Contraceptive use dynamics in developing countries

The majority of existing studies on fertility regulation primarily seek to explain contraceptive practices and behaviour in terms of the individual’s or couple’s personal attributes, and household risk factors, neglecting the contextual, social and cultural environment in which the outcomes occur. Evidences regarding how contextual and community level factors influence contraceptive adoption are limited, especially in the developing countries. Using a multistage sampling design, data on contraceptive use and individual, household and community level information were collected from 1,348 women residing in an underdeveloped region of a rural area of West Bengal, India. Of all women in union about 88% were using one contraceptive method at the time of survey. Among them about 82% were using any modern method, while a minority (about 6%) were using any traditional method. The female sterilization was the most commonly used method (68% of women) followed by oral pill (17%). The preliminary results of multilevel binary logit analysis suggest that a significant community-level variation is present in contraceptive use. Village level developmental indicators and participation in community activities were found to be significantly associated with contraceptive use even after controlling the potential confounders.

Mass media has numerous functions in the society and the most prominent of these is information dissemination that can lead to changes in behavior, knowledge and practices of individuals towards certain matters such as family planning. In the context of the increasing prevalence of contraceptive use in the Philippines over the last 40 years (NDHS 2008), this paper hopes to provide inputs on the relationship between exposure to family planning (FP) messages in the tri-media (i.e. print, radio, and television) and use of contraceptives by Filipino women 15-49 years old. The data forms part of the 2008 Philippines National Demographic and Health Survey (NDHS). Bivariate and multivariate analyses were employed and Chi-square test of association was used to examine relationships between the variables. Results show that among the tri-media, television is most popular source of FP messages among Filipino women. A positive relationship exists between women’s exposure to FP messages in any of the tri-media and contraceptive use most especially on modern contraceptive methods. Albeit weak, women’s contraceptive use and exposure to FP messages in television and radio were significantly associated. Education was found to affects the relationship between exposure to FP messages in tri-media and contraceptive use.

Engaging men in family planning (FP) has been found to improve programmatic outcomes and increase gender equality. Little is known about the influence of couple communication on FP decision-making in India. We describe an intervention that utilized existing best practices for this purpose in Jharkhand, India. 572 men received 6, 90 minute sessions every 11 days for approximately 2 months. Sessions topics addressed: 1) gender equity, 2) communication skills, and 3) family planning knowledge. Post-intervention data collection is presently underway (October, 2012). At baseline 23% of the couples were using contraception and male condoms method most reported. We will test the relationship between changes in participants’ knowledge of FP, attitudes toward FP, GEM Scale scores, ease and frequency of communication and in increases in FP use. All statistically significant changes will be reported and complemented with qualitative data (focus group discussions & IDI) from participants and providers.

The fertility level in Asian countries has been declining, albeit at different pace, since the launching of family planning programmes about five decades ago. This paper uses data from published data to examine the relationship between family planning efforts, contraceptive use and fertility in four South Asian and four Southeast Asian countries. Data from Demographic and Health Surveys are used to examine fertility differentials within each country, with special emphasis on the effects of contraceptive use, women’s education, age at marriage, work participation and their status in the family. Of the countries in this study, India was the first developing country to adopt a national family planning programme in 1952, followed by Bangladesh, Nepal and Pakistan, Indonesia and Philippines in the mid- 1960s to 1970. Vietnam and Cambodia adopted a national family planning policy as recently as 1993-1994. The pace of fertility decline in South Asia accelerated only after 20-30 years of family planning program. In contrast, the impact of family planning programme on fertility decline was more immediate in the Southeast Asian countries. Scatter plots and regression analysis show that contraceptive prevalence rate (CPR) is related to family planning efforts, and fertility level is strongly associated with CPR.

Sterilization is the most popular method of contraception in India. As the demand for sterilization services remains very high with a large unmet need, the country has continued with the camp mode (mobile clinic) to reach the people in under-served and under-reached areas (MoHFW, 2008). The paper compares the types of service delivery for female sterilization in India by their socio-economic characteristics and by the awareness of alternative contraceptive methods. At the same time, the study also tries to see differentials in static and mobile service delivery facilities. The present study uses the third round of DLHS (2007-08). In the DLHS-III, 1,156,932 ever married women in the age group 15-49 have been interviewed. To analyse the data, bi-variate analysis have been performed to compare static and mobile service facilities. At the same time, logistic regression analysis has been performed to look into the factors responsible for different service deliveries. The result shows that mobile facility is more effective in rural areas. The result also depicts that Muslims compared to Hindus; urban resident compared to rural resident; and women having higher education compared to no education are statistically significant and less likely to use female sterilization.

