Conceiving of Contraception: World Society, Cultural Resistance, and Contraceptive Use, 1970–2012

Social Forces ◽  
2020 ◽  
Author(s):  
Wade M Cole ◽  
Claudia Geist
Keyword(s):  
Contraceptive Use ◽  
Unmet Need ◽  
World Society ◽  
Modern Contraceptive ◽  
Cultural Resistance ◽  
African Countries ◽  
Orthodox Christian ◽  
Cultural Effects ◽  
Sub Saharan ◽  
Using Data

Abstract Taking world society theory as our point of departure, we examine the effect of world culture on contraceptive use rates around the world. World-cultural rhetoric frames contraception as a necessity for economic development, a human rights issue, and a women’s health matter. Using data on contraceptive use among married women for a sample of 159 countries over the period from 1970 to 2012, we find that linkages to all three sets of discourses are associated with increased use of modern contraceptive methods, over and above countries’ sociocultural and economic characteristics. Nevertheless, we also find that world society influences vary across major cultural zones, defined in terms of predominant religions and geographic regions. World cultural effects are strongest in Orthodox Christian, Hindu, non-Western Protestant, and sub-Saharan African countries. There is no effect in Western and East Asian countries, where contraceptive use is comparatively high, or in zones such as non-Western Catholic nations, where the unmet need for contraception is often greatest. Compared to development and women’s rights rhetoric, health-based frames appear to have the broadest and most effective reach across cultural divides. Overall, however, we find that world society processes tend to produce cross-cultural convergence in contraceptive use rates.

Factors Influencing Contraceptive Use in Sub-Saharan Africa: A Systematic Review

2017 ◽  
Vol 37 (2) ◽  
pp. 79-91 ◽  
Author(s):  
Sarah R. Blackstone ◽  
Ucheoma Nwaozuru ◽  
Juliet Iwelunmor
Keyword(s):  
Contraceptive Use ◽  
Male Partner ◽  
Sub Saharan Africa ◽  
Modern Contraceptive ◽  
African Countries ◽  
Factors Influencing ◽  
Contraceptive Side Effects ◽  
Modern Contraceptive Use ◽  
Negative Perceptions ◽  
Sub Saharan

The purpose of this study was to systematically review the literature regarding factors influencing contraceptive use in sub-Saharan Africa between 2005 and 2015. A total of 58 studies from twelve Sub-Saharan African countries were reviewed. Keywords were grouped using the PEN-3 cultural model. Negative factors prohibiting or reducing contraceptive use were women’s misconceptions of contraceptive side–effects, male partner disapproval, and social/cultural norms surrounding fertility. Positive factors included education, employment, and communication with male partner. Increasing modern contraceptive use in Sub-Saharan Africa is a multi-faceted problem that will require community and systems wide interventions that aim to counteract negative perceptions and misinformation.

TRACKING CHANGES IN STATES OF CONTRACEPTIVE USE OVER TIME IN SUB-SAHARAN AFRICA THROUGH COHORT AND PERIOD ANALYSES

2014 ◽  
Vol 47 (3) ◽  
pp. 329-344 ◽  
Author(s):  
ELIZABETH LEAHY MADSEN ◽  
BERNICE KUANG ◽  
JOHN ROSS
Keyword(s):  
Contraceptive Use ◽  
Age Groups ◽  
Unmet Need ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Younger Women ◽  
Health Survey Data ◽  
Sub Saharan ◽  
Representative Samples ◽  
Unmet Need For Contraception

SummaryIt is difficult to gauge the success of programmatic efforts to reduce unmet need for contraception without knowing whether individual women have had their need met and adopted contraception. However, the number of true longitudinal datasets tracking the transition of panels of individual women in and out of states of contraceptive use is limited. This study analyses changes in contraceptive use states using Demographic and Health Survey data for 22 sub-Saharan African countries. A cohort approach, tracking representative samples of five-year age groups longitudinally across surveys, as well as period-based techniques, are applied to indicate whether new users of contraception have been drawn from women who previously had no need and/or those who had unmet need for family planning. The results suggest that a greater proportion of increases in contraceptive use in recent years can be attributed to decreases in the percentage of women with no need, especially among younger women, than to decreases in the proportion with unmet need.

