Contraceptive use dynamics in developing countries

This paper explores the influence of women’s education on having a particular category of unmet need (unmet need for spacing and stopping, met need for spacing and stopping, no need). Women’s education is one of the most well-established factors linked to fertility. Although we have evidence on the connections between women’s education and her fertility behavior and outcomes, we know much less about how women’s education influences unmet need. This paper attempts to fill that gap by studying education differentials in unmet need over time in India. We use data from the National Family Health Surveys to decompose total unmet need into its components of met and unmet need for spacing and stopping respectively. Preliminary analyses suggest a strong educational gradient in unmet need for spacing and stopping. The complete paper will assess this relationship using multivariate analyses, explore some of the reasons thereof, and consequences of these differentials.

Despite numerous reproductive health programmes on contraceptive use, many African countries still record low contraceptive prevalence and high levels of fertility. Studies have shown mismatch in fertility intention and subsequent reproductive behaviour of women. A possible explanation is the influence of male partners on contraceptive use and fertility outcomes. Could the fertility intention of males therefore predict contraceptive use and eventual fertility outcome in households? Using the 2008 Nigerian Demographic and Health Survey male data, this study investigates if and the extent to which fertility intention of sexually active males in Nigeria influences their contraceptive use. Result show that only 9.3% of men in the analysis were using modern contraceptive methods while 15.9% wanted to limit and 34.9% wanted to space births. Fertility intention was found to be significantly associated with use of modern methods at both bivariate and multivariate levels. The implications of the findings were also discussed.

Since the mid-1990s, the humanitarian community has expressed increasing concern for the reproductive health needs of conflict-affected populations, including access to contraceptive information and services. Yet, empirical research on the reproductive health consequences of armed conflicts has remained relatively scarce, mainly due to a shortage of reliable data.
This paper represents the first attempt to examine the effect of the recent war in Iraq on contraceptive use dynamics. The analysis relies on pooled data from the 2000 and 2006 Iraq Multiple Indicator Cluster Surveys (I-MICS). A difference-in-differences approach is used to assess changes in contraceptive use before and after the onset of war across governorates with different levels of conflict intensity. From 2000 to 2006, the probability of contraceptive use increased by 19% among women in the Kurdish region, and by 14% among those in the Southern governorates of the country that were only mildly affected by the conflict. However, the probability of contraceptive use stalled among women in the governorates with a high level of conflict intensity, including Baghdad, and dropped by 10% among those in the most conflict-affected governorate of Anbar. The paper addresses possible reasons for these diverging trends and discusses their policy implications.

Uganda has a low contracepive prevalence of 30%, high total fertility rate of 6.2 children and high under five morality rates of 90 deaths per 1000 live births. Using the 2006 DHS dataset on a sample of 8531 women, we set out to examine the effects of under-five mortality on fertility preference and contraceptive use in Uganda. The data used herein was selected based on birth and death histories as well as on reproduction and contraception information. Studied variables included; whether women would want to have another child, had lost a child and whether they were using or intended to use contraceptives. Descriptive statistics of Resepondents' background characteristics were generated. Logistic regression models were used to examine the relationship between child survival status with whether a woman would want to have another child and whether they were using or intend to use contraceptives. Findings present statistical significance between child survival and the independent variables which included; contraceptive use, fertility preference, education, religion and wealth status. Women who had lost a child had higher odds of not using contraceptives and were more likely to prefer having anmother child. The results present a high need to reduce mortality and improve access to health care to vulnerable populations.

Background
The right to reproductive choice and the contraceptive choices made to actualize reproductive preferences are of importance to population and development policy.

Methods
This study is based on a Sexual and Reproductive Health survey which was undertaken in 2011 by the Kintampo Health Research Centre in Ghana. It aims to identify the methods chosen by non-pregnant women in union who desire to space or stop childbearing and to determine how contraceptive choices are influenced by their fertility desires. A simple random sample of 5975 was drawn from a resident population of 35619 women aged 15 to 49 years from the KHDSS database.

Expected Outputs:
Tabulations of basic descriptive statistics and tabulations of outcome and explanatory variables, cross-tabulations of all fertility preferences and contraceptive method choice and are tested for significant relationships using chi-squared tests and relative risk ratios from multinomial logistic regression fitting explanatory variable against outcome variable

This study is based on analysis of variations in contraceptive use for women born between 1957 through 1991 considering age cohort effects; this is based on the hypothesis that people born at different time periods experience different socio - economic circumstances which influence their attitudes and behaviors towards development issues like contraception. Uganda Demographic and Health Survey 2006 data with a sample of 5,362 currently married women and those living together in unions was analyzed and conclusions drawn at the multivariate level. Binary logistic regression model was used in analysis because of the binary nature of the outcome and results indicate higher likelihood of contraceptive use for older cohorts compared to younger ones hence family planning programs should be targeted towards younger cohorts to reduce fertility rate from 6.4 children per woman and reduce maternal health problems that result from too many or too closely spaced births. Although age cohort differences are pertinent in influencing contraceptive use, other factors like women’s income levels, schooling level, place of residence have a stronger effect on the same therefore regional interventions focused particularly in the North and West Nile regions, rural communities and efforts to increase literacy levels will yield greater results.

