Variation In Contraceptive Use Research Articles

Contraceptive Use Among Traditional Medicare And Medicare Advantage Enrollees.

Medicare is the primary source of health insurance coverage for reproductive-age people with Social Security Disability Insurance. However, Medicare does not require contraceptive coverage for pregnancy prevention, and little is known about contraceptive use in traditional Medicare and Medicare Advantage. We analyzed Medicare and Optum data to assess variations in contraceptive use and methods used by traditional Medicare and Medicare Advantage enrollees, as well as among enrollees with and without noncontraceptive clinical indications. Clinically indicated contraceptives are used for reasons other than pregnancy prevention, including menstrual regulation or to treat acne, menorrhagia, and endometriosis. Contraceptive use was higher among Medicare Advantage enrollees than traditional Medicare enrollees, but use in both populations was low compared with contraceptive use among Medicaid enrollees. We found significant variation by Medicare type with respect to contraceptive methods used. Relative to traditional Medicare, the probability of long-acting reversible contraception was more than three times higher in Medicare Advantage, and the probability of tubal sterilization was more than ten times higher. Overall, Medicare enrollees with noncontraceptive clinical indications had twice the probability of contraceptive use as those without them. Medicare coverage of all contraceptive methods without cost sharing would help address financial barriers to contraceptives and support the reproductive autonomy of disabled enrollees.

Comparative analysis of contraceptive use in Punjab and Manipur: exploring beyond women\u2019s education and empowerment

BackgroundWomen’s education and empowerment are important predictors of contraceptive use across countries. However, two of the Indian states, namely, Punjab and Manipur, showed large variations in contraceptive use, despite the similar level of women’s educational attainment and empowerment. Therefore, this paper attempts to understand variation in contraceptive use between these states, despite having similar level of educational attainment and empowerment among the married women.MethodsThis study primarily used cross-sectional data of the National Family Health Survey (NFHS) 2015–16 and to some extent the District Level Household Survey (DLHS) 2012–13 data. The analytical sample includes 13,730 currently married women in Punjab and 8,872 in Manipur. Modern contraceptive prevalence rate (mCPR) is the key outcome variable of this study. Bivariate, multivariate, and multilevel regression analysis are applied to understand the differences in mCPR between these states and its determinants.ResultsMean years of schooling was about 8 years among women of both the states, and about 34% of the women in Punjab and 27% of the women in Manipur have high level of autonomy. Despite this, use of modern method was 66% in Punjab and only 13% in Manipur. Coverage of family planning program indicators were significantly lower in Manipur than Punjab – frontline workers’ (FLWs) outreach for family planning was only 18% in Manipur compared to 52% in Punjab. Similarly, only 11% of the public health facilities in Manipur compared to 50% of the health facilities in Punjab were ready to provide at least one clinical method of family planning.ConclusionDespite the similar level of individual level characteristics across the two states, poor coverage of family planning programs – low outreach of FLWs, low level of facility readiness, as well as sociocultural norms discouraging contraceptive use – might be responsible for lower contraceptive use in Manipur than Punjab. This implies for strengthening the health system for family planning in Manipur to meet the contraception needs of women by addressing sociocultural barriers in the state.

Contraceptive Use and Pregnancy Outcomes Among Women Enrolled in South Carolina Medicaid Programs.

State medicaid programs provide access to effective contraception for people with lower incomes. This study examined contraception use and pregnancy among reproductive-age women enrolled in the South Carolina Medicaid, by eligibility program and socio-demographic sub-groups. A retrospective cohort of women aged 15-45 who were newly eligible for South Carolina Medicaid from 2012 to 2016 was examined. Log-binomial regression and average marginal effects assessed relationships between contraception use and pregnancies ending in live and non-live births. Contraception was categorized as permanent, long acting reversible contraception (LARC), short-acting hormonal contraception (SAC), or no contraceptive claims. Women with family planning or full-benefit medicaid coverage were included. Approximately 11% of women used LARC methods, 41% used SAC methods, and 46% had no evidence of contraceptive claims. Method utilization varied by eligibility program, race/ethnicity and age. The likelihood of pregnancy was lower among SAC users and lowest among LARC users compared to women with no evidence of contraception across all three programs (family planning APR = 0.44; 95% CI 0.41-0.49 and APR = 0.13, 95% CI 0.10-0.17; Low income families APR = 0.82; 95% CI 0.77-0.88 and APR = 0.33, 95% CI 0.28-0.38; Partners for Healthy Children APR = 0.72; 95% CI 0.68-0.77 and APR = 0.35, 95% CI 0.30-0.43, respectively). Non-Hispanic Black and Hispanic teens were less likely to experience a pregnancy than non-Hispanic white teens. The likelihood of pregnancy was lower among women using SAC methods and markedly lower among women using LARC. Variation in contraceptive use among racial/ethnic groups was noted despite Medicaid coverage. As new policies and initiatives emerge, these findings provide important context for understanding the role of Medicaid programs in reducing financial barriers to contraceptive services and ensuring access to effective contraception, while fostering reproductive health autonomy among women.

