Women’s employment and family planning in rural Uganda

Abstract

Despite impressive progress in increasing contraceptive use in developing countries during recent decades, the uptake has lagged behind in Africa. One of the most critical factors in raising the use of contraception is women's employment status. This study analyzed the link between women's employment and family planning in rural Uganda and addressed shortcomings in the literature by using nationally representative panel data from the 2010 and 2012 rounds of the Uganda National Panel Survey for 800 women aged 15-49 years, and estimating heterogeneous effects for different types of employment and across socioeconomic characteristics. Employment was not associated with greater use of modern contraceptives, but off-farm wage-employed women were more likely to use traditional contraception. The correlation of employment was strongest for women who had reached their desired fertility status, but became insignificant for poorer women who lived in remote areas. However, likely due to the ineffectiveness of traditional methods, off-farm wage employment was not associated with greater spacing between births. Our findings implied that providing rural employment opportunities for women is insufficient to increase the uptake of modern contraceptives. To enhance the effectiveness of family planning programs, health-care officers should target off-farm wage-employed women to address their unmet contraceptive needs.

Employment Status in the United States and Use of Long-Acting Reversible Contraception or Moderately Effective Contraception before and after the Affordable Care Act: National Survey of Family Growth 2006–2010 and 2015–2017

“…( Kelaher et al, 2007 ). Our findings are dissimilar, however, from older studies in the Unites States ( Kraft and Coverdill, Nov 1994 , Engelhardt et al, 2004 ) and from recent studies on this topic in developing countries ( Al Riyami et al, May 2004 , Islam et al, 2016 , Van den Broeck, 2020 ) which link female employment and greater contraceptive use.…”

“…Since half of all women who experience an unintended pregnancy reported not using a contraceptive method ( Finer and Henshaw, 2006 ), one goal of Healthy People 2020 was aimed at decreasing the proportion of unintended pregnancies in the US primarily by increasing access to reliable contraceptives ( Office of Disease Prevention and Health Promotion, 2019 , Jones et al, 2002 ). Employment has been linked to an increase in contraceptive use in many recent studies of developing countries ( Al Riyami et al, May 2004 , Islam et al, 2016 , Van den Broeck, 2020 ). About 50% of the population in the US receive health insurance from their employer ( Kaiser Family Foundation, 2018 ) and historically, female employment has been associated with increased contraceptive use and falling fertility rates ( Kraft and Coverdill, Nov 1994 , Engelhardt et al, 2004 ).…”

Understanding perceived access barriers to contraception through an African feminist lens: a qualitative study in Uganda

“…Recognizing that many communities in Africa still use traditional methods of contraception such as the pullback method or herbs and teas, for the purpose of this study modern contraception refers to hormonal birth control such as the pill, vaginal ring, injection, implant, IUD and patch. The question about the accessibility of modern contraception has been a topic of serious debate in the international development community, especially in the Sub Saharan African context where fertility remains very high [2][3][4]. Uganda's exceptionally high birth rate is one of the highest in the world at 5.8 children per woman of child bearing age [5].…”

“…While there are governmental policies in place that give Ugandan women the right to access contraception, poor implementation of these policies is keeping reproductive and maternal health indicators low [4]. The rates of modern contraception use among youth are especially troubling, as 63% of unmarried sexually active women between 15 and 19 years old, and 43% of unmarried sexually active women between the ages of 20 and 24 years old are not using any type of birth control at all [8].…”

“…The overall rate of unmet need for contraception, that is women who want to either stop or delay pregnancies and cannot get access, is 31% in Uganda, despite the average in East Africa being 24% [11]. A reduction in unmet need of contraception would reduce the occurrence of unwanted pregnancies, meet the fertility desires of women in rural areas, improve overall community health, and serve national population policy goals [4,7,[11][12][13].…”