth_male / stillbirth_female * 1,000
• firstborn: The number of firstborns.
• secondborn: The number of secondborns.
• thirdborn: The number of thirdborns.
• forthborn: The number of forthborns.
• fifthborn_and_above: The number of fifthborns and above.
• weeks_under_28: The number of births occurred under week 28. Early terms.
• weeks_28-31: The number of births occurred between weeks 28 and 31. Early terms.
• weeks_32-36: The number of births occurred between weeks 32 and 36. Early terms.
• weeks_37-41: The number of births occurred between weeks 37 and 41. Full terms.
• weeks_over_42: The number of births occurred over week 42. Late terms.
• mother_age_avg: The mother's average age.
• mother_age_firstborn: The mother's average age of the firstborn.
• mother_age_secondborn: The mother's average age of the secondborn.
• mother_age_thirdborn: The mother's average age of the thirdborn.
• mother_age_under_19: The number of births by mothers under age 19.
• mother_age_20-24: The number of births by mothers between age 20 and 24.
• mother_age_25-29: The number of births by mothers between age 25 and 29.
• mother_age_30-34: The number of births by mothers between age 30 and 34.
• mother_age_35-39: The number of births by mothers between age 35 and 39.
• mother_age_40-44: The number of births by mothers between age 40 and 44.
• mother_age_over_45: The number of births by mothers over 45.
• father_age_avg: The father's average age.
• father_age_firstborn: The father's average age of the firstborn.
• father_age_secondborn: The father's average age of the secondborn.
• father_age_thirdborn: The father's average age of the thirdborn.
• legitimate_child: The Number of births under married parents.
• illegitimate_child: The number of births under non-married parents.

Acknowledgement

E-Stat Demographic Survey

Abstract

The 1993 Turkish Demographic and Health Survey (TDHS) is a nationally representative survey of ever-married women less than 50 years old. The survey was designed to provide information on fertility levels and trends, infant and child mortality, family planning, and maternal and child health. The TDHS was conducted by the Hacettepe University Institute of Population Studies under a subcontract through an agreement between the General Directorate of Mother and Child Health and Family Planning, Ministry of Health and Macro International Inc. of Calverton, Maryland. Fieldwork was conducted from August to October 1993. Interviews were carried out in 8,619 households and with 6,519 women.

The Turkish Demographic and Health Survey (TDHS) is a national sample survey of ever-married women of reproductive ages, designed to collect data on fertility, marriage patterns, family planning, early age mortality, socioeconomic characteristics, breastfeeding, immunisation of children, treatment of children during episodes of illness, and nutritional status of women and children. The TDHS, as part of the international DHS project, is also the latest survey in a series of national-level population and health surveys in Turkey, which have been conducted by the Institute of Population Studies, Haeettepe University (HIPS).

More specifically, the objectives of the TDHS are to:

Collect data at the national level that will allow the calculation of demographic rates, particularly fertility and childhood mortality rates; Analyse the direct and indirect factors that determine levels and trends in fertility and childhood mortality; Measure the level of contraceptive knowledge and practice by method, region, and urban- rural residence; Collect data on mother and child health, including immunisations, prevalence and treatment of diarrhoea, acute respiratory infections among children under five, antenatal care, assistance at delivery, and breastfeeding; Measure the nutritional status of children under five and of their mothers using anthropometric measurements.

The TDHS information is intended to assist policy makers and administrators in evaluating existing programs and in designing new strategies for improving family planning and health services in Turkey.

MAIN RESULTS

Fertility in Turkey is continuing to decline. If Turkish women maintain current fertility rates during their reproductive years, they can expect to have all average of 2.7 children by the end of their reproductive years. The highest fertility rate is observed for the age group 20-24. There are marked regional differences in fertility rates, ranging from 4.4 children per woman in the East to 2.0 children per woman in the West. Fertility also varies widely by urban-rural residence and by education level. A woman living in rural areas will have almost one child more than a woman living in an urban area. Women who have no education have almost one child more than women who have a primary-level education and 2.5 children more than women with secondary-level education.

The first requirement of success ill family planning is the knowledge of family planning methods. Knowledge of any method is almost universal among Turkish women and almost all those who know a method also know the source of the method. Eighty percent of currently married women have used a method sometime in their life. One third of currently married women report ever using the IUD. Overall, 63 percent of currently married women are currently using a method. The majority of these women are modern method users (35 percent), but a very substantial proportion use traditional methods (28 percent). the IUD is the most commonly used modern method (I 9 percent), allowed by the condom (7 percent) and the pill (5 percent). Regional differences are substantial. The level of current use is 42 percent in tile East, 72 percent in tile West and more than 60 percent in tile other three regions. "File common complaints about tile methods are side effects and health concerns; these are especially prevalent for the pill and IUD.

One of the major child health indicators is immunisation coverage. Among children age 12-23 months, the coverage rates for BCG and the first two doses of DPT and polio were about 90 percent, with most of the children receiving those vaccines before age one. The results indicate that 65 percent of the children had received all vaccinations at some time before the survey. On a regional basis, coverage is significantly lower in the Eastern region (41 percent), followed by the Northern and Central regions (61 percent and 65 percent, respectively). Acute respiratory infections (ARI) and diarrhea are the two most prevalent diseases of children under age five in Turkey. In the two weeks preceding the survey, the prevalence of ARI was 12 percent and the prevalence of diarrhea was 25 percent for children under age five. Among children with diarrhea 56 percent were given more fluids than usual.

Breastfeeding in Turkey is widespread. Almost all Turkish children (95 percent) are breastfed for some period of time. The median duration of breastfeeding is 12 months, but supplementary foods and liquids are introduced at an early age. One-third of children are being given supplementary food as early as one month of age and by the age of 2-3 months, half of the children are already being given supplementary foods or liquids.

By age five, almost one-filth of children arc stunted (short for their age), compared to an international reference population. Stunting is more prevalent in rural areas, in the East, among children of mothers with little or no education, among children who are of higher birth order, and among those born less than 24 months after a prior birth. Overall, wasting is not a problem. Two percent of children are wasted (thin for their height), and I I percent of children under five are underweight for their age. The survey results show that obesity is d problem among mothers. According to Body Mass Index (BMI) calculations, 51 percent of mothers are overweight, of which 19 percent are obese.

