Wang, Wenjuan, Soumya Alva, Rebecca Winter, and Clara Burgert. 2013. Contextual Influences of Modern Contraceptive Use Among Rural Women in Rwanda and Nepal. DHS Analytical Studies No. 41. Calverton, Maryland, USA: ICF International.
This study takes a multilevel approach to identify determinants of women’s use of modern contraceptives in Nepal and Rwanda. Data for this study come primarily from the 2011 NDHS and the 2010 RDHS, and also draw from spatial data sources to measure community levels of socioeconomic development. The study focuses on rural women who do not wish to have a child within the next two years, a subset of women of particular interest to family planning policymakers. We explore the extent to which four spheres of community-level influence—socioeconomic development, women’s empowerment, fertility norms, and access to family planning information and services—shape women’s contraceptive use, after adjusting for women’s individual socio-demographic characteristics and for other contextual factors. A sequence of random-effects logit regression models are run—separately for Rwanda and Nepal.
Overall, results from this study indicate the relevance for family planning programs of the community context in which women live. The demand for family planning services is influenced not only by women’s individual and household characteristics, but also by the community’s socioeconomic development, its access and exposure to family planning, the gender norms of local community members regarding decision-making for family planning and health issues, and community norms regarding marriage and childbirth. Among the factors we explored, the analysis suggests that socioeconomic development and access to family planning services may play a bigger role in affecting women’s contraceptive behaviors than the community’s norms regarding gender and fertility.