Wang, Wenjuan, Shanxiao Wang, Thomas Pullum, and Paul Ametepi. 2012. How Family Planning Supply and the Service Environment Affect Contraceptive Use: Findings from Four East African Countries. DHS Analytical Studies No. 26. Calverton, Maryland, USA: ICF International.
By linking Demographic Health Surveys (DHS) and Service Provision Assessment (SPA) surveys, this study measures the extent to which women’s contraceptive use is associated with regional facility-based family planning supply and service environment in four African countries: Kenya, Rwanda, Tanzania, and Uganda. The outcome variable, drawn from DHS surveys, is women’s current use of any modern contraceptive method. Supply and service environment variables are drawn from SPA surveys. Supply is measured as the average number of methods provided and available in facilities in the region. Family planning service environment is measured by an index score created based on a number of variables that are selected based on the availability of data and their relevance to providing good-quality family planning services in a facility.
Multivariate regression analysis finds that an average increase of one contraceptive method available in a region increases women’s odds of using modern contraception by 50 percent if family planning facility density in the region and other individual-level variables are held constant. Women in regions with a more favorable service environment (as measured by a higher service environment score) in facilities are more likely to use a modern contraceptive method. The analysis also suggests that regional-level factors significantly contribute to the between-region variation in contraceptive use. The increased proportion of variation explained by adding regional contraceptive supply and service environment variables to the model is 18 percent and 27 percent, respectively.