Risky fertility characteristics and determinants of pastoralist women: the case of southeastern Anatolia region

Risky fertility characteristics; short birth intervals (< 24 months), high birth counts (≥ 4 births), and extremes of maternal age (< 18 or ≥ 35 years) increase the risk of adverse maternal outcomes. Progress in improving risky fertility characteristics has been slow, especially among pastoralist women who spend part of the year in hard-to-reach places, despite interventions. In this study, we investigated to identify the characteristics and determinants of risky fertility among pastoralist women. This cross-sectional study was conducted between October 2022 and March 2023 in a city located in the southeastern Anatolian region of Türkiye with involving 300 women of childbearing age from pastoralist communities. Data from face-to-face interviews were analyzed using descriptive statistics, chi-square tests, and four-step hierarchical logistic regression analysis to identify determinants of risky fertility. The 78.7% of pastoralist women were at risk for short birth intervals (27.0%), high number of births (73.0%), and extremes of maternal age (50.0%). In the final logistic regression model, older maternal age (≥ 40 years) (OR = 32.06, 95%CI = 4.89–210.07), husband’s illiteracy (OR = 6.29, 95%CI = 1.98–20.01), speaking Kurdish at home (OR = 9.14, 95% CI = 2.96–28.20), living in temporary shelters (OR = 11.69, 95%CI = 2.68–58.96), exclusion of women from decision-making on number of children (OR = 1.16, 95%CI = 0.04–1.61), and gender-selective births (OR = 3.57, 95%CI = 1.26–10.15) were significant determinants (P < 0.05). These variables explained 67.5% of the variance of risky fertility characterstics. The majority of pastoralist women had risks considered preventable in terms of short birth intervals, high number of births, and extremes of maternal age. Empowering pastoralist women and meeting their nomadic lifestyle needs can reduce risky fertility characterstics.