Contraceptive use pattern based on the number and composition of children among married women in sub-Saharan Africa: a multilevel analysis

Achamyeleh Birhanu TESHALE, Vicky Qi WANG, Godness Kye BINEY, Edward Kwabena AMEYAW, Nicholas Kofi ADJEI, Sanni YAYA*

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)peer-review

Abstract

Background
The relationship between composition of children and contraception use has received limited scholarly attention in sub-Saharan Africa. In this study, we examined the relationship between contraceptive methods, the number and composition of children in SSA.

Methods
Data on 21 countries in sub-Saharan Africa (SSA) countries that had a Demographic and Health Survey on or before 2015 were analysed. We applied a multilevel multinomial logistic regression model to assess the influence of family composition on contraceptive use. Adjusted relative risk ratio (aRRR) and 95% CI were estimated. The significant level was set at p < 0.05. All the analyses were conducted using weighted data.

Results
Women who had one son and two daughters (aRRR = 0.85, CI = 0.75, 0.95), two sons and one daughter (aRRR = 0.81 CI = 0.72, 0.92), one son and three daughters (aRRR = 0.66, CI = 0.54, 0.80), two sons and two daughters (aRRR = 0.59, CI = 0.50, 0.69), and three or more sons (aRRR = 0.75, CI = 0.63, 0.91) were less likely to use temporary modern contraceptive methods. Those with two sons and two daughters were less likely to use traditional methods (aRRR = 0.52, CI = 0.35, 0.78). Women in the older age group (35–49 years) were less likely to use temporary modern methods (aRRR = 0.60; 95%CI; 0.57, 0.63). However, this group of women were more likely to use permanent (sterilization) (aRRR = 1.71; 95%CI; 1.50, 1.91) and traditional methods (aRRR = 1.28; 95%CI; 1.14, 1.43).

Conclusion
These findings suggest that contraception needs of women vary based on the composition of their children, hence a common approach or intervention will not fit. As a result, contraception interventions ought to be streamlined to meet the needs of different categories of women. The findings can inform policymakers and public health professionals in developing effective strategies to improve contraceptive use in SSA.
Original languageEnglish
Article number39
JournalContraception and Reproductive Medicine
Volume8
Issue number1
Early online date24 Jul 2023
DOIs
Publication statusPublished - Jul 2023

Bibliographical note

Publisher Copyright:
© 2023, The Author(s).

Keywords

  • Children
  • Contraception
  • Global health
  • Reproductive health
  • Sexual health
  • Sub-saharan Africa
  • Women

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