Geographic coverage

The Turkish Demographic and Health Survey (TDHS) is a national sample survey.

Analysis unit

• Household
• Women age 12-49
• Children under five

Universe

The population covered by the 1993 DHS is defined as the universe of all ever-married women age 12-49 who were present in the household on the night before the interview were eligible for the survey.

Kind of data

Sample survey data

Sampling procedure

The sample for the TDHS was designed to provide estimates of population and health indicators, including fertility and mortality rates for the nation as a whole, fOr urban and rural areas, and for the five major regions of the country. A weighted, multistage, stratified cluster sampling approach was used in the selection of the TDHS sample.

Sample selection was undertaken in three stages. The sampling units at the first stage were settlements that differed in population size. The frame for the selection of the primary sampling units (PSUs) was prepared using the results of the 1990 Population Census. The urban frame included provinces and district centres and settlements with populations of more than 10,000; the rural frame included subdistricts and villages with populations of less than 10,000. Adjustments were made to consider the growth in some areas right up to survey time. In addition to the rural-urban and regional stratifications, settlements were classified in seven groups according to population size.

The second stage of selection involved the list of quarters (administrative divisions of varying size) for each urban settlement, provided by the State Institute of Statistics (SIS). Every selected quarter was subdivided according tothe number of divisions(approximately 100 households)assigned to it. In rural areas, a selected village was taken as a single quarter, and wherever necessary, it was divided into subdivisions of approximately 100 households. In cases where the number of households in a selected village was less than 100 households, the nearest village was selected to complete the 100 households during the listing activity, which is described below.

After the selection of the secondary sampling units (SSUs), a household listing was obtained for each by the TDHS listing teams. The listing activity was carried out in May and June. From the household lists, a systematic random sample of households was chosen for the TDHS. All ever-married women age 12-49 who were present in the household on the night before the interview were eligible for the survey.

Mode of data collection

Face-to-face

Research instrument

Two questionnaires were used in the main fieldwork for the TDHS: the Household Questionnaire and the Individual Questionnaire for ever-married women of reproductive age. The questionnaires were based on the model survey instruments developed in the DHS program and on the questionnaires that had been employed in previous Turkish population and health surveys. The questionnaires were adapted to obtain data needed for program planning in Turkey during consultations with population and health agencies. Both questionnaires were developed in English and translated into Turkish.

a) The Household Questionnaire was used to enumerate all usual members of and visitors to the selected households and to collect information relating to the socioeconomic position of the households. In the first part of the Household Questionnaire, basic information was collected on the age, sex, educational attainment, marital status and relationship to the head of household for each person listed as a household member

Pre-pandemic (data of 2019) epidemiologic and demographic data have shown that some parameters such as cancer, Alzheimer's disease, advanced age, and alcohol intake levels are positively correlated to Covid-19 mortality, instead, birth and fertility rates are negatively correlated to Covid-19 mortality. A stepwise multiple regression analysis of the above parameters against Covid-19 mortality in 32 countries from Asia, America, Africa, and Europe has generated two main predictors of Covid-19 mortality: alcohol consumption and birth/mortality ratio. A first-order equation correlated alcohol intake to Covid-19 mortality as follows; Covid-19 mortality= 0.1057 x (liters of alcohol intake) + 0.2214 (Coefficient of determination = 0.750, F value = 38.63 , P-value = 7.64x10-7). A second equation correlated (birth rate/mortality rate) to Covid-19 mortality as follows; Covid-19 mortality= - 0.3129 x (birth rate/mortality) ratio +1.638 (coefficient of determination = 0.799, F value = 51.2, P-value = 7.09x10-8). Thus, pre-pandemic alcohol consumption is a high predictor of Covid-19 mortality that should be taken into account as a serious risk factor for future safety measures against SARS-CoV-2 infection.

