Exploring Socio-Ecological Effects and Spatial Heterogeneity in Total Fertility Rate in Bangladesh

The fertility rate in Bangladesh has declined over the past few decades, with significant variations across 64 administrative districts. However, there is limited knowledge regarding spatial variations in the total fertility rate (TFR) in this country. Using publicly available data, this study investigated district-level variations in TFR and their socio-ecological determinants. It also explored the spatial clustering and dependence of the TFR using Global and Local Moran’s I statistics. Spatial lag/error models were used to examine the effects of correlates on district-level TFRs. The results of this study indicate spatial clustering across districts in the east and west, with high-high clusters or hotspots observed in the northeast and southeast districts, and low-low clusters or coldspots in the western and southwestern parts of the country. Spatial models identified several factors affecting the TFR, including the percentage of the poorest population, housing conditions, modern contraceptive use, skilled birth attendance (SBA), under-five mortality rates, frequency of storms, extreme temperature events, and number of people affected by extreme temperature events. This study reveals intricate spatial spillover effects in Bangladeshi districts, emphasizing the importance of targeted and collaborative regional interventions in fertility management, the localized impact of family planning programs, the regional influence of female education, the interconnectedness of poverty across districts, the potency of local healthcare interventions, the indirect role of storms in reducing fertility rates in neighboring areas, and the shared vulnerability of districts to environmental events. These findings provide crucial insights for developing effective locally focused interventions for fertility management in Bangladesh.