The Effect of Access to Contraceptive Services on Injectable Use and Demand for Family Planning in Malawi
- 1 January 2015
- journal article
- research article
- Published by Guttmacher Institute in International Perspectives on Sexual and Reproductive Health
- Vol. 41 (1), 20-30
- https://doi.org/10.1363/4102015
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.Keywords
This publication has 22 references indexed in Scilit:
- A geographical perspective on access to sexual and reproductive health care for women in rural AfricaSocial Science & Medicine, 2013
- Geographically linking population and facility surveys: methodological considerationsPopulation Health Metrics, 2013
- Use of modern contraception increases when more methods become available: analysis of evidence from 1982–2009Global Health: Science and Practice, 2013
- ACCESS TO CONTRACEPTIVE METHODS AND PREVALENCE OF USEJournal of Biosocial Science, 2012
- Association between Proximity to a Health Center and Early Childhood Mortality in MadagascarPLOS ONE, 2012
- Geographic influences on sexual and reproductive health service utilization in rural MozambiqueApplied Geography, 2012
- Effect of Geographical Access to Health Facilities on Child Mortality in Rural Ethiopia: A Community Based Cross Sectional StudyPLOS ONE, 2012
- The Influence of Distance and Level of Care on Delivery Place in Rural Zambia: A Study of Linked National Data in a Geographic Information SystemPLoS Medicine, 2011
- Distance decay in delivery care utilisation associated with neonatal mortality. A case referent study in northern VietnamBMC Public Health, 2010
- Strategies for reducing maternal mortality: getting on with what worksThe Lancet, 2006