Does cosmopolitan culture weaken ethnic and regional diversity: contraceptive behaviours of women in Istanbul, Turkey

Objective The primary aim of the study was to examine the relationship between self-reported ethnic identity, region of birth and contraceptive use, in Istanbul, Turkey. Methods Cross-sectional data from a random sample of 3038 married women of reproductive age living in two urban districts of Istanbul were used in a series of logistic regression models to assess key relationships. Results Kurdish ethnic minority women were less likely than Turkish ethnic majority women to use traditional contraceptive methods over no method (relative risk ratio [RRR] 0.69; 95% confidence interval [CI] 0.50, 0.96). However, there were no significant differences between ethnicities (i.e., Turkish, Kurdish and other) and modern method use. Among Turkish women, those born in regions farther away from the western region were more likely to use traditional methods (RRRnorthern 2.06; 95% CI 1.31, 3.22). Conclusion While Kurdish ethnic minority women were less likely to use traditional methods, compared with Turkish ethnic majority women, the difference might have been due to the length of time living in a neighbourhood. Regional variations in contraceptive use were concentrated only among Turkish ethnic majority women and for traditional methods. Regional norms of traditional method use may be a barrier to modern contraceptive use in Turkey.

Patterns, trends, and factors associated with contraceptive use among adolescent girls in Zambia (1996 to 2014): a multilevel analysis

BackgroundDespite high levels of pregnancy and childbearing among adolescents in Africa, contraceptive use remains low. Examining variations in contraceptive use among adolescent girls is vital for informing programs to improve contraceptive utilisation among this segment of the population. This study aimed to examine the patterns, trends, and factors associated with contraceptive use among adolescents in Zambia over the period 1996–2014.MethodsThe study involved an analysis of data from 1996, 2001/2, 2007 and 2013/14 Zambia Demographic and Health Surveys focusing on adolescent girls aged 15–19 years. Analysis entailed descriptive statistics and estimation of multilevel logistic regression models examining variations in contraceptive use among adolescent girls over time. Estimates with p-values less than 0.05 were considered statistically significant.ResultsResults showed that contraceptive use remains low and ranged from 7.6% in 1996 to 10.9% in 2013/14, reflecting a change of 3.3 percentage points over 18 years. Over the 18 years, contraceptive use was significantly associated with age, level of education, and marital status. Older adolescent girls and those with higher levels of education were significantly more likely to use contraception compared to younger ones and those with lower levels of education. Although initially significant (AOR 0.556, 95% CI 0.317, 0.974 in 1996), rural-urban differences disappeared between 2001/2 and 2007 but re-emerged in 2013/14 (AOR 0.654, 95% CI 0.499, 0.859). Across all survey years, adolescents who were married or living with a partner were significantly more likely to use contraceptives compared to those who were not married.ConclusionsThe findings suggest the need for targeted interventions to improve contraceptive use among sexually active adolescent girls in the country in general, and those who are disadvantaged in particular.

Does Higher Percentages of Women With Higher Education Within District Impacts Individuals Use of Contraception in Uttar Pradesh?

Uttar Pradesh in India is high fertility state which contributes maximum to India’s population growth. The use of family planning method is amongst the lowest in the State and has witnessed a decline during the two consecutive National Family Health Survey (NFHS) period of round 3 & 4. The use of any methods of contraception declined from 56.3% in 2005-06 to 53.5 % in 2015-16. A decline of 2.8 percent points in-spite of all the programmatic push. Similarly, the use of any modern contraceptive methods declined from 48.5% to 47.8% during this period. This decline in the use of contraception necessitates revisiting determinants of contraceptive use at the district (group) level. The availability of district level data from NFHS-4 makes it possible to estimate between district variations in contraceptive use in UP. The Intra-class correlation coefficient of 0.1528 reveals that 15.28 percent of the variation in contraceptive use is due to between district differences in Uttar Pradesh while 84.72 percent variation is due to within district individual differences. At individual level younger age, higher parity, Hindu religion, educated secondary or higher school levels and those belonging to higher SES other than poor quintile have significant higher odds of contraceptive use. At district (group) level, the higher percentages of women educated higher school levels within district significantly determines the use of contraception in Uttar Pradesh.

