Contraceptive use dynamics in developing countries

Unmet need has been studied by various researchers and discussed extensively. However, there is dearth of studies, which address the issue of unmet need for contraception among the youth (15-24 years) women and compared it with the older women (25-49 years). The overall objective of this study is to address the issue of unmet need of family planning. Specifically, this study aims to focus the unmet need of family planning among the women of age group 15-25 years and compare the findings with the women of age group 25-49 years. The study also examines the key determinants of unmet need of family planning in India. National level data from third round of National Family Health Survey (NFHS) conducted during 2005-2007 has been used for the analysis purpose. This survey provides information on various issues including awareness about family planning, contraceptive use, unmet need to use for family planning methods. Women of 15-24 years total unmet need is 22.8 percent in comparison to the women of age group 25-49 years ( 9.4 percent). Among youth women the unmet need for spacing methods is 17.8 percent and for limiting methods 5.0 percent. One can infer from the levels of unmet need that youth women of the country would like to delay their next pregnancy but not able to use any spacing method of family planning.

It is well known that the contraceptive prevalence in sub-Saharan Africa is low Consequently, the unmet need for contraception is also likely to be quite high in these countries. Sub-Saharan countries differ significantly in educational level, economic status and population policy formulations. How do the patterns of contraceptive use vary by male and female in the context of higher HIV/AIDS? How did the patterns of contraceptive use change over time?
The objectives of this paper are; (a) to study the patterns of contraceptive use in southern Africa in the context of higher HIV/AIDS prevalence , (b) to find out the determinants of contraceptive use in southern Africa and (c) to correlate contraceptive prevalence and unmet need with the achievement of Millennium Development Goal 5,i.e. improving maternal health.
Data and Methods
Five countries viz. DRC, South Africa, Botswana, Mozambique and Zambia are selected for the study. The data from different rounds of DHS will be used for the analysis. Analysis will be carried out by pooling data from different rounds of DHS. Analysis will be carried out using bi-variate and multi-variate statistical techniques. Multilevel multinomial model will be applied to find out the e

Accessibility of contraceptives is a critical factor in determining the use of family planning. Regional differential in contraceptive access in India suggest for a better understanding and exploration of contraceptive method mix which might help program planners and increase use. Data from the District Level Household Survey Data 2007-08 on 4,73,768 currently married women belonging to 22,825 villages of India have been used to examine factors related to the accessibility of family planning services. The effects of individual- level and community-level factors were analyzed jointly.

The analysis measures access to health and family welfare services at village level, by a composite index. The results of the multivariate analysis indicate that not only access to public health facility have influence on utilization of family services after adjusting for the household-level and individual-level socioeconomic and demographic variables, there are some specific components of access e.g. presence of ANM (Auxiliary Nurse/Midwife), connectivity to all weather road, availability of pharmaceutical shops in village etc, have much higher effects on contraceptive use. Thus community resource and along with increased availability of contraceptive methods and information could increase use of family planning.

This analysis will examine the patterns of temporary contraceptive method use among a representative sample of urban women from Uttar Pradesh, India. In particular, differences between women that use condoms, other temporary modern methods (pills, IUD, or injectables), and traditional methods will be explored, including socio-demographic characteristics of users, fertility desires, patterns of switching between methods, and pregnancy outcomes within a two year period. Patterns of multiple method use during a two year period will also be examined. The data come from baseline and midterm surveys conducted in four cities of Uttar Pradesh, India in 2010 and 2012 by the Measurement, Learning & Evaluation (MLE) project as part of the evaluation of the Urban Health Initiative. The midterm survey included a two year calendar of contraceptive use, discontinuation, switching, and pregnancy, which will be used for the analysis. The authors aim to add to the evidence base on the use of temporary methods and birth spacing, specifically among condom users. The analysis will also contribute to the body of research on urban health by considering wealth and slum/non-slum residence among the characteristics that differentiate temporary method users.

Contraceptive use dynamics plays the vital role for the fertility reduction and empowered women in Bangladesh which is indeed one of the most substantial achievements for the Millennium Development Goals (MDGs). It is to identify the factors associated with contraceptive use and it seems imperative to know the issues related to contraceptive use through which fertility can be controlled. However, in Bangladesh though the rate of fertility has been declined for increasing use of contraceptives, but it is still far from replacement level. In this study, an attempt has been made to examine the role of contraceptive use dynamics for the fertility reduction in using nationally representative data from Bangladesh Demographic and Health Survey (BDHS), 2007. The study also emphasis on the issues related to contraceptive use and women autonomy and empowerment, which directly or indirectly have impact on fertility reduction in Bangladesh. The prominent multivariate technique such as logistic regression has been used to identify the important factors affecting contraceptive use, autonomy and empowerment. The result indicates that the contraceptive users are more empowered and autonomous than non-contraceptive users. Bongaarts model has been used to know the impact of contraceptive use on fertility reduction.