Background: Standard pediatric growth curves cannot be used to impute missing height or weight measurements in individual children. The Michaelis-Menten equation, used for characterizing substrate-enzyme saturation curves, has been shown to model growth in many organisms including nonhuman vertebrates. We investigated whether this equation could be used to interpolate missing growth data in children in the first three years of life and compared this interpolation to several common interpolation methods and pediatric growth models. Methods: We developed a modified Michaelis-Menten equation and compared expected to actual growth, first in a local birth cohort (N=97) and then in a large, outpatient, pediatric sample (N=14,695). Results: The modified Michaelis-Menten equation showed excellent fit for both infant weight (median RMSE: boys: 0.22kg [IQR:0.19; 90%<0.43]; girls: 0.20kg [IQR:0.17; 90%<0.39]) and height (median RMSE: boys: 0.93cm [IQR:0.53; 90%<1.0]; girls: 0.91cm [IQR:0.50;90%<1.0]). Growth data were modeled accurately with as few as four values from routine well-baby visits in year 1 and seven values in years 1-3; birth weight or length was essential for best fit. Interpolation with this equation had comparable (for weight) or lower (for height) mean RMSE compared to the best-performing alternative models. Conclusions: A modified Michaelis-Menten equation accurately describes growth in healthy babies aged 0–36 months, allowing interpolation of missing weight and height values in individual longitudinal measurement series. The growth pattern in healthy babies in resource-rich environments mirrors an enzymatic saturation curve. Methods Sources of data: Information on infants was ascertained from two sources: the STORK birth cohort and the STARR research registry. (1) Detailed methods for the STORK birth cohort have been described previously. In brief, a multiethnic cohort of mothers and babies was followed from the second trimester of pregnancy to the babies’ third birthday. Healthy women aged 18–42 years with a single-fetus pregnancy were enrolled. Households were visited every four months until the baby’s third birthday (nine baby visits), with the weight of the baby at each visit recorded in pounds. Medical charts were abstracted for birth weight and length. (2) STARR (starr.stanford.edu) contains electronic medical record information from all pediatric and adult patients seen at Stanford Health Care (Stanford, CA). STARR staff provided anonymized information (weight, height and age in days for each visit through age three years; sex; race/ethnicity) for all babies during the period 03/2013–01/2022 followed from birth to at least 36 months of age with at least five well-baby care visits over the first year of life.
Inclusion of data for modeling: All observed weight and height values were evaluated in kilograms (kg) and centimeters (cm), respectively. Any values assessed beyond 1,125 days (roughly 36 months) and values for height and weight deemed implausible by at least two reviewers (e.g., significant losses in height, or marked outliers for weight and height) were excluded from the analysis. Additionally, weights assessed between birth and 19 days were excluded. At least five observations across the 36-month period were required: babies with fewer than five weight or height values after the previous criteria were excluded from analyses. Model: We developed our weight model using values from STORK babies and then replicated it with values from the STARR babies. Height models were evaluated in STARR babies only because STORK data on height were scant. The Michaelis-Menten equation is described as follows: v = Vmax ([S]/(Km + [S]) , where v is the rate of product formation, Vmax is the maximum rate of the system, [S] is the substrate concentration, and Km is a constant based upon the enzyme’s affinity for the particular substrate. For this study the equation became: P = a1 (Age/(b1+ Age)) + c1, where P was the predicted value of weight (kg) or height (cm), Age was the age of the infant in days, and c1 was an additional constant over the original Michaelis-Menten equation that accounted for the infant’s non-zero weight or length at birth. Each of the parameters a1, b1 and c1 was unique to each child and was calculated using the nonlinear least squares (nls) method. In our case, weight data were fitted to a model using the statistical language R, by calling the formula nls() with the following parameters: fitted_model <-nls(weights~(c1+(a1*ages)/(b1+ages)), start = list(a1 = 5, b1 = 20, c1=2.5)), where weights and ages were vectors of each subject’s weight in kg and age in days. The default Gauss-Newton algorithm was used. The optimization objective is not convex in the parameters and can suffer from local optima and boundary conditions. In such cases good starting values are essential: the starting parameter values (a1=5, b1=20, c1=2.5) were adjusted manually using the STORK dataset to minimize model failures; these tended to occur when the parameter values, particularly a1 and b1, increased without bound during the iterative steps required to optimize the model. These same parameter values were used for the larger STARR dataset. The starting height parameter values for height modeling were higher than those for weight modeling, due to the different units involved (cm vs. kg) (a1=60, b1=530, c1=50). Because this was a non-linear model, goodness of fit was assessed primarily via root mean squared error (RMSE) for both weight and height. Imputation tests: To test for the influence of specific time points on the models, we limited our analysis to STARR babies with all recommended well-baby visits (12 over three years). Each scheduled visit except day 1 occurred in a time window around the expected well-baby visit (Visit1: Day 1, Visit2: days 20–44, Visit3: 46–90, Visit4: 95–148, Visit5: 158–225, Visit6: 250–298, Visit7: 310–399, Visit8: 410–490, Visit9: 500–600, Visit10: 640–800, Visit11: 842–982, Visit12: 1024–1125). We considered two different sets: infants with all scheduled visits in the first year of life (seven total visits) and those with all scheduled visits over the full three-year timeframe (12 total visits). We fit these two sets to the model, identifying baseline RMSE. Then, every visit, and every combination of two to five visits were dropped, so that the RMSE or model failures for a combination of visits could be compared to baseline. Prediction: We sought to predict weight or height at 36 months (Y3) from growth measures assessed only up to 12 months (Y1) or to 24 months (Y1+Y2), utilizing the “last value” approach. In brief, the last observation for each child (here, growth measures at 36 months) is used to assess overall model fit, by focusing on how accurately the model can extrapolate the measure at this time point. We identified all STARR infants with at least five time points in Y1 and at least two time points in both Y2 and Y3, with the selection of these time points based on maximizing the number of later time points within the constraints of the well-baby visit schedule for Y2 and Y3. The per-subject set of time points (Y1-Y3) was fitted using the modified Michaelis-Menten equation and the mean squared error was calculated, acting as the “baseline” error. The model was then run on the subset of Y1 only and of Y1+Y2 only. To test predictive accuracy of these subsets, the RMSE was calculated using the actual weights or heights versus the predicted weights or heights of the three time series. Comparison with other models: We examined how well the modified Michaelis-Menten equation performed interpolation in STARR babies compared to ten other commonly used interpolation methods and pediatric growth models including: (1) the ‘last observation carried forward’ model; (2) the linear model; (3) the robust linear model (RLM method, base R MASS package); (4) the Laird and Ware linear model (LWMOD method); (5) the generalized additive model (GAM method); (6) locally estimated scatterplot smoothing (LOESS method, base R stats package); (7) the smooth spline model (smooth.spline method, base R stats package); (8) the multilevel spline model (Wand method); (9) the SITAR (superimposition by translation and rotation) model and (10) fast covariance estimation (FACE method). Model fit used the holdout approach: a single datapoint (other than birth weight or birth length) was randomly removed from each subject, and the RMSE of the removed datapoint was calculated as the model fitted to the remaining data. The hbgd package was used to fit all models except the ‘last observation carried forward’ model, the linear model and the SITAR model. For the ‘last observation carried forward’ model, the holdout data point was interpolated by the last observation by converting the random holdout value to NA and then using the function na.locf() from the zoo R package. For the simple linear model, the holdout-filtered data were used to determine the slope and intercept via R’s lm() function, which were then used to calculate the holdout value. For the SITAR model, each subject was fitted by calling the sitar() function with df=2 to minimize failures, and the RMSE of the random holdout point was subsequently calculated with the predict() function. For this analysis, set.seed(1234) was used to initialize the pseudorandom generator.

In 2023, the crude birth rate in live births per 1,000 inhabitants in the Philippines stood at 16.02. Between 1960 and 2023, the figure dropped by 31.14, though the decline followed an uneven course rather than a steady trajectory.

Comparison of the total scores of the fertility decision model by socio-demographic variables.

