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

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.

Determinants of Modern Contraceptive Uptake among Nigerian Women: Evidence from the National Demographic and Health Survey

“…Similar studies in Malawi and Ghana respectively have found a strong association between wealth quintile and modern contraceptive use 11,29 . A study in Malawi reported a significant difference in prevalence of modern contraceptive use of 82.4% among women of richest wealth quintile compared to 66.8% among the poorest.…”

“…A study in Malawi reported a significant difference in prevalence of modern contraceptive use of 82.4% among women of richest wealth quintile compared to 66.8% among the poorest. Women in the richest wealth quintile were more likely to ever use modern contraceptive (OR=2.36; CI=2.07-2.69, p<0.001) than the poorest 11 . This suggests that financial constraint probably plays a role in reduced contraceptive usage among poor women.…”

“…In addition, an individual's financial capacity often affects the utilization of modern contraceptives 10 . Several studies have recorded higher contraceptive use among women with the richest wealth quintile compared to the poorest 6,9,[11][12][13] . The use of modern contraceptives has been reported to be higher among the highly empowered and the upper class women compared to the poorly empowered and lower class women 14 .…”

“…Several studies have reported higher uptake of modern contraceptives in the urban and southern parts of Nigeria compared to uptake by women in the rural and northern parts of Nigeria 11,21 . Several socio demographic factors which may be prevalent in those locations could possibly explain the differences and not the locations themselves.…”

What influences women’s contraceptive choice? A cross-sectional study from Turkey

“…According to the women interviewed, to be informed about how different contraceptive methods work and to have one's questions answered are both important components of contraceptive counselling. In undeveloped countries, household income was shown to have an effect on the use and choice of contraception method [21]. Both the prevalence of regular use of contraceptives and choice of modern contraceptives were higher among women with higher incomes.…”