Women Deprivation Index and Family Planning Utilisation in Urban Geography of West African Countries

Abstract

Inequalities in health care utilisation and outcomes vary significantly across geographies. Though available evidence suggests disparity in contraceptive uptake in favour of urban compared with rural geographies, there are unassessed nuances among women in urban communities. This study examines some of these disparities within the context of socioeconomic deprivations and family planning utilisation among urban women in West Africa. A secondary analysis of the most recent Demographic and Health Survey dataset of five selected West African countries was conducted, using pooled data of 21,641 women aged 15–49 years. Associations between family planning utilisation and women's deprivation status were investigated using a binary logistic regression model. The findings show that more than one-quarter of the women were severely deprived across the countries except Senegal (17.4%), and the severely deprived consistently have relatively low contraceptive prevalence rates (CPR) (16.0–24.3%) compared with women with no/low deprivation across the countries except Senegal (39.8%). The results for long-acting reversible contraceptives (LARC) were not consistent across the five countries: whereas, LARC utilisation was lower among severely deprived women in Nigeria (9.1%), Guinea (9.6%), and Mali (19.3%), utilisation was similar across the deprivation groups in Benin and Senegal. In the multivariable analyses, the log-odds of modern contraceptive utilisation decreases by 0.27 among the moderately deprived (ß = −0.27, SE = 0.05, p < 0.01) and by 0.75 among the severely deprived women (ß = −0.75, SE = 0.05, p < 0.01) compared with those with no/low deprivation, with variations across the countries. Similarly, the log-odds of LARC utilisation decreases by 0.44–0.72 among the severely deprived women compared with those with no/low deprivation across the countries except Senegal. This study concluded that family planning intervention programmes and policies need to underscore the deprivation context of urban geographies, particularly among women living in informal settlements.

Multidimensional Deprivations and Associated Factors Among Older Adults in Urban Geographies of Nigeria: Implications for Poor Health Outcomes in Later Life

“…However, there are unassessed disparities and nuances in urban settings. Urban geographies in many developing countries, especially in Nigeria, are susceptible to alarming crime rates, poverty, high cost of living, environmental hazards and socioeconomic inequalities [15][16][17]. Poverty in the urban setting is linked to the worsening environmental degradation and poor socioeconomic infrastructure coupled with poor governance and institutional deficiencies [18][19][20][21].…”

Disentangling rural-urban modern contraceptive utilization disparity among sexually active women of reproductive age in Sierra Leone: a Blinder-Oaxaca decomposition analysis

“…Additionally, evidence from studies done in Sub Saharan Africa, western Africa, D.R Congo and Nigeria reported that urban women use modern contraception more frequently than rural women (1,15,16), and rural fertility is significantly higher than urban fertility (1).…”

“…A study conducted in Sierra Leone using the 2013 demographic health survey (DHS) data found that living in an urban area was associated with increased odds of modern contraceptive utilization among married or in-union women when compared to living in rural areas (14). Additionally, evidence from studies done in Sub Saharan Africa, western Africa, D.R Congo and Nigeria reported that urban women use modern contraception more frequently than rural women (1, 15, 16), and rural fertility is significantly higher than urban fertility (1).…”