As China continues to implement its progressive fertility promotion policy, there has been a drastic decline in the fertility rate. Given that the migrant population constitutes more than a quarter of China’s total population, enhancing the willingness of this demographic to have additional children through policy-guided urban public services is pivotal for optimizing China’s population development strategy. This study analyzes the influence of urban public services on the reproductive intentions of the migrant population, utilizing data from 110,667 migrant families with one child, drawn from China’s Migrant Population Dynamic Monitoring data in 2016 and 2018. The data analysis reveals several key findings: (1) Urban public services, overall, exhibit a notable positive effect on the willingness of the migrant population to have more children, albeit with limitations and a declining trend. (2) Among urban public services, primary basic education significantly impacts the willingness of the migrant population to expand their families. (3) Large cities have created a ’reverse screening’ effect on the migrant population, leading to differential access to public services. This scenario caters effectively to the high human capital migrant individuals while reducing accessibility to livelihood public services for the low human capital migrant population. This paper critically evaluates China’s progressively adjusted fertility policy from the perspective of the migrant population. It underscores the necessity of establishing a comprehensive fertility support policy system across China.

This dataset contains California’s adolescent birth rate (ABR) by county, age group and race/ethnicity using aggregated years 2014-2016. The ABR is calculated as the number of live births to females aged 15-19 divided by the female population aged 15-19, multiplied by 1,000. Births to females under age 15 are uncommon and thus added to the numerator (total number of births aged 15-19) in calculating the ABR for aged 15-19. The categories by age group are aged 18-19 and aged 15-17; births occurring to females under aged 15 are added to the numerator for aged 15-17 in calculating the ABR for this age group. The race and ethnic groups in this table utilized five mutually exclusive race and ethnicity categories. These categories are Hispanic and the following Non-Hispanic categories of Multi-Race, Black, American Indian (includes Eskimo and Aleut), Asian and Pacific Islander (includes Hawaiian) combined, and White. Note that there are birth records with missing race/ethnicity or categorized as “Other” and not shown in the dataset but included in the ABR calculation overall.

This is the supplementary dataset S8 to the paper "How to quantify heavy mineral fertility from point-counting data". The table contains an example of the stepwise calculation of mineral fertility (in this case for apatite and zircon) from grain diameters measured in 2D phase maps or area%.

Abstract

The JPFHS is part of the worldwide Demographic and Health Surveys (DHS) program, which is designed to collect data on fertility, family planning, and maternal and child health.

The 1990 Jordan Population and Family Health Survey (JPFHS) was carried out as part of the Demographic and Health Survey (DHS) program. The Demographic and Health Surveys is assisting governments and private agencies in the implementation of household surveys in developing countries.

The JPFIS was designed to provide information on levels and trends of fertility, infant and child mortality, and family planning. The survey also gathered information on breastfeeding, matemal and child health cam, the nutritional status of children under five, as well as the characteristics of households and household members.

The main objectives of the project include: a) Providing decision makers with a data base and analyses useful for informed policy choices, b) Expanding the international population and health data base, c) Advancing survey methodology, and d) Developing skills and resources necessary to conduct high quality demographic and health surveys in the participating countries.

Geographic coverage

National

Analysis unit

• Household
• Children under five years
• Women age 15-49
• Men

Kind of data

Sample survey data

Sampling procedure

The sample for the JPFHS survey was selected to be representative of the major geographical regions, as well as the nation as a whole. The survey adopted a stratified, multi-stage sampling design. In each governorate, localities were classified into 9 strata according to the estimated population size in 1989. The sampling design also allowed for the survey results to be presented according to major cities (Amman, Irbid and Zarqa), other urban localities, and the rural areas. Localities with fewer than 5,000 people were considered rural.

For this survey, 349 sample units were drawn, containing 10,708 housing units for the individual interview. Since the survey used a separate household questionnaire, the Department of Statistics doubled the household sample size and added a few questions on labor force, while keeping the original individual sample intact. This yielded 21,172 housing units. During fieldwork for the household interview, it was found that 4,359 household units were ineligible either because the dwelling was vacant or destroyed, the household was absent during the team visit, or some other reason. There were 16,296 completed household interviews out of 16,813 eligible households, producing a response rate of 96.9 percent.

The completed household interviews yielded 7,246 women eligible for the individual interview, of which 6,461 were successfully interviewed, producing a response rate of 89.2 percent.

Note: See detailed description of sample design in APPENDIX A of the survey report.

Mode of data collection

Face-to-face

Research instrument

The 1990 JPFIS utilized two questionnaires, one for the household interview and the other for individual women. Both questionnaires were developed first in English and then translated into Arabic. The household questionnaire was used to list all members of the sample households, including usual residents as well as visitors. For each member of the household, basic demographic and socioeconomic characteristics were recorded and women eligible for the individual interview were identified. To be eligible for individual interview, a woman had to be a usual member of the household (part of the de jure population), ever-married, and between 15 and 49 years of age. The household questionnaire was expanded from the standard DHS-II model questionnaire to facilitate the estimation of adult mortality using the orphanhood and widowhood techniques. In addition, the questionnaire obtained information on polygamy, economic activity of persons 15 years of age and over, family type, type of insurance covering the household members, country of work in the summer of 1990 which coincided with the Gulf crisis, and basic data for the calculation of the crude birth rate and the crude death rate. Additional questions were asked about deceased women if they were ever-married and age 15-49, in order to obtain information for the calculation of materoal mortality indices.

The individual questionnaire is a modified version of the standard DHS-II model "A" questionnaire. Experience gained from previous surveys, in particular the 1983 Jordan Fertility and Family Health Survey, and the questionnaire developed by the Pan Arab Project for Child Development (PAPCHILD), were useful in the discussions on the content of the JPFHS questionnaire. A major change from the DHS-II model questionnaire was the rearrangement of the sections so that the marriage section came before reproduction; this allowed the interview to flow more smoothly. Questions on children's cause of death based on verbal autopsy were added to the section on health, which, due to its size, was split into two parts. The first part focused on antenatal care and breastfeeding; the second part examined measures for prevention of childhood diseases and information on the morbidity and mortality of children loom since January 1985. As questions on sexual relations were considered too sensitive, they were replaced by questions about the husband's presence in the household during the specified time period; this served as a proxy for recent sexual activity.

