Proximate Determinants Model

Once the indices of the three major proximate determinants have been calculated for each survey year, the next step is to decompose the change in total fertility rate observed between two time points to determine contributions to that change of the three proximate determinants (Table 2). A decline in the total fertility rate (-25.5%) observed in the Amhara National Regional State during the period 2000 to 2011 is much stronger in the years towards the end of the period. In the period 2000 to 2005, a 6.9% decline in total fertility rate is observed as opposed to a 19.9% decline in total fertility rate witnessed during the period 2005 to 2011. In the first-half of the decade, 2000 to 2005, it is only use of contraception played a role in the

But this doesn’t mean it always works for all populations. Sometimes, the estimates brought about by this model may be higher or lower than the actual levels of fertility. Due to lack of required data, the model was not properly applied in Ethiopia until recently. The average number of induced abortion is difficult to establish because a non-availability of data from the Ethiopia Demographic and Health surveys. Therefore, the index of induced abortion is taken to be 1 in all populations, that is, induced abortion is assumed to have no inhibition effect on fertility of a woman. However, exclusion of abortion in the model could have an effect on the estimates of total fecundity especially in areas where it is high. It is documented induced abortion rates in sub-Saharan Africa growing very fast, particularly in urban areas and amongst the youngest and unmarried women [43-47]. Data on induced abortion are very rare in Africa due to illegality of induced abortion unless performed to save the mother's life [48]. Before 2005, abortion in Ethiopia was permitted only in the case where the life of the woman was physically at risk. With the 2005 revised abortion law, abortion is allowable due to fetal impairment or deformity, rape or incest (based on the woman’s complaint only), minors (stated maternal age <18 years), and physically and mentally unable to care for the would be born child