Unintended effects of Janani Suraksha Yojana on maternal care in India.

BackgroundThe Janani Suraksha Yojana (JSY) is the largest ever conditional cash transfer programme worldwide. It primarily aimed to reduce the maternal and child mortality by increasing the facility based delivery in India. Besides, the JSY has resulted in reduction of out-of-pocket expenditure for delivery care and increased antenatal care. Though studies have examined the direct outcome of JSY, limited studies have attempted to understand the unintended effects (indirect) of the programme. The aim of this study is to examine the effect of JSY on contraceptive use, initiation of breast feeding and postnatal check-up in India.Data & MethodsData from the National Family Health Survey 4, 2015–16 was used in the analyses. A total of 148,746 institutional births in five years preceding the survey were analysed and the analyses were carried out for Low Performing States (LPS) and High Performing States (HPS). Descriptive statistics and the propensity score matching were used to understand the unintended effects of JSY.ResultsIn India, the use of contraception, early initiation of breastfeeding and postnatal check up was consistently higher among JSY beneficiaries compared to non-JSY beneficiaries. Among JSY beneficiaries, about 45% of the mothers breastfed their child within one hour compared to 42% of the JSY non-beneficiaries. The pattern was almost similar for postnatal check-up. The variations in contraceptive use, breastfeeding practice and postnatal check-up among JSY beneficiaries were higher in LPS states compared to HPS. For instance, in LPS, among JSY beneficiaries, about 58% mothers breastfed their child within one hour of delivery compared to 46% in HPS. Controlling for socio-economic covariates, the JSY beneficiaries in LPS were 12% more likely to use contraception, 8% were more likely to initiate the breast feeding within one hour of child delivery and 6% were more likely to get their postnatal check-up than their counterparts in HPS.DiscussionThe unintended effects of JSY were strong and significant in the low performing states. The coverage of JSY should be further extended and the programme needs to be continued.

Variation in contraceptive prevalence rates in Tanzania: A multilevel analysis of individual and regional determinants

ObjectiveThe aim of this study was to answer two key questions: (1) what are the individual and regional determinants of contraceptive use; and (2) what are the effect(s) of individual and regional variables on regional differences in contraceptive use? Data and methodMultilevel logistic regression was applied on data from the Tanzania Demographic and Health Survey (TDHS) 2010 that allowed us to investigate simultaneously the individual and the regional determinants of contraceptive use and its regional variation. ResultsThere was significant variation in contraceptive use, both between population groups as well as between regions. A higher number of children ever born, urban residence, and a non-manual occupation are characteristics associated with higher odds of a woman using contraceptives. Women who talk about family planning with community-based distribution workers and clinic staff also have higher odds of using contraceptives. The regional differences in the shares of women with a secondary education or above explain a significant portion of the regional variance in contraceptive use. Having secondary education and above is related to lower contraceptive use. ConclusionThis study constitutes a first step towards gaining a better understanding of the macro-level effects on decision-making processes regarding contraceptive use. The regional educational level explains a significant portion of the regional variance in contraceptive use. Implication statementAn advantage of our study over other studies in Tanzania is that we extended the determinants of contraceptive use to include not only individual-level factors, but also regional-level factors.

Regional variations of contraceptive use in Bangladesh: A disaggregate analysis by place of residence.

This study advances current knowledge on contraceptive use in Bangladesh by providing new insights into the extent of regional variations in contraceptive use across rural and urban areas of Bangladesh. We examined the regional variations in contraceptive use among 15,699 currently married women ages 15–49 years using data from the 2014 Bangladesh Demographic and Health Survey (BDHS). Multivariate logistic regression models of contraceptive use were calibrated with sociodemographic attributes and cultural factors. Based on the aggregate sample (i.e., rural and urban combined), we found significant regional variations in contraceptive use across the administrative divisions in Bangladesh. Based on a disaggregate sample (i.e., rural and urban separately), we found that there were significant differences in divisional variations in contraceptive use in rural areas. In contrast, no significant variation in contraceptive use across divisions in urban areas of Bangladesh was found. More specifically, among women living in rural areas, the Rajshahi and Rangpur divisions had higher odds of contraceptive use than the Barisal division, whereas the Chittagong and Sylhet divisions had much lower odds of contraceptive use even after adjusting for selected sociodemographic attributes and cultural factors. A separate analysis of the divisional variations in usage of modern methods of contraception also revealed similar findings with only one exception. Findings of this study provide an evidence-based direction for adapting a pragmatic approach to reducing the divisional disparity of contraceptive use in rural areas of Bangladesh.