The JPFHS individual questionnaire consists of nine sections: - Respondent's background and household characteristics - Marriage - Reproduction - Contraception - Breastfeeding and health - Immunization, morbidity, and child mortality - Fertility preferences - Husband's background, residence, and woman's work - Height and weight of children

Response rate

For the individual interview, the number of eligible women found in the selected households and the number of women successfully interviewed are presented. The data indicate a high response rate for the household interview (96.9 percent), and a lower rate for the individual interview (89.2 percent). Women in large cities have a slightly lower response rate (88.6 percent) than those in other areas. Most of the non-response for the individual interview was due to the absence of respondents and the postponement of interviews which were incomplete.

Note: See summarized response rates by place of residence in Table 1.1 of the survey report.

Sampling error estimates

The results from sample surveys are affected by two types of errors, non-sampling error and sampling error. Nonsampling error is due to mistakes made in carrying out field activities, such as failure to locate and interview the correct household, errors in the way the questions are asked, misunderstanding on the part of either the interviewer or the respondent, data entry errors, etc. Although efforts were made during the design and implementation of the JPFHS to minimize this type of error, non-sampling errors are impossible to avoid and difficult to evaluate statistically

Sampling errors, on the other hand, can be measured statistically. The sample of women selected in the JPFHS is only one of many samples that could have been selected from the same population, using the same design and expected size. Each one would have yielded results that differed somewhat from the actual sample selected. The sampling error is a measure of the variability between all possible samples; although it is not known exactly, it can be estimated from the survey results.

Sampling error is usually measured in terms of standard error of a particular statistic (mean, percentage, etc.), which is the square root of the variance. The standard error can be used to calculate confidence intervals within which one can reasonably assured that, apart from nonsampling errors, the true value of the variable for the whole population falls. For example, for any given statistic calculated from a sample survey, the value of that same statistic as measured in 95 percent of all possible samples with the same design (and expected size) will fall within a range of plus or minus two times the standard error of that statistic.

If the sample of women had been selected as a simple random sample, it would have been possible to use straightforward formulas for calculating sampling errors. However, the JPFI-IS sample design depended on stratification, stages and clusters. Consequently, it was necessary to utilize more complex formulas. The computer package CLUSTERS, developed by the International Statistical Institute for the World Fertility Survey, was used to assist in computing the sampling errors with the proper statistical methodology.

Note: See detailed estimate of sampling error calculation in APPENDIX B of the survey report.

Data appraisal

Data Quality Tables - Household age distribution - Age distribution of eligible and interviewed women - Completeness of reporting - Births by calendar year since birth - Reporting of age at death in days - Reporting of age at death in months

Note: See detailed tables in APPENDIX C of the report which is presented in this documentation.

Abstract

The 1995 Uganda Demographic and Health Survey (UDHS-II) is a nationally-representative survey of 7,070 women age 15-49 and 1,996 men age 15-54. The UDHS was designed to provide information on levels and trends of fertility, family planning knowledge and use, infant and child mortality, and maternal and child health. Fieldwork for the UDHS took place from late-March to mid-August 1995. The survey was similar in scope and design to the 1988-89 UDHS. Survey data show that fertility levels may be declining, contraceptive use is increasing, and childhood mortality is declining; however, data also point to several remaining areas of challenge.

The 1995 UDHS was a follow-up to a similar survey conducted in 1988-89. In addition to including most of the same questions included in the 1988-89 UDHS, the 1995 UDHS added more detailed questions on AIDS and maternal mortality, as well as incorporating a survey of men. The general objectives of the 1995 UDHS are to: - provide national level data which will allow the calculation of demographic rates, particularly fertility and childhood mortality rates; - analyse the direct and indirect factors which determine the level and trends of fertility; - measure the level of contraceptive knowledge and practice (of both women and men) by method, by urban-rural residence, and by region; - collect reliable data on maternal and child health indicators; immunisation, prevalence, and treatment of diarrhoea and other diseases among children under age four; antenatal visits; assistance at delivery; and breastfeeding; - assess the nutritional status of children under age four and their mothers by means of anthropometric measurements (weight and height), and also child feeding practices; and - assess among women and men the prevailing level of specific knowledge and attitudes regarding AIDS and to evaluate patterns of recent behaviour regarding condom use.

MAIN RESULTS

• Fertility:

Fertility Trends. UDHS data indicate that fertility in Uganda may be starting to decline. The total fertility rate has declined from the level of 7.1 births per woman that prevailed over the last 2 decades to 6.9 births for the period 1992-94. The crude birth rate for the period 1992-94 was 48 live births per I000 population, slightly lower than the level of 52 observed from the 1991 Population and Housing Census. For the roughly 80 percent of the country that was covered in the 1988-89 UDHS, fertility has declined from 7.3 to 6.8 births per woman, a drop of 7 percent over a six and a half year period.

Birth Intervals. The majority of Ugandan children (72 percent) are born after a "safe" birth interval (24 or more months apart), with 30 percent born at least 36 months after a prior birth. Nevertheless, 28 percent of non-first births occur less than 24 months after the preceding birth, with 10 percent occurring less than 18 months since the previous birth. The overall median birth interval is 29 months. Fertility Preferences. Survey data indicate that there is a strong desire for children and a preference for large families in Ugandan society. Among those with six or more children, 18 percent of married women want to have more children compared to 48 percent of married men. Both men and women desire large families.

• Family planning:

Knowledge of Contraceptive Methods. Knowledge of contraceptive methods is nearly universal with 92 percent of all women age 15-49 and 96 percent of all men age 15-54 knowing at least one method of family planning. Increasing Use of Contraception. The contraceptive prevalence rate in Uganda has tripled over a six-year period, rising from about 5 percent in approximately 80 percent of the country surveyed in 1988-89 to 15 percent in 1995.

Source of Contraception. Half of current users (47 percent) obtain their methods from public sources, while 42 percent use non-governmental medical sources, and other private sources account for the remaining 11 percent.

• Maternal and child health:

High Childhood Mortality. Although childhood mortality in Uganda is still quite high in absolute terms, there is evidence of a significant decline in recent years. Currently, the direct estimate of the infant mortality rate is 81 deaths per 1,000 births and under five mortality is 147 per 1,000 births, a considerable decline from the rates of 101 and 180, respectively, that were derived for the roughly 80 percent of the country that was covered by the 1988-89 UDHS.

