{"id":"https://openalex.org/W7222871979","doi":"https://doi.org/10.1186/s12889-026-29263-3","title":"Fertility decline and population ageing in the Greater Poland Voivodeship, 2013\u20132024: a longitudinal analysis of implications for regional health and social services planning","display_name":"Fertility decline and population ageing in the Greater Poland Voivodeship, 2013\u20132024: a longitudinal analysis of implications for regional health and social services planning","publication_year":2026,"publication_date":"2026-10-19","ids":{"openalex":"https://openalex.org/W7222871979","doi":"https://doi.org/10.1186/s12889-026-29263-3"},"language":"en","primary_location":{"id":"doi:10.1186/s12889-026-29263-3","doi":"https://doi.org/10.1186/s12889-026-29263-3","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12889-026-29263-3","pdf_url":null,"source":{"id":"https://openalex.org/S200437886","display_name":"BMC Public Health","issn_l":"1471-2458","issn":["1471-2458"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Public Health","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1186/s12889-026-29263-3","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5093484414","display_name":"Andrzej Ciborek","orcid":"https://orcid.org/0009-0002-7437-1579","observed_orcids":["https://orcid.org/0009-0002-7437-1579"]},"institutions":[{"id":"https://openalex.org/I4210151843","display_name":"Uniwersytet Kaliski im. Prezydenta Stanis\u0142awa Wojciechowskiego","ror":"https://ror.org/05he0t313","country_code":"PL","type":"education","lineage":["https://openalex.org/I4210151843"]}],"countries":["PL"],"is_corresponding":true,"raw_author_name":"Andrzej Ciborek","raw_affiliation_strings":["Department of Interprofessional Education, Chair of Basic Sciences and Health Sciences, Faculty of Medicine and Health Sciences, Kalisz University of President Stanis\u0142aw Wojciechowski, ul. Kaszubska 13, Kalisz, 62-800, Poland"],"raw_orcid":"https://orcid.org/0009-0002-7437-1579","affiliations":[{"raw_affiliation_string":"Department of Interprofessional Education, Chair of Basic Sciences and Health Sciences, Faculty of Medicine and Health Sciences, Kalisz University of President Stanis\u0142aw Wojciechowski, ul. Kaszubska 13, Kalisz, 62-800, Poland","institution_ids":["https://openalex.org/I4210151843"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5035822443","display_name":"Zuzanna Ch\u0119ci\u0144ska-Maciejewska","orcid":"https://orcid.org/0000-0001-8884-3069","observed_orcids":["https://orcid.org/0000-0001-8884-3069"]},"institutions":[{"id":"https://openalex.org/I4210151843","display_name":"Uniwersytet Kaliski im. Prezydenta Stanis\u0142awa Wojciechowskiego","ror":"https://ror.org/05he0t313","country_code":"PL","type":"education","lineage":["https://openalex.org/I4210151843"]}],"countries":["PL"],"is_corresponding":false,"raw_author_name":"Zuzanna Ch\u0119ci\u0144ska-Maciejewska","raw_affiliation_strings":["Department of Food and Nutrition, Kalisz University of President Stanis\u0142aw Wojciechowski, Kalisz, Poland"],"raw_orcid":"https://orcid.org/0000-0001-8884-3069","affiliations":[{"raw_affiliation_string":"Department of Food and Nutrition, Kalisz University of President Stanis\u0142aw Wojciechowski, Kalisz, Poland","institution_ids":["https://openalex.org/I4210151843"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159020137","display_name":"Aleksander Bogda\u0144ski","orcid":"https://orcid.org/0009-0003-1288-9839","observed_orcids":["https://orcid.org/0009-0003-1288-9839"]},"institutions":[{"id":"https://openalex.org/I7877124","display_name":"Charit\u00e9 - Universit\u00e4tsmedizin Berlin","ror":"https://ror.org/001w7jn25","country_code":"DE","type":"healthcare","lineage":["https://openalex.org/I7877124"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Aleksander Bogda\u0144ski","raw_affiliation_strings":["Charit\u00e9 \u2014 Universit\u00e4tsmedizin Berlin, Charit\u00e9platz 1, Berlin, 10117, Germany"],"raw_orcid":"https://orcid.org/0009-0003-1288-9839","affiliations":[{"raw_affiliation_string":"Charit\u00e9 \u2014 Universit\u00e4tsmedizin Berlin, Charit\u00e9platz 1, Berlin, 10117, Germany","institution_ids":["https://openalex.org/I7877124"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5040053410","display_name":"Hanna