Shaping the Family: Contraception and Family Formation in Ghana and Mali as viewed through the Lens of the Capability Approach

We apply here the capability framework developed by Amartya Sen to revisit the debate on the link between fertility and contraception and the domination in this respect of the “unmet needs” paradigm. Upstream from the demand for contraception what matters is whether a woman possesses the freedom to formulate a plan about having children, that is, the capacity to shape the contours of her family.

We use the most recent DHS from Ghana and Mali, two countries with different fertility levels but characterized, in both cases, by low contraception prevalence, and a large gap between the knowledge and use of modern contraception. We proceed using a three-step analysis. First, we examine the extent to which contraception knowledge opens up the opportunity to manage realized fertility through the use of contraception and, in this respect, how women differ from men. Second, we examine the characteristics of women who do not use contraception but have the intention of using it. Finally, we examine how women with distinct contraceptive behaviour have control over their pace of family formation as measured by their birth intervals. More generally, we discuss whether the dimension of individual control introduced by contraception has generated new inequalities.