Childhood Vaccination Coverage. One possible reason for the declining mortality is improvement in childhood vaccination coverage. The UDHS results show that 47 percent of children age 12-23 months are fully vaccinated, and only 14 percent have not received any vaccinations.

Childhood Nutritional Status. Overall, 38 percent of Ugandan children under age four are classified as stunted (low height-for-age) and 15 percent as severely stunted. About 5 percent of children under four in Uganda are wasted (low weight-for-height); 1 percent are severely wasted. Comparison with other data sources shows little change in these measures over time.

• AIDS:

Virtually all women and men in Uganda are aware of AIDS. About 60 percent of respondents say that limiting the number of sexual partners or having only one partner can prevent the spread of disease. However, knowledge of ways to avoid AIDS is related to respondents' education. Safe patterns of sexual behaviour are less commonly reported by respondents who have little or no education than those with more education. Results show that 65 percent of women and 84 percent of men believe that they have little or no chance of being infected.

Availability of Health Services. Roughly half of women in Uganda live within 5 km of a facility providing antenatal care, delivery care, and immunisation services. However, the data show that children whose mothers receive both antenatal and delivery care are more likely to live within 5 km of a facility providing maternal and child health (MCH) services (70 percent) than either those whose mothers received only one of these services (46 percent) or those whose mothers received neither antenatal nor delivery care (39 percent).

Geographic coverage

The 1995 Uganda Demographic and Health Survey (UDHS-II) is a nationally-representative survey. For the purpose of the 1995 UDHS, the following domains were utilised: Uganda as a whole; urban and rural areas separately; each of the four regions: Central, Eastern, Northern, and Western; areas in the USAID-funded DISH project to permit calculation of contraceptive prevalence rates.

Analysis unit

• Household
• Women age 15-49
• Men age 15-54
• Children under four

Universe

The population covered by the 1995 UDHS is defined as the universe of all women age 15-49 in Uganda. But because of insecurity, eight EAs could not be surveyed (six in Kitgum District, one in Apac District, and one in Moyo District). An additional two EAs (one in Arua and one in Moroto) could not be surveyed, but substitute EAs were selected in their place.

Kind of data

Sample survey data

Sampling procedure

A sample of 303 primary sampling units (PSU) consisting of enumeration areas (EAs) was selected from a sampling frame of the 1991 Population and Housing Census. For the purpose of the 1995 UDHS, the following domains were utilised: Uganda as a whole; urban and rural areas separately; each of the four regions: Central, Eastern, Northern, and Western; areas in the USAID-funded DISH project to permit calculation of contraceptive prevalence rates.

Districts in the DISH project area were grouped by proximity into the following five reporting domains: - Kasese and Mbarara Districts - Masaka and Rakai Districts - Luwero and Masindi Districts - Jinja and Kamuli Districts - Kampala District

The sample for the 1995 UDHS was selected in two stages. In the first stage, 303 EAs were selected with probability proportional to size. Then, within each selected EA, a complete household listing and mapping exercise was conducted in December 1994 forming the basis for the second-stage sampling. For the listing exercise, 11 listers from the Statistics Department were trained. Institutional populations (army barracks, hospitals, police camps, etc.) were not listed.

From these household lists, households to be included in the UDHS were selected with probability inversely proportional to size based on the household listing results. All women age 15-49 years in these households were eligible to be interviewed in the UDHS. In one-third of these selected households, all men age 15-54 years were eligible for individual interview as well. The overall target sample was 6,000 women and 2,000 men. Because of insecurity, eight EAs could not be surveyed (six in Kitgum District, one in Apac District, and one in Moyo District). An additional two EAs (one in Arua and one in Moroto) could not be surveyed, but substitute EAs were selected in their place.

Since one objective of the survey was to produce estimates of specific demographic and health indicators for the areas included in the DISH project, the sample design allowed for oversampling of households in these districts relative to their actual proportion in the population. Thus, the 1995 UDHS sample is not self-weighting at the national level; weights are required to estimate national-level indicators. Due to the weighting factor and rounding of estimates, figures may not add to totals. In addition, the percent total may not add to 100.0 due to rounding.

Mode of data collection

Face-to-face

Research instrument

Four questionnaires were used in the 1995 UDHS.

a) A Household Schedule was used to list the names and certain

Total first marriage rates and age-specific first marriage rates per 1,000 females, all marriages, by place of occurrence, 2000 to 2004.

Abstract

The 1992 Namibia Demographic and Health Survey (NDHS) is a nationally representative survey conducted by the Ministry of Health and Social Services, assisted by the Central Statistical Office, with the aim of gathering reliable information on fertility, family planning, infant and child mortality, maternal mortality, maternal and child health and nutrition. Interviewers collected information on the reproductive histories of 5,421 women 15-49 years and on the health of 3,562 children under the age of five years.

The Namibia Demographic and Health Survey (NDHS) is a national sample survey of women of reproductive age designed to collect data on mortality and fertility, socioeconomic characteristics, marriage patterns, breastfeeding, use of contraception, immunisation of children, accessibility to health and family planning services, treatment of children during episodes of illness, and the nutritional status of women and children. More specifically, the objectives of NDHS are: - To collect data at the national level which will allow the calculation of demographic rates, particularly fertility rates and child mortality rates, and maternal mortality rates; To analyse the direct and indirect factors which determine levels and trends in fertility and childhood mortality, Indicators of fertility and mortality are important in planning for social and economic development; - To measure the level of contraceptive knowledge and practice by method, region, and urban/rural residence; - To collect reliable data on family health: immunisations, prevalence and treatment of diarrhoea and other diseases among children under five, antenatal visits, assistance at delivery and breastfeeding; - To measure the nutritional status of children under five and of their mothers using anthropometric measurements (principally height and weight).

