Low contraceptive use among the poor in Africa: an equity issue

Andreea A. Creanga, U.S. Centers for Disease Control and Prevention
Duff G. Gillespie, Johns Hopkins University
Sabrina Karklins, Johns Hopkins Bloomberg School of Public Health
Amy Tsui, Johns Hopkins University

This study analyzes Demographic and Health Surveys data collected at 2 points of time for 13 sub-Saharan countries. Through an equity lens, we examine changes in contraceptive use among women of reproductive age. The study finds that wealthier women are more likely to meet their contraceptive needs (limit or space children) than their less wealthy counterparts. However, the findings also suggest that in most countries family planning programs have started to satisfy women’s need for contraceptive services among the poorer strata of society, thus, reducing the wealth-related inequity between the poorer and wealthier segments of society. The likelihood of concordance between actual method use and reported fertility intentions at both time points is greater than 75% in only 7 of the 13 countries. While the gap in met contraceptive need is being narrowed, women’s overall expressed need for contraception in this region remains low, regardless of their wealth status.