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. 2014 Mar 7;14(1):40.
doi: 10.1186/1472-6874-14-40.

Differential effect of wealth quintile on modern contraceptive use and fertility: evidence from Malawian women

Stephen A Adebowale  1 , Sunday A Adedini, Latifat D Ibisomi, Martin E Palamuleni
Affiliations

Differential effect of wealth quintile on modern contraceptive use and fertility: evidence from Malawian women

Stephen A Adebowale et al. BMC Womens Health. .

Abstract

Background: High fertility and wide inequality in wealth distribution are phenomenal problems in sub-Saharan Africa. Modern Contraceptives (MC) are useful for limiting fertility, but are not always easily accessible in Malawi. This study examines the gap in MC use and fertility between women in the richest and poorest Wealth Quintile (WQ).

Methods: The study was cross-sectional in design and utilized Malawi DHS dataset, 2010. It focused on women of reproductive age. The dependent variables are ever and current use of MC. Chi-square and multinomial logistic regression were used for the analysis.

Results: Mean children ever born by women in the poorest and richest WQs were 3.94 ± 2.7 and 2.82 ± 2.3 respectively (p < 0.001). The adjusted total fertility rate (Adj.TFR) was higher among women in the poorest (Adj.TFR = 7.60) WQ than the richest (Adj.TFR = 4.45). The prevalence of ever use of MC was higher among women in the richest WQ (82.4%) than the poorest (66.8%) (p < 0.001). Similar pattern exists for current use of MC; 58.5% and 45.9% for women in the richest and poorest WQs respectively (p < 0.001). Women in the richest WQ were more likely to ever use (OR = 2.36; C.I = 2.07-2.69, p < 0.001) and currently using (OR = 1.66; C.I = 1.40-1.97, p < 0.001) MC than their counterparts in the poorest WQ. Slight reduction in odd-ratio of MC use among women in richest WQ resulted when socio-demographic variables were used as control.

Conclusion: Fertility was higher and the use of MC was lower among women in the poorest than their counterparts in the richest WQ. Ensuring availability of MC at little or no cost may bridge the gap in contraceptive use between women in the poorest and richest WQ in Malawi.

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Figures

Figure 1
Figure 1
Population Pyramid of people in wealthiest and poorest wealth quintile in Malawi, 2012.
Figure 2
Figure 2
Unadjusted and adjusted total fertility rates for total population, poorest and richest wealth quintiles, Malawi, 2010.
Figure 3
Figure 3
Line graph of adjusted age specific fertility rates for women in poorest and richest wealth quintile in Malawi.
See this image and copyright information in PMC

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