USING COUPLES’ DISCORDANT REPORTS TO ESTIMATE FEMALE COVERT USE OF MODERN CONTRACEPTION IN SUB-SAHARAN AFRICA

2017 ◽  
Vol 50 (3) ◽  
pp. 326-346 ◽  
Author(s):  
Natalie C. Gasca ◽  
Stan Becker
Keyword(s):  
Contraceptive Use ◽  
Modern Method ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Modern Contraceptive ◽  
African Countries ◽  
Couple Communication ◽  
Significant Difference ◽  
Contraceptive Prevalence ◽  
Sub Saharan

SummarySubstantial numbers of married women use contraceptives without their partner’s knowledge in sub-Saharan Africa, but studies of female covert use across time are rare. This study investigates the levels, trends and correlates of covert use in nine countries and determines which contraceptive methods are more frequently used covertly by women. Data from monogamous couples in Demographic and Health Surveys were used from nine sub-Saharan African countries that had experienced an increase of 10 percentage points in current modern contraceptive use between an earlier (1991–2004) and later (2007–2011) survey. Covert use was indirectly estimated as the percentage of women who reported a female modern method whose husband did not report a modern method. The percentage of women using covertly increased in eight of the countries studied (significantly in three of them), yet when comparing across countries cross-sectionally, covert use was lower where contraceptive prevalence was higher. In general, women with more years of schooling and those with larger spousal schooling gaps had lower odds of covert use. There was no significant difference between covert and open injectable use, though more than half of both groups used this method in the later surveys. Encouraging couple communication about contraception, where the woman feels it is safe to do so, could be an important strategy to minimize covert use. Further research is needed to better identify the contraceptive prevalence and social context in which covert use declines within a country.

scholarly journals Currently married women with an unmet need for contraception in Eritrea: Profile and determinants

2011 ◽  
Vol 38 (1-2) ◽  
pp. 61 ◽  
Author(s):  
Gebremariam Woldemicael ◽  
Roderic Beaujot
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Economic Status ◽  
Unmet Need ◽  
Married Women ◽  
Sub Saharan Africa ◽  
The Status ◽  
Sub Saharan ◽  
Using Data ◽  
Unmet Need For Contraception

Eritrea’s contraceptive prevalence rate is one of the lowest in sub-Saharan Africa and its fertility has only started to decline. Using data from the 2002 Eritrea Demographic and Health Survey (EDHS), this study examines the determinants of unmet need for family planning that is the discrepancy between fertility goals and actual contraceptive use. More than one-quarter of currently married women are estimated to have an unmet need, and this has remained unchanged since 1995. The most important reason for unmet need is lack of knowledge of methods or of a source of supply. Currently married women with higher parity, and low autonomy, low or medium household economic status, and who know no method of contraception or source of supply are identified as the most likely to have an unmet need. Addressing the unmet need for family planning entails not merely greater knowledge of or access to contraceptive services, but also the enhancement of the status of women.

scholarly journals The relationship between spatial access and modern contraceptive use: is proximity to a healthcare facility a determinant of use among women in Kinshasa, DRC?

2021 ◽  
Vol 5 ◽  
pp. 80
Author(s):  
Saleh Babazadeh ◽  
Julie Hearnandez ◽  
Philip Anglewicz ◽  
Jane Bertrand
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Modern Contraceptive ◽  
Family Planning Services ◽  
Spatial Access ◽  
Modern Contraceptives ◽  
Contraceptive Services ◽  
Modern Contraceptive Use ◽  
Sub Saharan

