Determinants of Fertility and Contraceptive Use among Palestinian Women in the Gaza Strip: Qualitative Study

Abstract

The current total fertility rate among Palestinian women in the Gaza Strip (4.5 births per woman) is higher than that of all neighbouring countries, and the population growth rate of 3.3% per year is also one of the highest in the world. This study aimed to examine the main determinants of fertility and contraceptive use among Palestinian women in the Gaza Strip. The study entailed collecting primary qualitative data that were collected through focus group discussions with contraceptive users and non-users who have at least one child less than 5 years of age. Six focus groups were assembled with 9 participants per group. Framework analysis was used to analyse the focus group data. The findings of study verified that the lack of social security policies and welfare services for elderly people encouraged parents to have many children to secure old age support. The current Israeli-Palestinian conflict was a driving force for fertility. Women desire more children as insurance against expected deaths due to the on-going conflict. Also, unemployment among women was a motivating factor for women to have more children and to use contraceptive, while Religion: “the Islamic doctrine”–does not have a direct effect on fertility decisions and contraception use. The findings of this study suggest that the Palestinian National Authority need to implement strategies to increase women’s labor force participation rate and to establish a social security system to provide income and other social welfare services to needy elderly people. Finally, increased knowledge about the availability and best practices of contraceptive methods is an important policy action.