Wubegzier MekonnenGelila Samuel2025-08-072025-08-072024-10-18https://etd.aau.edu.et/handle/123456789/6228Background: - In Ethiopia TFR has been declining over the years from 6.4 in 1990 to 4.6 in 2016. There has been national paucity in available evidence regarding the influence of proximate and distal determinants over the trend of fertility decline and past evaluation of family planning programs and resource allocation through understanding the pattern in the contribution of other proximate determinants on fertility decline. Objectives: - The study aims to measure the contribution of family planning and other proximate and distal determinants to reduce fertility from its natural level during the past twenty years in Ethiopia. Methods: - The study used the data sets of four rounds of EDHS. A total of 15367, 14070, 16515 and 15683 women were interviewed on the four rounds. The John Bongaart’s proximate determinants model has been employed. The contribution of contraception, marriage, post-partum infecundity and abortion ranging from 0 to 1 is determined by selected background characteristics and the significance of the trends were tested. Socioeconomic determinants affecting fertility were identified using children ever born as outcome variable by employing multi-level zero inflated negative binomial regression. Point estimates for incidence rate ratio are used to identify distal factors associated with fertility. Results: - Delayed marriage inhibited fertility by 35%, 36%, 37% and 34.4% while contraception use reduced fertility from its natural level by 8%, 14%, 29% and 37% in 2000, 2005, 2011 and 2016. Postpartum infecundity inhibited fertility by 48%, 43%, 43% and 42%. Induced Abortion inhibited fertility by 0.61% and 0.73% in 2011 and 2016. Rural residence, Somali Region (IRR= 1.55 95% CI: 1.41, 1.71), Muslim (IRR=1.12, 95%CI: 1.06, 1.19) and Traditional Religion (IRR=1.1, 95% CI:1.02, 1.19) women with no education (IRR=2.1 95% CI: 1.92, 2.31) and age of women (IRR= 1.057, 95% CI: 1.055, 1.059) were positively associated with fertility while employment (IRR= 0.96, 95% CI: 0.93, 0.99)is negatively associated with it. Conclusion: -. The inhibition effect of delayed marriage has declined from 2011 while the effect of contraception has been increasing over the four survey years. Post-partum infecundity was the highest contributing determinant on the four surveys with declining trend over the time.en-USTrend, Fertility, Proximate, Distal, Determinants, EthiopiaThesis