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. 2020 Dec 15;15(12):e0243316.
doi: 10.1371/journal.pone.0243316. eCollection 2020.

Individual- and country-level correlates of female permanent contraception use in sub-Saharan Africa

Babayemi O Olakunde  1   2 , Jennifer R Pharr  1 , Lung-Chang Chien  3 , Rebecca D Benfield  4 , Francisco S Sy  1
Affiliations

Individual- and country-level correlates of female permanent contraception use in sub-Saharan Africa

Babayemi O Olakunde et al. PLoS One. .

Abstract

Background: Female permanent contraception is a cost-effective contraceptive method that can help clients with the desire to limit childbearing achieve their reproductive intention. However, despite its benefits, the use of FPC remains low in sub-Saharan Africa (SSA), and limited studies have examined the correlates of its uptake. In this study, we assessed the individual- and country-level factors associated with the use of FPC among married or in-union women using modern contraceptive methods to limit childbearing in SSA.

Methods: This study was a secondary data analysis of individual- and country-level data obtained from the Demographic and Health Surveys (DHS) Program and three open data repositories. The study included 29,777 married or in-union women aged 15-49 years using modern contraceptive methods to limit childbearing from DHS conducted in 33 sub-Sahara African countries between 2010 and 2018. We performed descriptive statistics and fitted multilevel logistic regression models to determine the predisposing, enabling, and need factors associated with the use of FPC.

Results: Approximately 13% of the women used FPC. About 20% of the variance in the odds of using FPC was attributable to between-country differences. In the full model, the significant individual-level factors associated with the use of FPC compared with other modern contraceptive methods were: age (odds ratio [OR] = 1.10; 95%CI = 1.08-1.12), living children (OR = 1.11, 95%CI = 1.04-1.16), high household wealth (OR = 1.39, 95%CI = 1.18-1.64), rural residence (OR = 0.83, 95% CI = 0.71-0.97), joint contraceptive decision with partner (OR = 1.68, 95% = 1.43-1.99), contraceptive decision by partner and others (OR = 2.46, 95% = 1.97-3.07), and the number of living children less than the ideal number of children (OR = 1.40, 95%CI = 1.21-1.62). The significantly associated country-level factors were births attended by skilled health providers (OR = 1.03, 95%CI = 1.00-1.05) and density of medical doctors (OR = 1.37, 95%CI = 1.01-1.85).

Conclusions: Our results suggest that both individual- and country-level factors affect uptake of FPC in SSA. Increasing geographic, economic, and psychosocial access to FPC may improve its uptake in SSA.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Conceptual framework.
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References

    1. Westoff CF. Unmet need for modern contraceptive methods DHS analytical studies No. 28. Calverton, Maryland: ICF International; 2012.
    1. Westoff CF, Bankole A. Trends in the demand for family limitation in developing countries. Int Fam Plan Perspect. 2000;26: 56–62.
    1. The RESPOND Project. A matter of fact, a matter of choice: The case for investing in permanent contraceptive methods EngenderHealth White Paper. New York: EngenderHealth, The RESPOND Project; 2014.
    1. Van Lith LM, Yahner M, Bakamjian L. Women’s growing desire to limit births in sub-Saharan Africa: Meeting the challenge. Glob Health Sci Pract. 2013;1: 97–107. 10.9745/GHSP-D-12-00036 - DOI - PMC - PubMed
    1. Guttmacher Institute. Adding it up: Investing in contraception and maternal and newborn health, 2017-Fact sheet. New York: Guttmacher Institute; 2017.