Patterns and determinants of contraceptives utilization in a religiously homogeneous settlement: a Nigerian case study

Objective: To identify the determinants of contraceptive utilization in a religiously homogenous settlement in Nigeria. Methods: Using Nsukka, Enugu State as a case study, the study utilized primary data generated using a structured questionnaire administered on 600 female respondents aged 15-49 on pre/post-natal care hospital visits. The datasets were analyzed at univariate and bivariate levels and using binary regression. Results: Women aged 20–29 constituted 44.6% of the respondents, 80% were married, 80.2% were Christians, 42.1% had secondary education, 5.2% earned above N80,000 monthly and 56.8% used contraceptives. Variations in contraceptive use were found to be significantly associated with age, income, occupation and religion (P < 0.05) while the regression analyses showed that religion was the only significant predictor of contraceptive use among the sample (P < 0.05). Being unemployed became significant only when religion was controlled for. Conclusion: With religion being a more dominant determinant of contraceptive utilization, even in a largely religiously-homogeneous settlement, scaling up contraceptive usage for population health and development should involve health professionals and social workers in their various churches. Keywords: Contraceptive Use, Religion, Health Professionals, Social Workers, Nsukka, Nigeria

Beyond geography: Cultural zones and global patterns of modern-method contraceptive use

To increase understanding of global variation in contraceptive use, we classify countries into “cultural zones” based on religious traditions and geographical regions. Using data for 156 countries, we model modern contraceptive use rates as a function of cultural zones, geographic regions, economic development, women’s education, and time. We find that cultural zones explain modern-method contraceptive use better than geographic regions alone, even when adjusting for economic development, women’s education, and time. We argue that practitioners and researchers should make use of cultural zones as a tool for understanding cross-national variation in sexual and reproductive health outcomes.

Correction: Does proximity of women to facilities with better choice of contraceptives affect their contraceptive utilization in rural Ethiopia?

[This corrects the article DOI: 10.1371/journal.pone.0187311.].

Does proximity of women to facilities with better choice of contraceptives affect their contraceptive utilization in rural Ethiopia?

BackgroundThere is limited evidence of the linkage between contraceptive use, the range of methods available and level of contraceptive stocks at health facilities and distance to facility in developing countries. The present analysis aims at examining the influence of contraceptive method availability and distance to the nearby facilities on modern contraceptive utilization among married women in rural areas in Ethiopia using geo-referenced data.MethodsWe used data from the first round of surveys of the Performance Monitoring & Accountability 2020 project in Ethiopia (PMA2020/Ethiopia-2014). The survey was conducted in a sample of 200 enumeration areas (EAs) where for each EA, 35 households and up to 3 public or private health service delivery points (SDPs) were selected. The main outcome variable was individual use of a contraceptive method for married women in rural Ethiopia. Correlates of interest include distance to nearby health facilities, range of contraceptives available in facilities, household wealth index, and the woman’s educational status, age, and parity and whether she recently visited a health facility. This analysis primarily focuses on stock provision at public SDPs.ResultsOverall complete information was collected from 1763 married rural women ages 15–49 years and 198 SDPs in rural areas (97.1% public). Most rural women (93.9%) live within 5 kilometers of their nearest health post while a much lower proportion (52.2%) live within the same distance to the nearest health centers and hospital (0.8%), respectively. The main sources of modern contraceptive methods for married rural women were health posts (48.8%) and health centers (39.0%). The mean number of the types of contraceptive methods offered by hospitals, health centers and health posts was 6.2, 5.4 and 3.7 respectively. Modern contraceptive use (mCPR) among rural married women was 27.3% (95% CI: 25.3, 29.5). The percentage of rural married women who use modern contraceptives decreased as distance from the nearest SDP increased; 41.2%, 27.5%, 22.0%, and 22.6% of women living less than 2 kilometers, 2 to 3.9kilometers, 4 to 5.9 kilometers and 6 or more kilometers, respectively (p-value<0.01). Additionally, women who live close to facilities that offer a wider range of contraceptive methods were significantly more likely to use modern contraceptives. The mCPR ranged from 42.3% among women who live within 2 kilometers of facilities offering 3 or more methods to 22.5% among women living more than 6 kilometers away from the nearest facility with the same number (3 or more methods) available after adjusting for observed covariates.ConclusionsAlthough the majority of the Ethiopian population lives within a relatively close distance to lower level facilities (health posts), the number and range of methods available (method choice) and proximity are independently associated with contraceptive utilization. By demonstrating the extent to which objective measures of distance (of relatively small magnitude) explain variation in contraceptive use among rural women, the study fills an important planning gap for family planning programs operating in resource limited settings.

