Determinants of contraceptive use and method choice

Paper examines the contraceptive use dynamics and investigates whether there has been enough informed choice for contraceptives in South Asia using data from 3 rounds of recent DHS in four countries-Bangladesh, India Nepal and Pakistan. DHS asked the current users whether they were informed about the possible side effects, what to do if they experienced side effects, told about other methods they could use and told that sterilization is permanent. Informed choice is analyzed by selected socio-economic characteristics of users through descriptive statistics and multivariate methods.

Nepal, Bangladesh and India have made about 10% point progress (36% in early 1990s to 44%-48% in 2005-07). There is one or another dominant method of family planning in most of the countries in the region. Only 25% users in India, 38% in Pakistan and almost half in Nepal were ever informed by a health worker about other methods they could use. Also very few were informed about the side effects. Informed choice significantly differs by socio-economic characteristics of users and was low among poor and public facilities users. Finding of study that basket of contraceptive choice is limited and informed choice is significantly low, calls urgent attention from program managers and policy makers.

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

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.

This paper uses data from the 2000 and 2004 Demographic and Health Surveys to examine the factors explaining the contraceptive method choice in Malawi. Multinomial logistic regressions were used to study the determinants of the contraceptive method-choice. The results show that the major determinants of contraceptive use are age, respondents’ and partners’ approval of family planning, family planning discussion with partner, number of living children, work status, education and visit to a health centre. As a policy measure, information, education and communication programmes on family planning should be intensified, particularly in rural areas and targeting men.

Key words: Malawi, Contraceptive use, logistic regression, socio-economic, Demographic and health survey