Reproductive Inequality and the Stalled Fertility Transition in Egypt: Multilevel Evidence from the Demographic and Health Survey

Reproductive Inequality and the Stalled Fertility Transition in Egypt: Multilevel Evidence from the Demographic and Health Survey | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Reproductive Inequality and the Stalled Fertility Transition in Egypt: Multilevel Evidence from the Demographic and Health Survey Dr Mohamed Ahmed Elkhouli This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9268221/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Despite ongoing investments in family planning initiatives and significant improvements in female education, fertility decline in Egypt has shown clear signs of stagnation. This study examines reproductive inequality from a biostatistical perspective by modelling high fertility rates and modern contraceptive use within a hierarchical population framework. Using nationally representative data from 9,722 ever-married women aged 15-49 from the 2014 Egypt Demographic and Health Survey, multilevel logistic regression models were applied to measure both individual-level associations and variability across different contexts in reproductive outcomes. Higher educational attainment was linked to notably lower odds of high fertility and a greater likelihood of using modern contraception. Nonetheless, these effects were influenced by socioeconomic and life-course factors. Cross-level interaction analyses revealed a significant amplification of the educational impact among women in higher wealth quintiles (OR ≈ 12.4) and older age groups (OR ≈ 3.0). Random-effects estimates showed that a considerable proportion of variation in reproductive outcomes remained attributable to community-level factors, even after adjusting for individual characteristics. Results suggest that the stagnation of fertility decline in Egypt reflects reproductive inequality within hierarchical social structures. This study highlights the importance of multilevel inference to capture conditional effects and contextual heterogeneity in population health research. multilevel inference reproductive health heterogeneity fertility dynamics socioeconomic moderation hierarchical data contraceptive behaviour Full Text Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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