Differential effect of wealth quintile on modern contraceptive use and fertility: evidence from Malawian women

Sunday A Adedini,Latifat D Ibisomi,Stephen A Adebowale,Martin E Palamuleni

doi:10.1186/1472-6874-14-40

Abstract

BackgroundHigh fertility and wide inequality in wealth distribution are phenomenal problems in sub-Saharan Africa. Modern Contraceptives (MC) are useful for limiting fertility, but are not always easily accessible in Malawi. This study examines the gap in MC use and fertility between women in the richest and poorest Wealth Quintile (WQ).MethodsThe study was cross-sectional in design and utilized Malawi DHS dataset, 2010. It focused on women of reproductive age. The dependent variables are ever and current use of MC. Chi-square and multinomial logistic regression were used for the analysis.ResultsMean children ever born by women in the poorest and richest WQs were 3.94 ± 2.7 and 2.82 ± 2.3 respectively (p < 0.001). The adjusted total fertility rate (Adj.TFR) was higher among women in the poorest (Adj.TFR = 7.60) WQ than the richest (Adj.TFR = 4.45). The prevalence of ever use of MC was higher among women in the richest WQ (82.4%) than the poorest (66.8%) (p < 0.001). Similar pattern exists for current use of MC; 58.5% and 45.9% for women in the richest and poorest WQs respectively (p < 0.001). Women in the richest WQ were more likely to ever use (OR = 2.36; C.I = 2.07-2.69, p < 0.001) and currently using (OR = 1.66; C.I = 1.40-1.97, p < 0.001) MC than their counterparts in the poorest WQ. Slight reduction in odd-ratio of MC use among women in richest WQ resulted when socio-demographic variables were used as control.ConclusionFertility was higher and the use of MC was lower among women in the poorest than their counterparts in the richest WQ. Ensuring availability of MC at little or no cost may bridge the gap in contraceptive use between women in the poorest and richest WQ in Malawi.

Highlights

High fertility and wide inequality in wealth distribution are phenomenal problems in sub-Saharan Africa
The mean children ever born of the women in the poorest (3.94±2.7) was higher than their counterparts in the richest (2.82±2.3) wealth quintile (p
Conscious of the implications of high fertility on the health and socioeconomic status of women, in this study, in addition we explored the association between modern contraceptive use and children ever born

Summary

Introduction

High fertility and wide inequality in wealth distribution are phenomenal problems in sub-Saharan Africa. Modern Contraceptives (MC) are useful for limiting fertility, but are not always accessible in Malawi. This study examines the gap in MC use and fertility between women in the richest and poorest Wealth Quintile (WQ). Planning is the conscious effort by a couple to limit or space the number of children they want to have through the use of contraceptives [1]. It improves health, reduces poverty, and empowers women [1]. Contraceptive is the main issue galvanizing unprecedented efforts to the attainment of the themes of Millennium Development Goals by year 2015 [2] and action plan of 1994 International Conference on Population and Development in Cairo [3].

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Conclusion