Contraceptive use dynamics in developing countries

The research focused on establishing the causes of low contraceptive use in the West Nile. Uganda. The study aimed at providing a clear basis for policy measures so as to reduce or curb down the high and rapidly growing population growth rate levels. The study used secondary data from the 2006 Uganda Demographic Health Surveys (UDHS). In this study, the sample size of 8369 women aged 15-49years from the districts, Adjumani, Arua, Koboko, Nyadri, Nebbi, and Yumbe was used. The researcher used both univariate and bivariate analysis. In bivariate analysis Correlations and Chi square test was also used to measure the degree of association between the dependant variable and the independent variables.
Results indicate a significant relationship was established between mother’s age at first birth, birth interval and infants dead for those which were demographic in nature, as well as education level, religion, marital status and wealth index for socio-economic variables of which all factors were statistically significant with infant mortality. The researcher recommended increasing the number of health facilities so as to supplement the few existing government and private facilities. This would increase the level of accessibility to contraceptives and family planning facilities especially to the rural majority.Our findings also sug

The study explored the origin, architecture and role of political will in increasing contraceptive use in three sub-Saharan African countries - Ethiopia, Malawi, and Rwanda – that have stood out for phenomenal increases in contraceptive use between 2000 and 2012.

We assessed factors that have propelled changes in the attitudes of some political leaders to champion family planning; how such political will has manifested in different contexts; and how political will impacts the policy and program environment.

We use mixed methods, including desk review of policy and program documents and stakeholder interviews. The study findings demonstrate that political will for family planning evolved due to increased availability of evidence that demonstrated that family planning is central to achieving the MDGs, and that high population growth undermines efforts to transform the economies of developing countries.

We postulate that lessons from this study will help galvanize efforts to improve access to family planning services in other African countries where little progress is being made.

Women in Malawi bear on average six children, with many unintended pregnancies. Although 42% of married women use modern methods of contraception, 26% have an unmet need. The Karonga Prevention Study operates a demographic surveillance site (DSS) in northern Malawi.

An innovative method was devised for collecting family planning (FP) data using patient-held records (a “FP card”) to build a prospective longitudinal dataset, allowing exploration of continuity of use and method-switching, which can be linked to the DSS database. All 8,176 women aged 15-49 living in the DSS were offered a FP card. When a woman received FP, the health provider recorded on the FP card the date, method/service received and provider-type. After one year, the FP cards were collected for analysis.

Analysis is at an early stage but preliminary findings show that 6% of FP users used more than one method of FP during the study year (excluding condoms). Survival analysis revealed that just over a quarter of women who used injectables at the start of the study were still adhering to injections at the end of the study year. There appears to be no association between fertility intentions and discontinuation.

FP data usually come from surveys or routine data. This alternative method enables better understanding of how women maintain continuity of use.

The concept of unmet need points to the gap between some women’s reproductive intensions and their contraceptive behaviour. It is a challenge to family planning programmes, to reach and serve these millions of women. It is imperative to understand the determinants of family planning practice for the people who are living in slum. The objectives of this study is to estimate the prevalence of unmet need for Family Planning among currently married women of reproductive age and determinants of unmet need for Family Planning residing at urban slums in India. This study utilizes the third round of National Family Health Survey (NFHS-3); first time has collected data from statistically representative of slums in India. Bivariate, Pearson’s chi-square test and multivariate techniques has been used to understand the unmet need for family planning among currently married women living in slums and non slums. The prevalence of unmet need for Family Planning was found to be 12.6 recent in slum and 6.3 percent in non-slum respectively. The significant association of unmet for family planning in non-slum was lower compare to slum areas. One an important result was found non-nuclear family had more unmet need for family planning as compare to nuclear family.

Reliance on unreliable traditional ways of birth control would always give psychological tension to a couple and debar them from leading healthy sexual life. However, in Assam, half of the total contraceptive users depend on traditional contraceptive methods. Thus, present paper attempts to find out the answer to this peculiarity by taking latest National Family Health Survey 2005-06 data. Bi-variate analyses show that most of the demographic and socio-economic characteristics of traditional method users are in-between users of modern spacing and terminal methods. Traditional method users are 31 years old and married for 13 years. Traditional method use is higher among Muslim, Bengali and backward castes women, compared to their counter parts. The burden of miss-timed and unwanted fertility is highest among the traditional method users. Multi-variate statistics shows that women with lesser education, lesser marital duration, from poorer economic condition, and speakers of Assamese and Bengali language are less likely to rely on traditional method. Further, women with lesser marital duration, younger and urban women are less likely to adopt terminal method. There is an urgent need to impart proper knowledge about traditional as well as modern effective contraceptive methods for healthy reproductive life.

