Impact of social, demographic, and economic factors on fertility trends in South Asia: longitudinal analysis based on World Bank and Global Burden of Disease Study 1980-2021

Abstract

Objectives: To investigate the association of socioeconomic factors with total fertility rate in five South Asian countries.

Method: The retrospective, longitudinal study based on secondary data was conducted from June 6 to December 31, 2024, at the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia, and comprised data from 1980 to 2021 for five South Asian countries, namely, Bangladesh, Bhutan, India, Nepal and Pakistan. Total fertility rates as well as sociodemographic and economic indicators were obtained from multiple authentic sources. Data was analysed using SPSS 29.

Results: The total fertility rate showed a decreasing trend, with the highest decline in Bhutan (78.3%) and the lowest change in Pakistan (48.5%). The total population increased in all the five countries, with the most significant increase in Pakistan (187%), and the smallest in Bhutan (87.2%). The crude death rate declined across the board, with the most prominent being Bhutan (64.1%) and the least prominent being India (31.3%). Life expectancy increased in all the countries, with the most significant change in Bhutan (48.9%), and the least change in Pakistan (14.8%). Gross domestic product per capita increased in all the countries, with the largest increase in Bhutan (1052.1%) and the smallest in Pakistan (413.9%). The results also revealed a consistent directional association between the total fertility rate and multiple sociodemographic indicators across the countries.

Conclusions: Total fertility rates declined alongside improvements in key demographic and economic indicators across South Asia. The observed fertility patterns reflected substantial cross-country heterogeneity, and underscored the complex interplay of social, financial and demographic factors shaping fertility transitions in the region.

Key Words: Fertility, Population, Socioeconomic, Life expectancy, Literacy.