Article

Contextual Influences on Modern Contraceptive Use in Sub-Saharan Africa

Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Ga 30322, USA.
American Journal of Public Health (Impact Factor: 4.23). 08/2007; 97(7):1233-40. DOI: 10.2105/AJPH.2005.071522
Source: PubMed

ABSTRACT We examined the role of community-level factors in explaining geographic variations in modern contraceptive use in 6 African countries.
We analyzed Demographic and Health Survey and contextual data sources with multilevel modeling techniques to identify factors contributing to geographic variations in women's use of modern contraceptives.
We found significant associations between several community-level factors and reported use of modern contraceptive methods. We also identified several pathways of influence between the community and the individual.
Aspects of a community's sociocultural and economic environment appear to influence a woman's use of modern contraceptive methods.

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    • "Lutz and Kc (2011) noted that this pattern is typically more pronounced in countries that have high fertility levels and that are in the early stages of demographic transition. In particular, some scholars suggest that more educated women have greater autonomy in reproductive decisionmaking and engage in more intensive parenting to ensure a better quality of life for their children (e.g., Martin, 1995; Kravdal, 2000; Basu, 2002; Manda and Meyer, 2005; Stephenson et al., 2007; Lutz and Kc, 2011). "
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    ABSTRACT: Many studies have suggested that there is an inverse relationship between education and number of children among women from sub-Saharan Africa countries, including Malawi. However, a crucial limitation of these analyses is that they do not control for the potential endogeneity of education. The aim of our study is to estimate the role of women’s education on their number of children in Malawi, accounting for the possible presence of endogeneity and for non-linear effects of continuous observed confounders. Our analysis is based on micro data from the 2010 Malawi Demographic Health Survey, by using a flexible instrumental variable regression approach. The results suggest that the relationship of interest is affected by endogeneity and exhibits an inverted-U shape among women living in rural areas of Malawi, whereas it exhibits an inverse (non-linear) relationship for women living in urban areas.
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    • "s the environment in which people operate , which is a core requirement for the proper availability and accessibility of contraception ( Borgoni & Billari , 2003 ) . Several studies on contraceptive use have concentrated on individual or household demographic and socioeconomic factors , such as determinants of the utiliza - tion of contraception ( Stephenson et al . , 2007 ) . However , the use of modern contracep - tion also has to integrate the geographic dimension , which is not often reported but can help capture certain local or shared factors such as cultural norms , as well as contracep - tive availability and accessibility ."
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    • "The reasons for this low rate of contraceptive use may be found in socioeconomic and cultural barriers that do not advocate the use of family planning methods (Stephenson, Baschieri, Clements, Hennink, & Madise, 2007). Empirical studies in several developing countries find that the use of modern contraceptive methods is more common among better educated women than among poorly educated women (Alpu & Fidan, 2006; Ayoub, 2004; Martin, 1995; Robinson, 1996; Stephenson et al., 2007). Education plays a crucial role because the knowledge accumulated through education stimulates new ideas, enhances individual talents, and improves social capital, job opportunities, healthcare and knowledge, and the ability to make informed decisions (Bhalotra & Rawlings, 2011; "
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