Krauss","orcid":"https://orcid.org/0000-0002-3820-563X","observed_orcids":["https://orcid.org/0000-0002-3820-563X"]},"institutions":[{"id":"https://openalex.org/I4210151843","display_name":"Uniwersytet Kaliski im. Prezydenta Stanis\u0142awa Wojciechowskiego","ror":"https://ror.org/05he0t313","country_code":"PL","type":"education","lineage":["https://openalex.org/I4210151843"]}],"countries":["PL"],"is_corresponding":false,"raw_author_name":"Hanna Krauss","raw_affiliation_strings":["Institute of Preventive Research, Department of Basic Sciences, Kalisz University of President Stanis\u0142aw Wojciechowski, Kalisz, Poland"],"raw_orcid":"https://orcid.org/0000-0002-3820-563X","affiliations":[{"raw_affiliation_string":"Institute of Preventive Research, Department of Basic Sciences, Kalisz University of President Stanis\u0142aw Wojciechowski, Kalisz, Poland","institution_ids":["https://openalex.org/I4210151843"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5093484414"],"corresponding_institution_ids":["https://openalex.org/I4210151843"],"apc_list":{"value":3290,"currency":"USD","value_usd":3290},"apc_paid":{"value":3290,"currency":"USD","value_usd":3290},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.94134585,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12011","display_name":"Insurance, Mortality, Demography, Risk Management","score":0.20080000162124634,"subfield":{"id":"https://openalex.org/subfields/3317","display_name":"Demography"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T12011","display_name":"Insurance, Mortality, Demography, Risk Management","score":0.20080000162124634,"subfield":{"id":"https://openalex.org/subfields/3317","display_name":"Demography"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10585","display_name":"Family Dynamics and Relationships","score":0.18880000710487366,"subfield":{"id":"https://openalex.org/subfields/3317","display_name":"Demography"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10453","display_name":"Maternal and Perinatal Health Interventions","score":0.06759999692440033,"subfield":{"id":"https://openalex.org/subfields/2729","display_name":"Obstetrics and Gynecology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/fertility-decline","display_name":"fertility decline","score":0.8009999990463257},{"id":"https://openalex.org/keywords/population-aging","display_name":"population aging","score":0.9440000057220459},{"id":"https://openalex.org/keywords/below-replacement-fertility","display_name":"below-replacement fertility","score":0.8100000023841858},{"id":"https://openalex.org/keywords/health-planning","display_name":"health planning","score":0.5410000085830688},{"id":"https://openalex.org/keywords/social-services-planning","display_name":"social services planning","score":0.7720000147819519},{"id":"https://openalex.org/keywords/income-and-fertility","display_name":"income and fertility","score":0.6800000071525574},{"id":"https://openalex.org/keywords/greater-poland-voivodeship","display_name":"Greater Poland Voivodeship","score":0.8790000081062317},{"id":"https://openalex.org/keywords/post-communist-transition","display_name":"post-communist transition","score":0.5659999847412109},{"id":"https://openalex.org/keywords/health-workforce-planning","display_name":"health workforce planning","score":0.38499999046325684},{"id":"https://openalex.org/keywords/health-service-quality","display_name":"health service quality","score":0.4320000112056732}],"concepts":[{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.6779999732971191},{"id":"https://openalex.org/C518429986","wikidata":"https://www.wikidata.org/wiki/Q964401","display_name":"Fertility","level":3,"score":0.6678000092506409},{"id":"https://openalex.org/C140556311","wikidata":"https://www.wikidata.org/wiki/Q214746","display_name":"Biostatistics","level":3,"score":0.5928999781608582},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5875999927520752},{"id":"https://openalex.org/C2776269092","wikidata":"https://www.wikidata.org/wiki/Q1611074","display_name":"Residence","level":2,"score":0.5867999792098999},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.5101000070571899},{"id":"https://openalex.org/C47122089","wikidata":"https://www.wikidata.org/wiki/Q285897","display_name":"Total fertility