MAIN RESULTS

According to the NDHS, fertility is high in Namibia; at current fertility levels, Namibian women will have an average of 5.4 children by the end of their reproductive years. This is lower than most countries in sub-Saharan Africa, but similar to results from DHS surveys in Botswana (4.9 children per woman) and Zimbabwe (5.4 children per woman). Fertility in the South and Central regions is considerably lower (4.1 children per woman) than in the Northeast (6.0) and Northwest regions (6.7).

About one in four women uses a contraceptive method: 29 percent of married women currently use a method (26 percent use a modem method), and 23 percent of all women are current users. The pill, injection and female sterilisation are the most popular methods among married couples: each is used by about 7 to 8 percent of currently married women. Knowledge of contraception is high, with almost 90 percent of all women age 15-49 knowing of any modem method.

Certain groups of women are much more likely to use contraception than others. For example, urban women are almost four times more likely to be using a modem contraceptive method (47 percent) than rural women (13 percent). Women in the South and Central regions, those with more education, and those living closer to family planning services are also more likely to be using contraception.

Levels of fertility and contraceptive use are not likely to change until there is a drop in desired family size and until the idea of reproductive choice is more widely accepted. At present, the average ideal family size (5.0 children) is only slightly lower than the total fertility rate (5.4 children). Thus, the vast majority of births are wanted.

On average, Namibian women have their first child when they are about 21 years of age. The median age at first marriage is, however, 25 years. This indicates that many women give birth before marriage. In fact, married women are a minority in Namibia: 51 percent of women 15-49 were not married, 27 percent were currently married, 15 percent were currently living with a man (informal union), and 7 percent were widowed, divorced or separated. Therefore, a large proportion of children in Namibia are born out of wedlock.

The NDHS also provides inlbrmation about maternal and child health. The data indicate that 1 in 12 children dies before the fifth birthday. However, infant and child mortality have been declining over the past decade. Infant mortality has fallen from 67 deaths per 1,000 live births for the period 1983-87 to 57 per 1,000 live births for the period 1988-92, a decline of about 15 percent. Mortality is higher in the Northeast region than elsewhere in Namibia.

The leading causes of death are diarrhoea, undemutrition, acute respiratory infection (pneumonia) and malaria: each of these conditions was associated with about one-fifth of under-five deaths. Among neonatal deaths low birth weight and birth problems were the leading causes of death. Neonatal tetanus and measles were not lbund to be major causes of death.

Maternal mortality was estimated from reports on the survival status of sisters of the respondent. Maternal mortality was 225 per 100,000 live births for the decade prior to the survey. NDHS data also show considerable excess male mortality at ages 15-49, which may in part be related to the war of independence during the 1980s.

Utilisation of maternal and child health services is high. Almost 90 percent of mothers received antenatal care, and two-thirds of children were bom in health facilities. Traditional birth attendants assisted only 6 percent of births in the five years preceding the survey. Child vaccination coverage has increased rapidly since independence. Ninety-five percent of children age 12-23 months have received at least one vaccination, while 76 percent have received a measles vaccination, and 70 percent three doses of DPT and polio vaccines.

Children with symptoms of possible acute respiratory infection (cough and rapid breathing) may have pneumonia and need to be seen by a health worker. Among children with such symptoms in the two weeks preceding the survey two-thirds were taken to a health facility. Only children of mothers who lived more than 30 km from a health facility were less likely to be taken to a facility.

About one in five children had diarrhoea in the two weeks prior to the survey. Diarrhoea prevalence was very high in the Northeast region, where almost half of children reportedly had diarrhoea. The dysentery epidemic contributed to this high figure: diarrhoea with blood was reported for 17 percent of children under five in the Northeast region. Among children with diarrhoea in the last two weeks 68 percent were taken to a health facility, and 64 percent received a solution prepared from ORS packets. NDHS data indicate that more emphasis needs to put on increasing fluids during diarrhoea, since only I 1 percent mothers of children with diarrhoea said they increased the amount of fluids given during the episode.

Nearly all babies are breastfed (95 percent), but only 52 percent are put on the breast immediately. Exclusive breastfeeding is practiced for a short period, but not for the recommended 4-6 months. Most babies are given water, formula, or other supplements within the first four months of life, which both jeopardises their nutritional status and increases the risk of infection. On average, children are breastfed for about 17 months, but large differences exist by region. In the South region children are breastfed lor less than a year, in the Northwest region for about one and a half years and in the Northeast region for almost two years.

Most babies are weighed at birth, but the actual birth weight could be recalled for only 44 percent of births. Using these data and data on reported size of the newborn, for all births in the last five years, it was estimated that the mean birth weight in Namibia is 3048 grams, and that 16 percent of babies were low birth weight (less than 2500 grams).

Stunting, an indication of chronic undemutrition, was observed for 28 percent of children under five. Stunting was more common in the Northeast region (42 percent) than elsewhere in Namibia. Almost 9 percent of children were wasted, which is an indication of acute undemutrition. Wasting is higher than expected for Namibia and may have been caused by the drought conditions during 1992.

Matemal height is an indicator of nutritional status over generations. Women in Namibia have an average height of 160 cm and there is little variation by region. The Body Mass Index (BM1), defined as weight divided by squared height, is a measure of current nutritional status and was lower among women in the Northwest and the Northeast regions than among women in the South and Central regions.

On average, women had a health facility available within 40 minutes travel time. Women in the Northwest region, however, had to travel more than one hour to reach the nearest health facility. At a distance of less than 10 km, 56 percent of women had access to antenatal services, 48 percent to maternity services, 72 percent to immunisation services, and 49 percent to family planning services. Within one hour of travel time, fifty-two percent of women had antenatal services, 48 percent delivery services, 64 percent immunisation services and 49 percent family planning services. Distance and travel time were greatest in the Northwest region.

Geographic coverage

The sample for the NDHS was designed to be nationally representative. The design involved a two- stage stratified sample which is self-weighting within each of the three health regions for which estimates of fertility and mortality were required--Northwest, Northeast, and the combined Central/South region. In order to have a sufficient number of cases for analysis, oversampling was necessary for the Northeast region, which has only 14.8 percent of the population. Therefore, the sample was not allocated proportionally across regions and is not completely

The domestic demand of baby formula products in China was gradually climbing to *** million metric tons in 2017. The increasing trend is probably related to the implementation of the two-child policy in 2016 in China. The country's fertility rate plummeted since the introduction of the one-child policy in 1980, resulting in a low birthrate in the recent decade.