Background: Spatial access has a direct effect on health service utilization in many settings. Distance to health facility has proven to affect family planning (FP) service use in many Sub-Saharan countries. Studies show that women who reside closer to facilities offering family planning services are more likely to use modern contraceptives. However, researchers often test the theory of distance decay. This study analyzed the significance of proximity to family planning services, service availability, and quality of family planning services on modern contraceptive use in Kinshasa, Democratic Republic of the Congo. Methods: We used a pool of four rounds of facility- and population-based survey data in Kinshasa from PMA2020 between 2014 and 2016. We used GPS coordinates to calculate the distance between the health facilities and households. We tested if women who live closer to service delivery points with higher level of availability and quality are more likely to use modern contraceptives or less likely to have unmet need for contraceptive services. Results: 10,968 women were interviewed over four rounds of data collection. Our findings show that living closer to an SDP is not a determinant of modern contraceptive use or having unmet need for FP services. Lack of cognitive access, economic barriers, bypassing the closest facility, and sociocultural norms are strong barriers for women in Kinshasa to use modern contraceptives. Proximity to quality services did not necessarily result in increased FP use among women of reproductive age living in Kinshasa, thus suggesting that a bypass phenomenon may occur when obtaining modern contraceptive services. Conclusions: This study notes that barriers other than proximity to access may be substantial determinants of contraceptive use or unmet need. More research should be conducted that directly measures multidimensional components of access in order to interpret women’s contraceptive seeking behaviors in urban areas of Sub-Saharan Africa.

scholarly journals The Relationship Between Spatial Access and Modern Contraceptive Use: Is Proximity to a Healthcare Facility a Determinant of Use Among Women in Kinshasa, DRC?

2019 ◽  
Author(s):  
Saleh Babazadeh ◽  
Julie Hernandez ◽  
Philip Anglewicz ◽  
Jane T Bertrand
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Modern Contraceptive ◽  
Family Planning Services ◽  
Spatial Access ◽  
Modern Contraceptives ◽  
Contraceptive Services ◽  
Modern Contraceptive Use ◽  
Sub Saharan

Abstract Background: Spatial access has a direct effect on health service utilization in many settings. While, all elements of access are usually affected by service delivery points and client characteristics. Distance to facility has proven to affect family planning service use in many Sub-Saharan countries. Studies show that women who reside closer to facilities offering family planning services are more likely to use modern contraceptives. However, researchers often test the theory of distance decay to observe any association between an increased distance of health facilities and health service utilization. This study to analyze the significance of proximity to family planning services, as well as service availability and quality of family planning services in Kinshasa. Method: We used a pool of four rounds of facility- and population-based survey data in Kinshasa. We tested if women who live closer to service delivery points with higher level of availability and quality are more likely to use modern contraceptives or less likely to have unmet need for contraceptive services. Results: Our findings show that living closer to an SDP is not a determinant of modern contraceptive use or having unmet need for FP services. Discussion: Lack of cognitive access, economic barriers, bypassing the closest facility, and sociocultural norms are among the strong barriers for women in Kinshasa to use modern contraceptives. Our analysis shows that proximity to quality services does not necessarily result in increased FP use among women of reproductive age living in Kinshasa, thus suggesting that a bypass phenomenon may occur when obtaining modern contraceptive services. Conclusion: This study indicates that proximity to facilities does not necessarily equate proximity to methods, nor does it necessarily enable current users or women with an unmet need (potential contraceptive users) to easily obtain services for their method of choice. This study notes that other barriers to access may be substantial determinants of contraceptive use or unmet need. More research should be conducted that directly measures multidimensional components of access in order to interpret women’s contraceptive seeking behaviors in urban areas of Sub-Saharan Africa.

scholarly journals ACCESS TO CONTRACEPTIVE METHODS AND PREVALENCE OF USE

2012 ◽  
Vol 45 (6) ◽  
pp. 761-778 ◽  
Author(s):  
JOHN ROSS ◽  
KAREN HARDEE
Keyword(s):  
Survey Data ◽  
Time Trends ◽  
Contraceptive Use ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Multiple Methods ◽  
African Countries ◽  
Total Prevalence ◽  
Cross Tabulation ◽  
Sub Saharan

SummarySurvey data on contraceptive use for about 80 countries are related to measures of contraceptive access, by method, from 1999 to 2009. Cross-tabulation and correlational methods are employed, with geographic comparisons and time trends. Total prevalence of use for five modern contraceptive methods correlates well to a variety of access measures. Greater access is also accompanied by a better balance among methods for both access and use. Sub-Saharan African countries show similar patterns though at lower levels. Improved access to multiple methods is consistently associated with higher levels of contraceptive use.

scholarly journals The Relationship Between Spatial Access and Modern Contraceptive Use: Is Proximity to a Healthcare Facility a Determinant of Use Among Women in Kinshasa, DRC?

