Document Type : Research Article


African Institute for Development Policy, Malawi, Africa


Background: Population growth is considered a problem in Malawi, Africa and fertility is reportedly a key factor in the growth of this population. The subject of studies on fertility-related factors has been period fertility rather than lifetime fertility. However, period fertility is reported to be associated with a tempo effect and therefore may not represent lifetime fertility accurately. The present study; therefore, examined whether age at first marriage or birth has an effect on lifetime fertility in Malawi, as it is the case with period fertility.
Methods: Secondary data from the Malawi Demographic and Health Survey were used for this study. The study was conducted from October 2015 to February 2016 and surveyed 24562 women of reproductive age (15-49 years). The research was limited to a subsample of 3583 women because the focus of this paper is on women aged 40-49 years. The number of children ever born was used to determine fertility. Analysis of variance and Poisson regression model were used as statistical tests. The multivariable association between the number of children ever born and the independent variables was predicted using the Poisson regression model, while the bivariate relationship was calculated using analysis of variance.
Results: The results of the bivariate analysis showed that age of first cohabitation (P=0.01) and age of first birth (P=0.01) were strongly associated with total number of births. Both unadjusted and adjusted Poisson regression models showed significant associations for multivariable outcomes. Accordingly, the number of children ever born was significantly associated with the following variables: an adjusted model with age of 26 years and older as the reference category, beginning cohabitation (AIRR=1.09, P=0.04) or first birth (AIRR=1.61, P=0.03) at age younger than 18 years; cohabitation (AIRR=1.09, P=0.04) or first birth (AIRR=1.48, P=0.03) at age of 18 to 21 years.
Conclusions: Based on the findings of the study, the study recommends stakeholders to support household income-generating capacity, expand access to education for both boys and girls, and maintain the use of modern contraceptives.


How to Cite: Forty J. Investigating the tempo Effect on Completed Fertility: The Effect of Age at First Cohabitation or Birth on Completed Fertility in Malawi, Africa. Women. Health. Bull. 2023;10(1):32-43. doi: 10.30476/WHB.2023.96775.1193.