Pregnancy Intention and Contraceptive Use among Women by Class of Obesity: Results from the 2006–2010 and 2011–2013 National Survey of Family Growth

ObjectiveConflicting research findings on the association of obesity and pregnancy intention may be due to their collective definition of obesity at a body mass index of 30 kg/m2 or greater. However, obese women with a BMI of 40 kg/m2 or greater may be both behaviorally and clinically different from obese women with a lower BMI. This study reexamines this relationship, stratifying by class of obesity; the study also explores variations in contraceptive use by class of obesity given their potential contribution to the incidence of unintended or unwanted pregnancy. MethodsThis study combined data from the 2006 through 2010 and 2011 through 2013 US National Survey of Family Growth. Pregnancy intention (intended, mistimed, unwanted) and current contraceptive use (no method, barrier, pill/patch/ring/injection, long-acting reversible contraceptive, sterilization) were compared across body mass index categories: normal (18.5–24.9 kg/m kg/m2), overweight (25.0–29.9), obese class 1 (30.0–34.9 kg/m2), class 2 (35.0–39.9 kg/m2), and class 3 (≥40 kg/m2, severe obesity). Weighted multinomial logistic regressions were refined to determine independent associations of body mass index class and pregnancy intention, as well as contraceptive method, controlling for demographic, socioeconomic, and reproductive factors. ResultsBody mass index data were available for 9,848 nonpregnant, sexually active women who reported not wanting to become pregnant. Women with class 3 obesity had significantly greater odds of mistimed (adjusted odd ratio [aOR], 1.67; 95% confidence interval [CI], 1.02–2.75) or unwanted (aOR, 1.96; 95% CI, 1.15–3.32) pregnancy compared with normal weight women. Women with class 2 or 3 obesity were more likely to not be using contraception (aOR, 1.53–1.62; 95% CI, 1.04–2.29). Although women with class 2 obesity were more likely to be using long-acting reversible contraceptive methods and sterilization over short-acting hormonal methods (aOR, 1.67; 95% CI, 1.08–2.57; aOR, 2.05; 95% CI,1.44–2.91), this association was not observed among women with class 3 obesity. ConclusionsWomen with class 3 obesity are at greater risk of unintended pregnancy and are less likely to be using contraception than normal weight women. Whether these findings are related to patient and/or provider barriers that are not as visible among women with class 1 and class 2 obesity warrants further investigation.

Trends and regional variations in contraceptive use among women in the united states based on the center for Medicaid and children's health insurance program (CHIP) services (CMCS) proposed quality measures

Trends and regional variations in contraceptive use among women in the united states based on the center for Medicaid and children's health insurance program (CHIP) services (CMCS) proposed quality measures

State variations in women's socioeconomic status and use of modern contraceptives in Nigeria.

BackgroundAccording to the 2014 World Population Data Sheet, Nigeria has one of the highest fertility and lowest contraceptive prevalence rates around the world. However, research suggests that national contraceptive prevalence rate overshadows enormous spatial variations in reproductive behavior in the country.ObjectiveI examined the variations in women’s socioeconomic status and modern contraceptive use across states in Nigeria.MethodsUsing the 2013 Nigeria Demographic and Health Survey data (n = 18,910), I estimated the odds of modern contraceptive use among sexually active married and cohabiting women in a series of multilevel logistic regression models.ResultsThe share of sexually active, married and cohabiting women using modern contraceptives widely varied, from less than one percent in Kano, Yobe, and Jigawa states, to 40 percent in Osun state. Most of the states with low contraceptive prevalence rates also ranked low on women’s socioeconomic attributes. Results of multilevel logistic regression analyses showed that women residing in states with greater shares of women with secondary or higher education, higher female labor force participation rates, and more women with health care decision-making power, had significantly higher odds of using modern contraceptives. Differences in women’s participation in health care decisions across states remained significantly associated with modern contraceptive use, net of individual-level socioeconomic status and other covariates of modern contraceptive use.ConclusionUnderstanding of state variations in contraceptive use is crucial to the design and implementation of family planning programs. The findings reinforce the need for state-specific family planning programs in Nigeria.