Using data from 20 recent Demographic and Health Surveys (DHS), we estimate 1) the impact of contraceptive failure on unintended births and induced abortions, and 2) levels of unintended births and induced abortions that could be achieved if current family planning users adopted more effective contraceptive methods. We use multiple-decrement life tables to calculate contraceptive failure rates and simulate alterations of the contraceptive method mix in each country. Results show the contribution of contraceptive failure to unintended births and induced abortions to be substantial. On average, 31% of births from unintended pregnancies and 53% of induced abortions resulted from contraceptive failure. Simulations show that if all women who currently use contraceptives began using the most effective (long-acting or permanent) method to meet their fertility intentions, the level of unintended births would decrease by an average of 27%, and the level of induced abortion could be cut in half.

The contraceptive use is not only the family planning program but also the strategy to increase women empowerment. Previous studies in Indonesia mostly focused on male participation in family planning, but litle is known about the role of women in decision making for family planning. Therefore, this paper aims to explore disparity in contraceptive use among Indonesian regions by exploring women’s role.
This paper used the 2007 Indonesian Demographic and Health Survey. The sample included 18,183 currently married women aged 15-49 years old. The contraceptive use refers to as using the modern method. The crucial independent variable was combination of gender and decision making. Other control variables were characteristics of women, characteristic of husbands, number of children, and residences. The descriptive statistics, the geographic information system application and logistic regression were applied.
It was found that there was a disparity in contraceptive use between areas and women decision making played an important role in increasing contraceptive use. In addition other variables could help to increase the use of contraception.
The results from this study suggested that to increase women empowerment would reduce disparity in contraception across the country.

This research used data collected from a randomly selected sample of sixty six respondents from Masha Sub County, Isingiro district of Uganda using an interviewer’s administered questionnaire. The main objective was to identify the factors influencing contraceptive use in the area. Frequencies, cross tabulations and Binary Logistic regression were carried out to find factors for contraceptive use in Masha, Isingiro district, Uganda.

Findings show that all women were aware of contraception, Injectables being mostly used while Implants least used, most people did not use contraceptives because they are expensive, fear side effects and long distance to the family planning units. Education level was significant with contraception after cross tabulation while multivariate analysis found education and religion significant.

The researcher recommends government to encourage girl child education to increase knowledge about contraceptives. Sensitization of masses including Religious leaders on benefits of small family sizes should be done which are only achievable through contraception. More government health facilities providing contraceptive services should be put up in rural areas with all categories of contraceptives and well trained personnel to ease service delivery in Masha.

The process by which migration impacts fertility behavior and family planning needs of migrant women in cities is not well understood. This is particularly true in post-conflict settings, which tend to have limited data but patterns of migration that are likely different from non-conflict countries. This paper investigates differences in fertility outcomes and family planning (FP) use between recent migrants and long-term residents in Kinshasa, Africa’s third-largest and fastest growing city. Findings show that migrants have higher unmet need and intention to use than long-term residents, but only slightly, and similar ASFRs. There is no significant difference for current or ever-use of contraception. This still suggests that high rates of migration without increases contraceptive access could contribute to greater increases in unmet need in Kinshasa relative to other areas of the country and that any increases in FP resources might be best spent meeting growing needs in Kinshasa.

Indian Family Planning programme has bestowed great deal of responsibility on women over the past five decades. However, it is well known that fertility decision making in traditional rural and patriarchal societies to a great deal be influenced by husbands and other family members. We examine the factors related to the use of contraception and preferred duration of child spacing among economically poor and nonpoor couples in India.

We use the couple data (N=39257) from the third round of National Family Health Survey (Indian version of DHS) conducted in 2005-06. We use wealth index and clubbed the lowest two categories of wealth index (poorest & poorest) to define poor and highest three categories (middle, richer & richest) to define nonpoor couples. We used logistic regression models to predict the likelihood of contraceptive use among couples. We also used ordered logistic regression models to examine the effect of socioeconomic and demographic factors on the length of child spacing.

We found significant differences in the use of contraceptive methods and preferred duration of birth interval among poor and non-poor couples in India. On average, poor couples are more likely to have sorter birth interval and opted for sterilization to restrict child bearing. On the contrary, couples from nonpo