Trends and socio-demographic components of modern contraceptive use among sexually active women in Rwanda: a multivariate decomposition analysis

Abstract

Background The attainment of targets set for modern contraceptive use remains a challenge in sub-Saharan Africa. Rwanda, in its new Family Planning and Adolescent Sexual Reproductive Health/Family Planning (FP/ASRH) Strategic Plan 2018–2024 has set the attainment of a contraceptive prevalence rate (CPR) of 60% by 2024. To achieve this, identifying factors that enhance modern contraceptive use among sexually active women is critical. Methods We used three Rwanda Demographic Health Surveys (RDHS) datasets collected in 2010, 2015, and 2019/2020 in a multivariable decomposition analysis technique to describe trends and identify factors influencing change in modern contraceptive use among sexually active women aged 15–49 years. Results presented as coefficients and percentages took into consideration the complex survey design weighted using StataSE 17. Results Modern contraceptive use increased from 40% in 2010 to 52.4% in 2020 among sexually active women. About 23.7% of the overall percentage change in modern contraceptive use was attributable to women’s characteristics which included women’s education levels, number of living children, and being told about family planning at health facilities. Coefficients contributed 76.26% to the change in modern contraceptive use. This change was attributed to modern contraceptive use among young women between the age of 20–24 years, women’s education level, the number of living children, changes in family size, and being visited by community health workers. Conclusion Rwanda remains on course to archive its 2024 family planning targets. However, there is a need to enhance programs that target sexually active adolescents and young adults, and women from rural areas to sustain the gains made. Furthermore, continuous support of community health workers will be key in exceeding the set targets of modern contraceptive use among sexually active women in Rwanda.

Social context of contraceptive use transition among sexually active women in Zambia (1992–2018): A decomposition analysis

“…Consistent with prior studies conducted in Rwanda, Tanzania, Ethiopia, and Kenya [ 12 , 60 – 62 ]. This study showed that change in contraceptive use was mainly as a result of changes in women’s contraceptive behaviour.…”

“…This study showed that change in contraceptive use was mainly as a result of changes in women’s contraceptive behaviour. However, the finding that 15% of the increase in contraceptive use in Zambia was explained by differences in women’s characteristics is lower compared to what was found in Ethiopia (34%), Cameroon (69%) and Rwanda (23%) [ 12 , 17 , 61 ]. The variations in population structure and socio-economic characteristics of women in the study countries may account for the disparity in the observed changes in CPR across different counties.…”

“…Literature show that contraceptive use transition differs across countries in SSA. While there has been an increase in contraceptive use in some countries, in others there has been a stall and yet a decrease is noted in some countries [ 12 ].…”

“…Many governments in SSA are investing local resources to strengthen FP programmes. Strong political commitment, public education campaigns, improved access to SRH services, and increased availability of contraception methods have contributed to success of family planning initiatives in various countries [ 12 , 16 – 19 ].…”

A multilevel analysis of trends and predictors associated with teenage pregnancy in Zambia (2001–2018)

“…Teenagers who live in rural areas and are from poorest households had an increase in teenage pregnancy over the four surveys analysed for this study. This finding could be explained by inadequate access to SRH information and low contraception use among young teenager from rural areas and those from poor communities [ 9 , 10 , 23 , 33 ]. The increase in the trends of teenage pregnancy was also observed among those illiterate and married/formerly married teenage women.…”