1. Coale AJ. Age patterns of marriage. Popul Stud. 1971;25(2):193-214. doi: 10.1080/00324728.1971.10405798. PubMed PMID: 22070107. ## 2. Islam MA, Rahman A. Age at first marriage and fertility in developing countries: A meta-analytical view of 15 Demographic and Health Surveys. Clinical Epidemiology and Global Health. 2020;8(3):775-779. doi: 10.1016/j.cegh.2020.01.018. ## 3. Malawi Government. Malawi Demographic and Health Survey. National Statistical Office (NSO) and ICF Macro, Zomba; 2016. Available from: ## 4. Southern African Development Community. SADC Energy Monitor; Enabling Industrialization and Regional Integration in SADC. SADC Secretariat, Gaborone, Botswana; 2018. Available from: ## 5. Malawi Government. National Population Policy. Ministry of Finance, Economic Planning and Development, Lilongwe; 2012. Available from: ## 6. Malawi government. National Sexual and Reproductive Health and Rights Policy, 2017-2022. Ministry of Health, Lilongwe; 2017. Available from: ## 7. Machira K, Palamuleni M. Fertility Differentials in Malawi: Any Lesson Learnt from Regional Socio-economic and Demographic Variations? Fertility Differences in Malawi. Journal of Human Ecology. 2017;58(1-2):88-97. doi: 10.1080/09709274.2017.1305607. ## 8. Forty J, Navaneetham K, Letamo G. Determinants of fertility in Malawi: Does women autonomy dimension matter? BMC Women’s Health. 2022;22(1):342. doi: 10.1186/s12905-022-01926-4. PubMed PMID: 35971111; PubMed Central PMCID: PMC9377123. ## 9. Bongaarts J, Feeney G. When is a tempo effect a tempo distortion? Genus. 2010;66(2). doi: 10.4402/genus-188. ## 10. MEASURE DHS. Guide to DHS Statistics DHS-7. Available from: ## 11. Palamuleni ME. Socioeconomic determinants of age at first marriage in Malawi. International Journal of Sociology and Anthropology. 2011;3(7):224-235. ## 12. Baruwa O, Amoateng AY, Biney E. Socio-demographic changes in age at first marriage in Malawi: Evidence from Malawi Demographic and Health Survey data, 1992–2016. J Biosoc Sci. 2020;52(6):832-845. doi: 10.1017/S0021932019000816. PubMed PMID: 31852549. ## 13. Bitew DA, Habitu YA, Gelagay AA. Time to first birth and its determinants among married female youths in Ethiopia, 2020: survival analysis based on EDHS 2016. BMC Women’s Health. 2021;21(1):278. doi: 10.1186/s12905-021-01414-1. PubMed PMID: 34340658; PubMed Central PMCID: PMC8327425. ## 14. Bongaarts J. Modelling the impact of proximate determinants of fertility: time for a tune-up. 2015;33(19):535-560. doi: 10.4054/DemRes.2015.33.19. ## 15. Shallo SA. Roles of Proximate Determinants of Fertility in Recent Fertility Decline in Ethiopia: Application of the Revised Bongaarts Model. Open Access J Contracept. 2020;11:33-41. doi: 10.2147/OAJC.S251693. PubMed PMID: 32581604; PubMed Central PMCID: PMC7276374. ## 16. Forty J, Rakgoasi SD, Keetile M. Patterns and determinants of modern contraceptive use and intention to use contraceptives among Malawian women of reproductive ages (15–49 years). Contracept Reprod Med. 2021;6(1):21. doi: 10.1186/s40834-021-00163-8. PubMed PMID: 34193289; PubMed Central PMCID: PMC8247247. ## 17. Khomba DC, Trew A. Aid and Local Growth in Malawi. The Journal of Development Studies. 2019;58(8):1478-1500. doi: 10.1080/00220388.2022.2032668. ## 18. Kanteh O, Palamuleni ME. Women status and fertility in the Gambia. Gender and Behavior. 2019;17(3):255-281. ## 19. Malawi: Marriage, Divorce and Family Relations Bill; 2015. Available from: ## 20. Ostertagova E, Ostertag O. Methodology and Application of one-way ANOVA. American Journal of Mechanical Engineering. 2013;1(7):256-261. doi: 10.12691/ajme-1-7-21. ## 21. Coxe S, West SG, Aiken LS. The Analysis of Count Data: A Gentle Introduction to Poisson Regression and its Alternatives. J Pers Assess. 2009;91(2):121-36. doi: 10.1080/00223890802634175. PubMed PMID: 19205933. ## 22. Ariho P, Kabagenyi A, Nzabona A. Determinants of change in fertility pattern among women in Uganda during the period 2006–2011. Fertil Res Pract. 2018;4:4. doi: 10.1186/s40738-018-0049-1. PubMed PMID: 29983990; PubMed Central PMCID: PMC6020355. ## 23. Sobotka T. Post-transitional Fertility: The Role of Childbearing Postponement in Fuelling the Shift to Low and Unstable Fertility Levels. J Biosoc Sci. 2017;49(S1):S20-S45. doi: 10.1017/S0021932017000323. PubMed PMID: 29160188. ## 24. Melnikas AJ, Mulauzi N, Mkandawire J, Amin S. Perceptions of minimum age at marriage laws and their enforcement: qualitative evidence from Malawi. BMC Public Health. 2021;21:1350. doi: 10.1186/s12889-021-11434-z. ## 25. Srivastava S, Thakur H. Relationship of Contraceptive use with Children Ever Born and Women's Empowerment in India: A Regional Analysis. Asian Journal of Research in Social Sciences and Humanities. 2017;7(10):466-476. doi: 10.5958/2249-7315.2017.00518.4. ##