The paper attempts to examine the failure and abandonment by different spacing methods of family planning and to know the reasons behind contraceptive failure and abandonment by method. We tested the hypothesis-Women from poor economic status tend to have higher relative risk for abandonment and Women having health related reasons more likely to discontinue family planning method. The data for the present study is taken from the third round of(NFHS-3)conducted during 2005-06.Cox-regression model has been used to analyze calendar data. The study shows that mainly fertility and health related reasons were the reasons behind discontinue for the last method. Method related reason was also having its significance in abandonment of the last method in all the selected states. Pearl pregnancy index was generally lower for five years exposure period as compare to three years exposure. In all the cases, those women who had desire for additional child have higher relative risk to discontinue the method.

This paper tries to assess the causal mechanisms which lead to changing patterns of contraceptive use in a sample of countries in Sub-Saharan Africa, alongside improvements in socio-economic conditions and in particular, progress in educational attainment. Factors associated with socioeconomic status and the respective probability of contraceptive prevalence and desired family size are well established. Nonetheless, in spite of education raising awareness and increasing the chances of using contraception, a considerable share of educated women are classified as having an unmet need in the Demographic and Health Surveys (DHS). Given the recently revised and homogenized methods for analyzing the unmet need for family planning in the DHS, it is now possible to compare changes in contraceptive prevalence and obstacles to family planning over time. The paper presented here will investigate data from 19 countries in Sub-Saharan Africa with at least three rounds of DHS available. By applying age-period-cohort methods, we aim to establish interactions of contraceptive prevalence and obstacles to contraception with improvements in educational attainment, changing norms and values in ideal family size, opposition to family planning, family planning efforts and economic well-being over time.

Keeping in view comprehensive reproductive health care, information from rural married 117,465 women aged 15-44 regarding their contraceptive knowledge, practices and utilization of services was carried out. From among the current contraceptive users all users of IUD, OC and acceptors of a permanent method in last one year (14,276) were interviewed and a systematically selected sample of 17,082 non users. Results reveal that overall contraceptive prevalence was 45.2%. Among the current users, the contraceptive had been availed mainly from either PHC (31.5%) or hospital (42.1%). A large majority of women (70.5%) used a family planning method for the first time only after completing their desired family size. Among the never users, 73.5% mentioned at least one modern method of family planning and 64.3% mentioned the service source available. Fewer women mentioned spacing methods as compared to female sterilization. The main reason given for not using any family planning method was “family not complete” (34.6%). There is need for informed counseling for all eligible women for contraceptive use to promote small family norm by policy makers and field workers to increase acceptance of family planning and efforts should be made to make people aware of the benefit of small family norm.

Kenya was the first Sub-Saharan African country to initiate a national family planning programme way back in 1967; however, contraceptive use still remains low and the unmet need for family planning has remained at 25 per cent over the years. This paper uses data from Kenya demographic and Health Survey of 2008-09 to examine differentials in contraceptive use among women in Kenya by method type. The sample is restricted to currently married women and current method of choice. Preliminary results indicate that women prefer to use short-term hormonal methods such as pills and injectables. This can be seen across regions, type of place of residence, education levels, wealth quintiles, and religion. However with regard to age groups, only women in the age range 45-49 prefer to use long term methods such as sterilization, implants etc. This implies that women may be using short term methods for the purpose of spacing births rather than limiting births. This has implications on further fertility reductions in the country. The issue of informed choice and method availability in facilities may also determine the type of method used. Paper is still in progress

Background: High fertility and persistent unmet need still remain health challenges among women in Uganda. We explore fertility desires, trends in use of family planning (FP) and changing FP preferences among women in a rural resource limited setting.
Methods: Retrospective analysis of non-pregnant sexually active women aged 15-44 yrs enrolled in an open community cohort between 2002 and 2008.
Results: The desire for childbearing significantly increased from 36% to 42% (p<0.0001). However, this significant increase was observed among HIV-ve and not HIV+ve women. Women’s desire for a/another child declined with age and higher parity. Use of modern FP significantly increased from 35% to 42% (p<0.0001). Among women who did not desire a/another child, increased FP use was observed for short term methods (44% to 66% among HIV+ve and 39% to 46% among HIV-ve; p<0.0001) while long term method use significantly declined from 4% to 2% among both groups of women. However, over half of the women who wanted to limit childbearing stated willingness to adopt a permanent FP method, irrespective of parity and HIV status.
Conclusions: Greater attention needs to be paid to women’s intentions to limit childbearing and to provision of long-term and permanent FP in Uganda.