rate","level":5,"score":0.48840001225471497},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.45669999718666077},{"id":"https://openalex.org/C2777895361","wikidata":"https://www.wikidata.org/wiki/Q1758614","display_name":"Longitudinal study","level":2,"score":0.4255000054836273},{"id":"https://openalex.org/C45355965","wikidata":"https://www.wikidata.org/wiki/Q1643441","display_name":"Socioeconomics","level":1,"score":0.41359999775886536},{"id":"https://openalex.org/C13774568","wikidata":"https://www.wikidata.org/wiki/Q439112","display_name":"Population ageing","level":3,"score":0.3806000053882599},{"id":"https://openalex.org/C37512671","wikidata":"https://www.wikidata.org/wiki/Q203516","display_name":"Birth rate","level":4,"score":0.3779999911785126},{"id":"https://openalex.org/C205649164","wikidata":"https://www.wikidata.org/wiki/Q1071","display_name":"Geography","level":0,"score":0.3596999943256378},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.35659998655319214},{"id":"https://openalex.org/C127142870","wikidata":"https://www.wikidata.org/wiki/Q7838279","display_name":"Trend analysis","level":2,"score":0.3368000090122223},{"id":"https://openalex.org/C2780877353","wikidata":"https://www.wikidata.org/wiki/Q2518253","display_name":"Health services research","level":3,"score":0.33550000190734863},{"id":"https://openalex.org/C74909509","wikidata":"https://www.wikidata.org/wiki/Q10387","display_name":"Gerontology","level":1,"score":0.3305000066757202},{"id":"https://openalex.org/C25511272","wikidata":"https://www.wikidata.org/wiki/Q295136","display_name":"Ecological study","level":3,"score":0.3276999890804291},{"id":"https://openalex.org/C2986043164","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demographic change","level":3,"score":0.31949999928474426},{"id":"https://openalex.org/C152877465","wikidata":"https://www.wikidata.org/wiki/Q208042","display_name":"Regression analysis","level":2,"score":0.3190000057220459},{"id":"https://openalex.org/C2779860289","wikidata":"https://www.wikidata.org/wiki/Q284137","display_name":"Population decline","level":3,"score":0.3059000074863434},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.30059999227523804},{"id":"https://openalex.org/C112299071","wikidata":"https://www.wikidata.org/wiki/Q835884","display_name":"Infant mortality","level":3,"score":0.28529998660087585},{"id":"https://openalex.org/C2779076696","wikidata":"https://www.wikidata.org/wiki/Q1280670","display_name":"Family planning","level":4,"score":0.28299999237060547},{"id":"https://openalex.org/C121272143","wikidata":"https://www.wikidata.org/wiki/Q17021791","display_name":"Health indicator","level":3,"score":0.26809999346733093},{"id":"https://openalex.org/C143845886","wikidata":"https://www.wikidata.org/wiki/Q381763","display_name":"Demographic transition","level":4,"score":0.2678999900817871},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.2655999958515167},{"id":"https://openalex.org/C146834321","wikidata":"https://www.wikidata.org/wiki/Q2979672","display_name":"Closure (psychology)","level":2,"score":0.26159998774528503},{"id":"https://openalex.org/C19159745","wikidata":"https://www.wikidata.org/wiki/Q828395","display_name":"Social policy","level":2,"score":0.2565000057220459},{"id":"https://openalex.org/C3020672099","wikidata":"https://www.wikidata.org/wiki/Q857354","display_name":"Longitudinal data","level":2,"score":0.25119999051094055}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1186/s12889-026-29263-3","doi":"https://doi.org/10.1186/s12889-026-29263-3","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12889-026-29263-3","pdf_url":null,"source":{"id":"https://openalex.org/S200437886","display_name":"BMC Public Health","issn_l":"1471-2458","issn":["1471-2458"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Public Health","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.1186/s12889-026-29263-3","doi":"https://doi.org/10.1186/s12889-026-29263-3","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12889-026-29263-3","pdf_url":null,"source":{"id":"https://openalex.org/S200437886","display_name":"BMC Public Health","issn_l":"1471-2458","issn":["1471-2458"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Public