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Community Factors Influencing Contraceptive Use among Married Women in 21 African Countries

Elfstrom, Klara Miriam (2011)
Master's Thesis (75 pages)
Committee Chair / Thesis Adviser: Stephenson, Robert
Committee Members:
Research Fields: Health Sciences, Public Health
Partnering Agencies: Emory University schools, faculty or affiliated programs ; International governmental organization (e.g., Agency for International Development, etc.)
Keywords: contraceptive use; community; Africa; married women
Program: Rollins School of Public Health, Hubert Department of Global Health
Permanent url: http://pid.emory.edu/ark:/25593/92g11

Abstract

Contraceptive prevalence is low in the African region despite considerable family planning programmatic efforts. This study investigates community level influences on modern contraceptive use among married women ages 15 - 49 in 21 African countries. The analysis builds on previous studies through an examination of the individual, household and community level factors that shape contraceptive use. The data used in this analysis were from nationally representative Demographic and Health Surveys completed between 2005 and 2009. A separate multi-level logistic model was fitted for the outcome of current modern contraceptive use in each country. After controlling for individual and household level factors, community level factors of demographics and fertility norms, gender norms and inequalities, and health knowledge remain significantly associated with contraceptive use. The results highlight the importance of harnessing community level factors in planning interventions for increasing access to and utilization of modern contraceptive methods.

Table of Contents

Table of Contents -- CHAPTER 1: INTRODUCTION ....................................................................................... 1 -- Contraceptive Use ........................................................................................................... 2 -- Aims and Objectives ....................................................................................................... 4 -- Study Setting: Family Planning in Africa ....................................................................... 5 -- CHAPTER 2: LITERATURE REVIEW ............................................................................ 8 -- Determinants of Contraceptive Use ................................................................................ 8 -- Multilevel Modeling and the Importance of Community Level Factors ...................... 11 -- Community Level Effects on Health Outcomes ........................................................... 13 -- CHAPTER 3: MANUSCRIPT ......................................................................................... 21 -- CHAPTER 4: PUBLIC HEALTH IMPLICATIONS ....................................................... 51 -- Future Directions .......................................................................................................... 52 -- Conclusion .................................................................................................................... 55 -- REFERENCES ................................................................................................................. 56 -- APPENDIX ....................................................................................................................... 61

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