Contraceptive use and lengthening birth intervals in rural and urban Eastern Africa

Towriss, Catriona; Timæus, IM

doi:10.4054/demres.2018.38.64

Cited by 19 publications

(26 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similarly, women in Muslim communities of Asian countries usually had more children, desire for additional children and if they desire no more children, less likely to use contraceptive methods than the non-Muslims [50]. Urban women uses contraceptive more than the rural, this finding is in agreement with other studies conducted in Ethiopia and different parts of the world [51–53]. Women in the urban areas might have better decision-making confidence, autonomy, availability of contraceptive methods and even better living standards than the rural women.…”

Section: Discussionsupporting

confidence: 85%

Individual and community level associates of contraceptive use in Ethiopia: a multilevel mixed effects analysis

Abate

Tareke

2019

Arch Public Health

View full text Add to dashboard Cite

BackgroundFamily planning is one of the four pillars of safe motherhood initiative to reduce maternal death in developing countries. Despite progress in contraceptive use, unmet needs are wide open and fertility remains high. Ethiopia have a higher fertility rate which contributes to maternal and child health destitution, putting pressure on the already weak health system. This study examined individual and community-level factors associated with contraceptive use in Ethiopia.MethodsData from Ethiopian Demographic and Health Survey 2016 were used to identify individual and community level associated factors among reproductive-age women. Non-pregnant, fecund and sexually active women aged 15–49 were included. Six hundred forty-two communities and 6854 women were involved from this two-stage cluster sampled data. The analysis was done using two-level mixed-effects logistic regression to determine fixed effects of individual and community-level factors and random intercept of between characteristics.ResultsFrom the total eligible women for contraceptive use 2393 (34.9%) of them were users. Injectables were the commonest of all contraceptive methods. Various individual-level variables were associated with contraceptive use. Household wealth index, women’s age, number of living children, husband’s occupation, ever experience of a terminated pregnancy, current working status of the women, number of births in the last 3 years, and hearing of FP messages through different media were significantly associated individual-level variables after adjusting other factors. Community characteristics like region, place of residence, religion, and community-level wealth were the factors associated with contraceptive use.ConclusionBoth individual and community-level characteristics were significant predictors of use of contraceptives in Ethiopian women. Besides the individual-level factors, interventions should also consider community-level associates.

show abstract

Section: Discussionsupporting

confidence: 85%

Individual and community level associates of contraceptive use in Ethiopia: a multilevel mixed effects analysis

Abate

Tareke

2019

Arch Public Health

View full text Add to dashboard Cite

show abstract

“…The importance of this result is underscored by the large proportion of women in the study expressing a desire to wait many years before the next child. This desire was also mentioned by the majority of respondents in a qualitative study in the same slums [11]. In this study, women explained that they would not want to have two children in secondary school at the same time.…”

Section: Discussionmentioning

confidence: 66%

“…In African cities, women experience a constant dilemma between concerns for the costs of an additional child and the desire for a larger family [11–13]. Having an additional child in these highly uncertain circumstances may put extra pressure not only on their household economic circumstances but also the spousal relationship [11]. Women who want to postpone childbearing for a long time or do not want any more children may also have conflicted preferences.…”

Section: Introductionmentioning

confidence: 99%

Childbearing desires and behaviour: a prospective assessment in Nairobi slums

Machiyama

Mumah

Mutua

et al. 2019

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background Advancing an understanding of childbearing desires is an important precursor to achievement of the policy goal of reducing unintended pregnancies. It has been long debated that concepts of fertility desires and planning may be particularly problematic in sub-Saharan Africa. However, examination of the utility of fertility preference measures and their link to reproductive behaviour is still rare in the region. The aim of this study is to assess the predictive validity of future childbearing desires on subsequent reproduction among women living in the highly unpredictable circumstances of Nairobi slums. Methods We used data from a longitudinal study (2007–2010) nested in the Nairobi Urban Health Demographic Surveillance System that is located in two slums in Nairobi, Kenya. We analysed baseline fertility desires among 4577 postpartum women. Cox proportional hazard model was employed to examine the effect of fertility desires on subsequent reproduction. Results One-third of the women wanted no more children and 37% wanted to wait for at least five years at baseline. While two-thirds of the women who wanted to have a child soon became pregnant within three years, less than one-third of those wanting no more children became pregnant. The multivariable analysis shows that the probability of becoming pregnant among women who expressed desires to stop or delay childbearing at least for five years was 50% less than among women who wanted to have a child in two to four years. In addition to prospective fertility desires, level of woman’s education, residence and ethnicity exerted important influences on implementation of baseline preferences. Conclusions Our study finds a strong link between baseline fertility desires and subsequent reproduction. A large difference in pregnancy risk was observed between those who wanted no more children and those who wanted another child. The link between a woman’s stated desire to stop childbearing and subsequent childbearing is just as strong in the Nairobi slums as elsewhere. In addition, the findings revealed a pronounced gradient in pregnancy risk according to preferred spacing length, which support other evidence on the important contribution of long-term spacing or postponement to fertility decline in sub-Saharan Africa.

show abstract

“…The status quo in the Sahelian fertility dynamics is usually briefly mentioned in the existing literature. Sahelian countries are generally referred to as an exception in the cross-continental trend of increasing birth intervals since the 1970s (Moultrie, Sayi, and Timaeus 2012: 248;Towriss andTimaeus 2018: 2029).…”

Section: Introductionmentioning

confidence: 99%

Forty years of fertility changes in the Sahel

Spoorenberg¹

2019

DemRes

View full text Add to dashboard Cite

BACKGROUND Despite much discussion on the fertility changes in sub-Saharan Africa, the countries of the Sahel have received only limited attention. Their comparatively high and stable fertility levels contributed them being labeled as an exception in sub-Saharan Africa. OBJECTIVE This study investigates whether countries of the Sahel are an exception in the crosscontinental trend of increasing birth intervals since the 1970s in sub-Saharan Africa. METHODS Using birth history data, the levels and trends in parity progression ratios and birth intervals are reconstructed for four decades in four countries of the Sahel (Burkina Faso, Chad, Mali, and Niger). RESULTS In all four countries, parity progression ratios have changed little, but births have been occurring later and the age at which an average woman is bearing her seventh child has increased. CONCLUSIONS While the lengthening of birth intervals has been associated with lower fertility in many analyses, this study shows that a similar process is found in countries with high and stable total fertility rates. CONTRIBUTION This study contributes to revise some commonly accepted views on the fertility dynamics in the Sahel.

show abstract

Contraceptive use and lengthening birth intervals in rural and urban Eastern Africa

Cited by 19 publications

References 25 publications

Individual and community level associates of contraceptive use in Ethiopia: a multilevel mixed effects analysis

Individual and community level associates of contraceptive use in Ethiopia: a multilevel mixed effects analysis

Childbearing desires and behaviour: a prospective assessment in Nairobi slums

Forty years of fertility changes in the Sahel

Contact Info

Product

Resources

About