Determinants and Consequences of High Fertility Among Indigenous Pygmy Populations in an Urban Peripheral Setting in Mbandaka, Democratic Republic of Congo
Abstract
Background
Among sedentary Pygmy populations in Mbandaka, the demographic transition has stagnated. The breakdown of ancestral regulation methods and the lack of modern contraception have led to an unmanaged natural fertility model, fostering extreme socio-economic vulnerability.
Objective
This study analyzed the determinants of high fertility rates in the Mambenga neighborhood and evaluated the direct impacts on reproductive health and household socio-economic conditions.
Methods
A quantitative, descriptive, cross-sectional study was conducted among 200 indigenous women of childbearing age (15-49 years) living in union in the Mambenga neighborhood, Mbandaka, Democratic Republic of Congo. Data were collected through structured face-to-face interviews using a pre-coded questionnaire between March and May 2026. Descriptive statistics, bivariate analysis (chi-square tests), and multivariate binary logistic regression were performed using SPSS version 25.0.
Results
The mean age at first childbirth was 16.8 years (SD=2.1). The majority of respondents had no formal education (71.0%), and the polygamy rate was 46.0%. The overall fertility rate was 7.8 children per woman, with 61.0% of households having at least 7 children. Family planning knowledge (18.0%) and current use (6.0%) were very low. The main motivations for high fertility were religious/ancestral beliefs (56.0%) and perception of children as labor force (24.0%). Multivariate analysis identified perception of children as a divine blessing (ORa=4.12, p<0.001), polygamy (ORa=3.45, p<0.001), low education level (ORa=0.32, p<0.001), and lack of contraceptive knowledge (ORa=0.28, p=0.003) as independent determinants of high fertility. High parity was significantly associated with under-five child mortality (χ²=29.38, p<0.001) and reduced school enrollment (ANOVA, p=0.012).
Conclusion
Hyper-fertility among indigenous populations in Mambenga is driven by cultural perceptions, polygamy, low education, and lack of contraceptive access, leading to adverse maternal and child health outcomes and perpetuating intergenerational poverty. Culturally adapted family planning interventions and girls' education are urgently needed.
Keywords
Full text
How to cite
Iseka Mboyo, M. A. (2026). Determinants and Consequences of High Fertility Among Indigenous Pygmy Populations in an Urban Peripheral Setting in Mbandaka, Democratic Republic of Congo. SDF Journal of Public Health. https://sfoundation.one/articles/sdf-2026-0049-determinants-and-consequences-of-high-fertility-among-indigenous-pygmy