Explanations of factors represented in the calculation process of PBQ.

The retail sales revenue of the baby formula products in China was growing steadily, reaching *** billion yuan in 2017. China announced to implement a two-child policy in 2016 to address its low birthrate. The country's fertility rate plummeted since the introduction of the one-child policy in 1980.

Baby Formula Market Outlook

The global baby formula market size was valued at approximately $55 billion in 2023 and is projected to reach around $105 billion by 2032, growing at a compound annual growth rate (CAGR) of 7.5%. This substantial growth can be attributed to the increasing awareness about infant nutrition and the rising number of working mothers worldwide. Furthermore, the market is driven by advancements in formula composition to closely mimic breast milk, which have significantly improved the nutritional benefits of baby formulas.

One of the key growth factors for the baby formula market is the rising birth rate in developing countries. Countries across Asia and Africa are witnessing a steady increase in their birth rates, which directly boosts the demand for baby formula products. Additionally, increased urbanization and changing lifestyles have led to a higher number of working mothers, who often rely on baby formula to ensure their infants receive adequate nutrition during their absence. This trend is particularly pronounced in regions like Asia Pacific and Latin America, where the combination of rising incomes and urbanization is driving market growth.

Another major growth factor is the rising consumer awareness about the importance of early childhood nutrition. Parents are becoming more conscious of the nutritional content of the food they provide to their infants. This has pushed manufacturers to innovate and develop formulas that are rich in essential nutrients, thereby closely replicating the benefits of breast milk. Moreover, advancements in biotechnology have allowed producers to include probiotics, prebiotics, and other beneficial compounds in baby formula, further enhancing its appeal to health-conscious parents.

The surge in online retailing has also played a crucial role in the expansion of the baby formula market. The convenience of online shopping, coupled with the availability of a wide range of products, has made it easier for parents to access high-quality baby formula. Additionally, online platforms often provide detailed information and customer reviews, which help parents make informed decisions. This shift towards e-commerce is particularly significant in developed regions like North America and Europe, where internet penetration is high, and consumers are accustomed to online shopping.

The importance of Baby Food and Formula in the early stages of an infant's life cannot be overstated. As parents become increasingly aware of the nutritional needs of their babies, the demand for high-quality baby food and formula has surged. These products are designed to provide essential nutrients that support growth and development, especially when breastfeeding is not an option. The market for baby food and formula has expanded significantly, driven by innovations that ensure these products are as close to natural nutrition as possible. This growth is also supported by the rising number of working mothers who seek convenient yet nutritious feeding options for their infants. As a result, manufacturers are continually enhancing their offerings to meet the evolving needs of parents and their babies.

Regionally, the Asia Pacific holds a prominent position in the baby formula market, driven by high birth rates and increasing disposable incomes. North America and Europe follow closely, with strong market growth fuelled by higher consumer spending on premium nutritional products. In contrast, regions like Latin America and the Middle East & Africa are emerging as new markets with considerable growth potential, thanks to improving economic conditions and rising awareness about infant nutrition.

Product Type Analysis

The baby formula market is segmented into various product types, including infant milk, follow-on milk, specialty baby milk, and growing-up milk. Infant milk is designed for newborns and is considered a complete substitute for breast milk during the first six months of life. This segment holds a significant market share due to its necessity for newborns whose mothers cannot breastfeed. The demand for infant milk is particularly strong in regions with higher birth rates and where breastfeeding might not be feasible due to lifestyle or health reasons.

Follow-on milk is targeted at babies aged six months and above and is designed to complement weaning foods. This segment is growing steadily as parents look for formulas that provide additional nutrients during the critical

BackgroundGuizhi Fuling (GZFL) pill, a traditional Chinese herbal formula including Semen Persicae, Ramulus Cinnamomi, Poria, Radix Paeoniae Alba, and Cortex Moutan, has been widely applied in the management of gynecological diseases.ObjectiveTo evaluate the add-on effect of the GZFL formula for treating reduced fertility potential in women with polycystic ovary syndrome (PCOS) by conducting a systematic review and meta-analysis.MethodsTwo reviewers independently searched the PubMed, Embase, Cochrane Library, Wanfang, SinoMed, and CKNI databases until 09/11/2022. Eligible studies were randomized controlled trials (RCTs) of the GZFL formula plus Western medicine versus the Western medicine for treating PCOS. The primary endpoint was the ovulation, pregnancy, and miscarriage rate. The secondary endpoints included the serum follicle-stimulating hormone (FSH), total testosterone, luteinizing hormone (LH), estradiol, and homeostasis model assessment insulin resistance (HOMA-IR).ResultsThere were 16 RCTs with 1,385 patients identified. The GZFL formula plus Western medicine significantly improved the ovulation rate (risk ratios [RR] 1.24; 95% confidence intervals [CI] 1.15–1.34) and pregnancy rate (RR 1.53; 95% CI 1.38 to 1.69) than the Western medicine alone. Adjuvant treatment with the GZFL formula also significantly decreased the serum FSH (mean difference [MD] -0.48 U/l; 95% CI -0.80 to -0.15), total testosterone (standard mean difference [SMD] -1.07; 95% CI -1.71 to -0.44), LH level (MD -2.19 U/l; 95% CI -3.04 to -1.34), and HOMA-IR (MD -0.47; 95% CI -0.60 to -0.34). However, there was no significant difference in the miscarriage rate (RR 0.89; 95% CI 0.36–2.20) and serum estradiol level (SMD 0.34; 95% CI -0.25 to 0.94) between two groups.ConclusionsThe GZFL formula as adjuvant therapy can improve the ovulation and pregnancy rates in women with PCOS. Its beneficial effects may correlate with reducing FSH, total testosterone, and LH and ameliorating insulin resistance. However, more well-designed RCTs with larger samples and multicenter trials are required to confirm the current findings due to uncertainty of the evidence.Systematic review registrationPROSPERO identifier, CRD42022354530.