| The Effect of Access to Contraceptive Services on Injectable Use and Demand for Family Planning in Malawi |
| Authors: |
Skiles M.P., Cunningham M., Inglis A., Wilkes B., Hatch B., Bock A., and Barden-O’Fallon J. |
| Source: |
International Perspectives on Sexual and Reproductive Health (formerly: International Family Planning Perspectives), 41(1):20–30, doi: 10.1363/4102015 |
| Topic(s): |
Contraception
|
| Country: |
Africa
Malawi
|
| Published: |
MAR 2015 |
| Abstract: |
CONTEXT: Previous studies have identified positive relationships between geographic proximity to family planning
services and contraceptive use, but have not accounted for the effect of contraceptive supply reliability or the diminishing
influence of facility access with increasing distance.
METHODS: Kernel density estimation was used to geographically link Malawi women’s use of injectable contraceptives
and demand for birth spacing or limiting, as drawn from the 2010 Demographic and Health Survey, with contraceptive
logistics data from family planning service delivery points. Linear probability models were run to identify
associations between access to injectable services—measured by distance alone and by distance combined with
supply reliability—and injectable use and family planning demand among rural and urban populations.
RESULTS: Access to services was an important predictor of injectable use. The probability of injectable use among
rural women with the most access by both measures was 7?8 percentage points higher than among rural dwellers
with the least access. The probability of wanting to space or limit births among urban women who had access to
the most reliable supplies was 18 percentage points higher than among their counterparts with the least access.
CONCLUSIONS: Product availability in the local service environment plays a critical role in women’s demand
for and use of contraceptive methods. Use of kernel density estimation in creating facility service environments
provides a refined approach to linking women with services and accounts for both distance to facilities and supply
reliability. Urban and rural differences should be considered when seeking to improve contraceptive access. |
| Web: |
http://www.guttmacher.org/pubs/journals/4102015.pdf |
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