LAUSR

Even though the fertility in Africa has started to decline, there was no demographic study done in southern Ethiopia except a census done more than a decade ago. Understanding the population dynamics can help policymakers forecasting future health needs. The objective of this study is to investigate the population characteristics in Sidama with an emphasis on fertility estimates, age, and death reporting. This is a mixed-method cross-sectional study, conducted in Sidama in southern Ethiopia, using baseline data of the newly established Dale-Wonsho Health and Demographic Surveillance System site in 2018. We used quantitative data of 5179 randomly selected households having 25,144 individuals. We also collected information on deaths in the same study period and from the same population from the traditional burial associations (Iddir). Qualitative data were collected using focus group discussions, and in-depth interviews. Life tables, age reliability indices and logistic regression were used to analyse the data. The total fertility rate was 2.9 children/woman, the crude birth rate was 22.8/1000 population and the crude death rate was 5.2/1000 population. The dependency ratio was 66/100 working-age population. Urban residents had higher birth rates(OR = 1.4 (95% CL: 1.05-1.78), and women with basic education had lower birth rates(OR = 0.6 (95% CL: 0.46-0.78). The Whipple's, Myer's, and United Nations Joint Score indices showed unreliable age reporting. As the number of deaths increased from 29 to 132 when we included deaths registered at the Iddirs, and as there was an under-reporting of neonatal and deaths of young children; the expected life expectancy became lower to 48-55 years. The fertility rate in Sidama is lower than previously reported and is affected by age, residence and education. As we have identified important measurement and reporting errors, future demographic surveillance sites should consider these limitations. The reduction in fertility is an important indicator of demographic transition. Age and vital events reporting system are crucial for demographic surveillance.