2020 ◽  
Author(s):  
Saleh Babazadeh ◽  
Julie Hernandez ◽  
Philip Anglewicz ◽  
Jane T Bertrand
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Modern Contraceptive ◽  
Family Planning Services ◽  
Spatial Access ◽  
Modern Contraceptives ◽  
Contraceptive Services ◽  
Modern Contraceptive Use ◽  
Sub Saharan

Abstract Background: Spatial access has a direct effect on health service utilization in many settings. While, all elements of access are usually affected by service delivery points and client characteristics. Distance to facility has proven to affect family planning service use in many Sub-Saharan countries. Studies show that women who reside closer to facilities offering family planning services are more likely to use modern contraceptives. However, researchers often test the theory of distance decay to observe any association between an increased distance of health facilities and health service utilization. This study to analyze the significance of proximity to family planning (FP) services, as well as service availability and quality of family planning services in Kinshasa. Methods: We used a pool of four rounds of facility- and population-based survey data in Kinshasa. We tested if women who live closer to service delivery points with higher level of availability and quality are more likely to use modern contraceptives or less likely to have unmet need for contraceptive services. Results: Our findings show that living closer to an SDP is not a determinant of modern contraceptive use or having unmet need for FP services. Discussion: Lack of cognitive access, economic barriers, bypassing the closest facility, and sociocultural norms are among the strong barriers for women in Kinshasa not to use modern contraceptives. Our analysis shows that proximity to quality services does not necessarily result in increased FP use among women of reproductive age living in Kinshasa, thus suggesting that a bypass phenomenon may occur when obtaining modern contraceptive services. Conclusion: This study indicates that proximity to facilities does not necessarily equate proximity to methods, nor does it necessarily enable current users or women with an unmet need (potential contraceptive users) to easily obtain services for their method of choice. This study notes that other barriers to access may be substantial determinants of contraceptive use or unmet need. More research should be conducted that directly measures multidimensional components of access in order to interpret women’s contraceptive seeking behaviors in urban areas of Sub-Saharan Africa.

scholarly journals A qualitative exploration of contraceptive use and discontinuation among women with an unmet need for modern contraception in Kenya

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Susan Ontiri ◽  
Lilian Mutea ◽  
Violet Naanyu ◽  
Mark Kabue ◽  
Regien Biesma ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Peer Influence ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Modern Contraceptive ◽  
Modern Contraception ◽  
Modern Contraceptives ◽  
Family Planning Programs ◽  
Contraceptive Discontinuation

Abstract Background Addressing the unmet need for modern contraception underpins the goal of all family planning and contraception programs. Contraceptive discontinuation among those in need of a method hinders the attainment of the fertility desires of women, which may result in unintended pregnancies. This paper presents experiences of contraceptive use, reasons for discontinuation, and future intentions to use modern contraceptives. Methods Qualitative data were collected in two rural counties in Kenya in 2019 from women with unmet need for contraception who were former modern contraceptive users. Additional data was collected from male partners of some of the women interviewed. In-depth interviews and focus group discussions explored previous experience with contraceptive use, reasons for discontinuation, and future intentionality to use. Following data collection, digitally recorded data were transcribed verbatim, translated, and coded using thematic analysis through an inductive approach. Results Use of modern contraception to prevent pregnancy and plan for family size was a strong motivator for uptake of contraceptives. The contraceptive methods used were mainly sourced from public health facilities though adolescents got them from the private sector. Reasons for discontinued use included side effects, method failure, peer influence, gender-based violence due to covert use of contraceptives, and failure within the health system. Five reasons were provided for those not willing to use in the future: fear of side effects, cost of contraceptive services, family conflicts over the use of modern contraceptives, reduced need, and a shift to traditional methods. Conclusion This study expands the literature by examining reasons for contraceptive discontinuation and future intentionality to use among women in need of contraception. The results underscore the need for family planning interventions that incorporate quality of care in service provision to address contraceptive discontinuation. Engaging men and other social influencers in family planning programs and services will help garner support for contraception, rather than focusing exclusively on women. The results of this study can inform implementation of family planning programs in Kenya and beyond to ensure they address the concerns of former modern contraception users.

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