Trend and determinants of contraceptive use among women of reproductive age in Ghana

The study examined the trend in contraceptive use among sexually active women of reproductive age in Ghana. The study also investigated the socioeconomic determinants of contraceptive use. Cross tabulations and logistic regression analyses were performed on data from the Ghana Demographic and Health Surveys 1988 - 2008. The results indicate low contraceptive use among women with marked variation in contraceptive use across various socioeconomic groups and administrative regions. Evidence from the logistic regressions suggests that improving education and reducing poverty are critical in improving contraceptive use and reducing unmet need for family planning. Child survival, access to family planning services and knowledge of contraceptive methods were also found to be significant determinants of contraceptive use. The importance of improving financial and infrastructural access to contraceptives was confirmed by the findings of the study.

Disparities in modern contraception use among women in the Democratic Republic of Congo: a cross-sectional spatial analysis of provincial variations based on household survey data.

This study investigates inequalities at the province level of the use of modern contraception and the proportion of short birth intervals among women in the DRC using data from the 2007 Demographic and Health Survey. Logistic regression and Bayesian geo-additive models were used. The posterior odds ratio and the associated 95% credible interval (95% CI) were estimated using Markov Chain Monte Carlo (MCMC) techniques. Posterior spatial effects were mapped at the province level with the associated posterior probability maps showing statistical significance at 5%. The overall rates of modern contraception use among the entire sample of women (15-49 years old; N = 7172) and youth (15-24 years old; N = 1389) were 5.7% and 6.0% respectively. However, there was striking variation in contraceptive use between the two groups across provinces with a clear east-to-west gradient. The highest use in the total sample was in Nord-Kivu (OR 1.32; 95% CI 1.12, 1.55) and Bas Congo provinces (1.47; 1.22, 1.78). For the youth, the highest use was observed in Nord-Kivu (1.19; 0.92, 1.65). In multivariate Bayesian geo-additive regression analyses among the entire sample of women, factors consistently associated with lower use of modern contraception were living in rural areas (0.71; 0.62, 0.82), living in low-income households (0.67; 0.54, 0.80) and having no education (0.83; 0.67, 0.97). For the youth sample, living in low-income households (0.57; 0.41, 0.84) and no breast-feeding (0.64; 0.47, 0.86) were consistently associated with a lower use of modern contraception. The study shows a distinct geographic pattern in the use of modern contraception in youth and the entire sample of women in the DRC, suggesting a potential role for socioeconomic factors, such as accessibility, affordability and availability, as well as environmental factors at the province level beyond individual-level risk factors.

The role of son preference on modern contraceptive use in Bangladesh

This study tries to examine the relationship between son preference and contraceptive use at different parities of women in Bangladesh. This study reveals that the sex composition of the surviving children moderately influences the women’s practices of modern contraceptive use at lower parities. The more sons a women has, she is more likely to use modern contraceptive at parity one and two. But this is not true for the women at parity three or more. At lower parities, this behavior may be primarily because women with at least one son among their living children are less likely to want more children and they are satisfied with the sex composition of their children. Among the women at parity three or more, contraceptive using rate is lower among them who have two or more son than those women who have one living son. This variation in contraceptive use at parity three or more may owe to have at least one daughter or not satisfied with the sex composition of children or lack of consciousness about family planning. Keyword: BDHS, modern contraceptive, parity, sex composition, son preference, trend.

Intergenerational Differences in Current Contraceptive Use among Married Women in Uganda

We analyze variations in contraceptive use and age cohort effects of women born from 1957 to 1991 based on the hypothesis that individuals born at different time periods experience different socio-economic circumstances. Differential exposure to socioeconomic circumstances may influence women's attitudes and behavior towards critical life issues such as contraceptive use. We use data from the 2006 Uganda Demographic and Health Survey by limiting the analysis to 5,362 women who were currently married (or cohabiting) at the time of the survey. Logistic regression analyses show a higher likelihood of contraceptive use among older cohorts than younger cohorts. These results call for interventions that target young women to reduce fertility and reproductive health challenges associated with too many or too closely spaced births. Although variations in age cohorts are critical in influencing current contraceptive use, other factors such as wealth status, education level, and place of residence are equally important. Thus, interventions that focused on selected regions (e.g., the North and the West Nile), rural communities, and efforts to increase literacy levels will accelerate uptake of contraception and improve maternal and child health.