Explaining Areal variation in contraceptive use in East and West Africa

Steve Clements, PhD¹, Rob Stephenson, MSc, PhD², Angela Baschieri, MSc¹, Monique M Hennink, BA (Hons), PhD¹, and Nyovani Madise, PhD¹. (1) Southampton Statistical Science Research Institute, University of Southampton, Highfield, Southampton, SO17 1BJ, United Kingdom, (2) Johns Hopkins Bloomberg School of Public Health, Gates Institute for Population and Reproductive Health, 615 N. Wolfe Street, Baltimore, MD 21205, 410 955 2103, rstephen@jhsph.edu

Previous researchers have found that many developing countries contain substantial geographical variation in contraceptive use. Researches concerning the use of modern methods of contraception have typically concentrated on the effect of individual, household level factors, and service provision. There is limited evidence as to how community contextual factors may influence variation in use of contraception. In this paper individual demographic and socioeconomic factors and community level factors have been considered in explaining the areal (sub- national geographic) variation in modern contraceptive use in three East African and three West African countries. Recent Demographic and Health Surveys (DHS) have collected a global positioning system (GPS) locator for the primary sampling units (PSU) in the survey. This allows for the linking of other contextual data sources to DHS data. This paper aims to advance the methodology used to explain areal variation in contraceptive use in developing countries though combining multilevel modelling and Geographical Information System Techniques. The determinants of modern contraceptive use in each country will be presented. The importance of these factors in accounting for the areal variation in use will be assessed. The findings will be compared between the study countries and the relative importance of individual / household and contextual factors discussed, along with their relevance to policy. Furthermore, detailed maps of the modelling results and contextual data can be plotted in order to better inform researchers and local policy makers, by highlighting the characteristics of those areas with unusually high or low levels of contraceptive use.

Learning Objectives:

1) To quantify, using data from DHS, the determinants of modern contraceptive use in East and West Africa.
2) To identify communities of unusually high or low contraceptive use within each countries after controlling for arrange of demographic and socio-economic variables.
3) Maps the outlying communities within each country and to examine the variations in modern contraceptive use both within and between the countries in order to highlight cross border variation between countries.

Keywords: Contraceptives, Geographic Information Systems

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation

Emerging Issues and Strategies in Reproductive Health Programming

The 132nd Annual Meeting (November 6-10, 2004) of APHA