Association of Demographics, Anxiety and Depression with Desired Number of Children and Frequency of Having another Child amongst Males Aged 15-49 Years in Nepal.

Objectives: Research examining the impact of anxiety and depression on the ideal number of children and birth frequency amongst men is needed.

Methods: Using the data from the 2022 Nepal Demographic and Health Survey and a sample of 4913 adult males, we performed multivariable logistic regression to examine whether depression and anxiety correlated with the desired number of children and frequency of having another child, adjusting for age, wealth status, religion and education. Depression and anxiety were evaluated using patient health questionnaire-9 and Generalised Anxiety Disorder-7 scales, respectively.

Results: Among all men, 546 (11.1%) had depression symptoms and 555 (11.3%) had anxiety symptoms. Wealth status significantly influenced the perceived ideal number of children; "poorer" men were more likely to desire more than two children compared to the poorest (odds ratio [OR] =1.83; 95% CI [1.12, 2.97]; P = 0.016). Muslim men were significantly more likely than Hindu men to desire more than two children (OR = 4.43; 95% confidence interval [CI] [2.47, 7.25]; P < 0.001). Higher anxiety levels were negatively associated with preferring to have another child within 3 years (OR = 0.89; 95% CI [0.82, 0.98]; P = 0.016), although depression levels didn't (P = 0.132).

Conclusions: Fertility improvement strategies should incorporate population-based preventive approaches addressing anxiety amongst adult males.