Associates of self-reported fertility status and infertility treatment-seeking in a rural district of Malawi

BACKGROUND: This study examines the demographic, fertility preference, health/infection and behavioural factors associated with self-reported fertility problems and infertility treatment-seeking in a rural district of Malawi. METHODS: Data come from a population-based survey of 678 women and 362 men. RESULTS: Having a higher ideal number of children than actual number of children, i.e. a 'child deficit', is highly associated with women's reported fertility impairment and treatment-seeking. Other factors associated with women's infertility treatment-seeking are being educated and reporting infertility in self or spouse. In contrast, being in a polygamous union, having exchanged money or goods for sex, and having multiple sex partners are significantly associated with men's reported fertility impairment. Significant factors associated with men's infertility treatment-seeking are having no education, having a long waiting time to pregnancy and having a 'child deficit'. CONCLUSIONS: There is a sex difference in which factors are associated with reported fertility impairment. Fertility preference variables are more often significantly related to women's reported fertility impairment, whereas sexual behaviours are more often significantly related to men's reported fertility impairment.