In Mexico, despite the overall increase in contraceptive use among women in reproductive ages (68.5% in 1997 and 72.5% in 2009); there are no in-depth studies of regional differences and changes over time.
The study shows regionally unmet needs for contraception of married women of reproductive age and changes between 1997 and 2009, using logistic regression models with information from national surveys.The regionalization identifies nine forms of exclusion measured as a percentage of the population that does not participate in the enjoyment of essential goods and services.
The proportion of women with unmet needs for contraception in 1997 was 12.2% and 9.8% in 2009. For both years (1997 and 2009), women with higher unmet needs are those belonging to the age group 15-19 years (27% and25%). Indigenous language speakers (26% and 21%), those living in rural areas (22% and 26%). Disparities persist on women with lower educational attainment (22% and 17%) and living in highly marginalized regions. It is concluded that there were no changes in the levels of women's unmet needs between the twelve years of study, after controlling certain socio-demographic variables. Changes showed are due to larger population groups with lower unmet needs for contraception in 2009.

This paper examine the trends and differentials in contraceptive use in Egypt using data from the 1988, 1995, 2000 and 2005 Egypt Demographic and Health Surveys. The contraceptive practice rate has increased from 30.3 percent in 1984 to 59.2 percent in 2005. This represents a relative increase of 95.4 percent. In 1984, 19.2 percent of rural women, compared with 45.1 percent of urban women, were using contraception. However, by 2005, the proportion of women using contraception has increased significantly in rural areas, 56.8 percent compared with 62.6 percent in urban areas. From 1984 to 2005, the relative increase of contraceptive use for rural women was 195.8 percent compared with 38.8 percent for urban women. The difference in contraceptive use in rural and urban areas in Egypt was less in 2005 compared with 1984 and 1988. In sum, the overall convergence in contraceptive use is evident among rural and urban women in Egypt. An analytical model composed of socioeconomic development, status of women, and family planning variables is tested using logistic regression. Decomposition analysis suggests that the shift in population structure favored increased contraceptive use in Egypt.

This paper utilizes data collected in 2011 from a randomized cluster survey conducted in three rural districts in Tanzania to examine whether women who reported use of contraceptives did so for the purposes of stopping or spacing childbirth. A total of 3,211 women were interviewed on reproductive and child health related issues, including fertility and family planning behavior. Women were asked if they would like to have any more children and if so at what time. Pregnant women were asked about the intentionality of their pregnancy. The analysis will tabulate bivariate relationships between relevant independent and dependent variables and develop a multinomial logit model examining the determinants of respondent classification into a five category polytomous outcome variable, on the implementation of reproductive preferences conditional on various independent variables. Analysis is ongoing and current results are tentative. The contraceptive prevalence rate in the study area mirrors the national measure obtained through the 2010 DHS. While the majority of met need amongst users is motivated by desire to space pregnancies, limiting is the dominant motivation amongst women reporting an unmet need for family planning. Implications for reproductive health programs and policies in Tanzania are reviewed and discussed.

Background: High levels of fertility in Nigeria are a function of both low demand for and low use of contraceptive methods. Method choice is an important determinant of sustained contraceptive use and a number of barriers have been identified. However, our understanding of how clients themselves perceive their choice of method is very limited.
Methods: This study uses qualitative data to examine attitudes and norms surrounding decision-making for method choice.
Results: Choosing a contraceptive method was presented as a medical decision. Participants often mentioned the issue of whether a method is compatible with a woman’s “body system”. This compatibility is determined by tests conducted by a doctor and dictates the method chosen, with the assumption that there will be no side effects.
Discussion: This level of medical mystery placed on family planning is problematic. A belief that a test exists to predict side effects would likely result in disappointment by the user, and possibly a reluctance to switch methods, when side effects do occur. Messages need to be crafted to increase understanding among current and potential family planning users about the process of choosing a contraceptive method, the potential for side effects, and the choice of switching methods.

Fertility in sub-Saharan Africa remains the highest in world and the decline in birth rates in the region has slowed further over the past decade. Yet, the average contraceptive prevalence in Africa is the lowest in major world regions and there has been limited investigation of contextual influences on contraceptive use in the region. Using data from the 2003 Mozambique Demographic and Health Survey, we estimate random intercept logistic regression models to examine the mechanisms through which community context influences women’s use of a modern method of contraception in Mozambique. We find that community context influences the use of modern methods of contraception by shaping the social and opportunity environment in which women live. In particular, we find that residing in a community with higher levels of female education, higher average age at first sexual intercourse, higher percentage of women who were told about family planning at health facility has a significant effect on a woman’s use of a modern method of contraception. We also find that living in a community where polygyny is common and where there is higher proportion of women who have not a final say on own visit to family or relatives has a significant negative effect.