Health","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.8999999761581421,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"sustainable_development_goals_aurora":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":[],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"Persistent":[2],"below-replacement":[3],"fertility":[4,191],"and":[5,17,78,106,119,126,138,212,225,297,343,346],"population":[6],"ageing":[7],"are":[8],"key":[9],"determinants":[10],"of":[11,69,88,151,206,249,314],"regional":[12],"health-system":[13],"resilience.":[14],"In":[15],"Central":[16],"Eastern":[18],"Europe":[19],"these":[20],"processes":[21],"intensified":[22],"after":[23,277],"the":[24,128,235,243,307,329],"1990s":[25],"transition,":[26],"but":[27],"sub-national":[28],"analyses":[29,123],"combining":[30],"administrative":[31],"maternity":[32,84],"data":[33,320],"with":[34,266],"trend":[35,332],"modelling":[36],"remain":[37],"scarce.":[38],"Greater":[39,286],"Poland":[40,287],"offers":[41],"an":[42,324],"informative":[43],"case":[44],"given":[45],"its":[46],"demographic":[47,76],"heterogeneity.":[48],"Methods":[49],"A":[50],"retrospective":[51],"longitudinal":[52],"ecological":[53],"study":[54],"was":[55,112,239,333],"conducted":[56],"for":[57,75,97],"2013\u20132023.":[58],"Two":[59],"sources":[60],"were":[61,101],"analysed":[62],"separately:":[63],"annual":[64],"live":[65,293],"births":[66,142,267,294],"by":[67,91,103,114,216],"place":[68,87],"residence":[70],"from":[71,81,144,194],"Statistics":[72],"Poland,":[73],"used":[74,96],"trends,":[77],"delivery":[79,308],"records":[80],"all":[82],"34":[83],"facilities":[85],"(by":[86],"delivery,":[89],"stratified":[90],"perinatal":[92,303,340],"reference":[93,304],"level":[94],"I\u2013III),":[95],"network":[98,309,341],"analysis.":[99],"Trends":[100],"estimated":[102],"ordinary":[104],"least-squares":[105],"segmented":[107],"regression.":[108],"The":[109,189,319,335],"income\u2013birth":[110],"association":[111,265,327],"assessed":[113],"Spearman":[115],"correlation":[116],"on":[117,268,338],"levels":[118,269],"first":[120],"differences.":[121],"Sensitivity":[122],"excluded":[124],"2020":[125],"restricted":[127,230],"facility":[129],"analysis":[130],"to":[131,148,157,180,198,231],"continuously":[132,232],"operating":[133,233],"units.":[134,318],"Reporting":[135],"followed":[136],"STROBE":[137],"RECORD.":[139],"Results":[140],"Live":[141],"rose":[143],"36,561":[145],"in":[146,153,159,196,200,208,259,292],"2013":[147,296],"a":[149,161,168,203,255,289],"peak":[150],"40,450":[152],"2017,":[154],"then":[155],"declined":[156],"27,532":[158],"2023,":[160,201,213,298],"31.9%":[162],"reduction.":[163],"Regression":[164],"over":[165],"2017\u20132023":[166],"confirmed":[167],"significant":[169,264],"decline":[170,238,291],"(slope":[171],"=":[172,187,271,274,280,283],"\u2212":[173,178,181],"2,118":[174],"births/year;":[175],"95%":[176],"CI":[177],"2,429":[179],"1,807;":[182],"p":[183,273,282],"<":[184],"0.001;":[185],"R\u00b2":[186],"0.973).":[188],"total":[190],"rate":[192],"fell":[193,215],"1.48":[195],"2017":[197,211],"1.33":[199],"against":[202],"national":[204],"low":[205],"1.099":[207],"2024.":[209],"Between":[210],"deliveries":[214],"40.3%":[217],"at":[218,222,227],"Level":[219,223,228,236,316],"I,":[220],"30.3%":[221],"II":[224],"29.2%":[226],"III;":[229],"units,":[234],"I":[237,317],"33.0%,":[240],"indicating":[241],"that":[242],"larger":[244],"figure":[245],"reflected":[246],"permanent":[247],"closure":[248,313],"four":[250],"peripheral":[251,315],"units":[252],"rather":[253,350],"than":[254,351],"disproportionately":[256,311],"greater":[257],"fall":[258],"demand.":[260],"Income":[261],"showed":[262],"no":[263],"(\u03c1":[270,279],"\u22120.370;":[272],"0.293)":[275],"or":[276],"first-differencing":[278],"0.167;":[281],"0.668).":[284],"Conclusions":[285],"experienced":[288],"sustained":[290],"between":[295],"distributed":[299],"broadly":[300],"evenly":[301],"across":[302],"levels,":[305],"while":[306],"contracted":[310],"through":[312],"did":[321],"not":[322],"support":[323],"independent":[325],"income\u2013fertility":[326],"once":[328],"common":[330],"time":[331],"removed.":[334],"findings":[336],"bear":[337],"adaptive":[339],"planning":[342,348],"geriatric-care":[344],"expansion,":[345],"represent":[347],"implications":[349],"tested":[352],"outcomes.":[353]},"counts_by_year":[],"updated_date":"2026-10-20T09:52:01.089006","created_date":"2026-10-19T00:00:00"}