Health information dissemination ensures behavior change among risk population against practices that promote ill-health. Facilities and personnel are used for its adoption for behavior change to teenagers’ lifesaving skills. However, research studies in Nigeria relating to information and communication technology (ICT) have been limited to only arts and dramas with limited attention paid to health information. This study therefore determined effects of communication technology in dissemination of contraceptive use among Nigerian teenagers

Total of 202 participants in 4 youth centres in Nigeria were used, 6 hypotheses tested and 4 ICT instruments used for the study at the four centres

The results revealed there was significant behavior change on teenagers’ attitude and behaviour. It showed there was significant behavior on teenagers’ knowledge in contraceptive use and significant result on attitude of teenagers to contraceptive use and education. However, there was no significant gender difference on teenagers’ knowledge and contraceptive use and no significant gender difference on teenagers’ attitude to contraceptive use and education

Government at all levels should support the establishment of ICT youth centres to improve teenagers’ behaviours and practices on contraceptive use to address risky practices

While playing a key role in all stages of reproduction Palestinian men remain absent from research on reproductive health. The present research thus proposes to analyze the involvement of these men in contraceptive choices and practices within the couple.We conducted a secondary analysis of data from the Palestinian Health Survey (2006) focused on family planning and fertility desire. Only women were interviewed in this survey but they were asked about the opinions and attitudes of their husbands (N=5,291 married women). In addition, 47 semi-structured interviews were conducted with married Palestinians (men and women) on their desire fertility and contraceptive itineraries.Women whose husband wants more children than they do have a higher probability of using contraception than those whose husband wants the same number of children:OR=1.58[1.25-2,01]. Second, reproductive behaviours involving men, such as deciding overall contraceptive use or a method involving men, are related to the socio-economic characteristics of the spouses and various indicators of marital closeness: monogamy, communication within the couple and consistency of fertility preferences. This research highlights the importance of conjugal interactions and the emergence of a space for domestic decision-making around procreative choices and practices.

Maternal health issue is a major global concern since pregnancy and childbirth are the leading causes of death, disease, and disability among women in their reproductive period. This concern is also well acknowledged in the fifth millennium development goal (MDG) that aims to reduce infant deaths and improve maternal health while providing universal access to sexual and reproductive health services by 2015. Contraception in postpartum period plays an essential role to prevent unwanted pregnancy and to reduce the risk of infant and maternal mortality by optimal birth intervals. Thus it calls for an investigation about the patterns and determinants of timing of postpartum contraceptive use among women. The present study is directed towards investigating the timing of contraceptive initiation among Indian women in extended postpartum period, a period which is different from other periods with regard to menstrual pattern and sexual behavior of women. Survival plots and hazard model techniques are employed to analyze the time variable with respect to various characteristics of women. The main finding obtained using the data of National Family Health Survey- III clearly demonstrate the lack of motivation among Indian women, whether amenorrheic or menstruating, about initiating modern contraceptives in this period.

In India, urban fertility has already reached the below replacement level. However, at the subnational levels, urban fertility varies from 1.4 in Assam to 3 children per woman in Uttar Pradesh. The national family health surveys suggest that the decline in fertility rate does not commensurate with an increase in contraceptive prevalence rate (CPR) during 1992-2006 at the state level. On one hand, urban Punjab registered a decline of two percent in CPR but the fertility declined by about a quarter while 76% increase is noticed with a decline in urban fertility was below 20% in UP. Thus, to examine contraceptive method-mix not only from the angle of fertility decline, but also becomes equally critical to see how couples making contraception choices in urban settings when sexually transmitted infections, sexual satisfaction and rights to make choice are at the centre stage. This paper finds that modern spacing methods are on the rise in the urban setting of all states except Tamil Nadu, Andhra Pradesh and J & K but use of limiting methods have gone up except in states like Punjab, Odisha, Assam and HP during 1992-2006. In most of the states, the prevalence of IUD and vasectomy has reduced that has been compensated by the rise in the prevalence of condoms and Pills, and traditional methods. Socioeconomic differentials in method-mix.