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AJPH First Look, published online ahead of print May 30, 2007
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July 2007, Vol 97, No. 7 | American Journal of Public Health 1233-1240
© 2007 American Public Health Association
DOI: 10.2105/AJPH.2005.071522

RESEARCH AND PRACTICE

Contextual Influences on Modern Contraceptive Use in Sub-Saharan Africa

Rob Stephenson, PhD, Angela Baschieri, PhD, Steve Clements, PhD, Monique Hennink, PhD and Nyovani Madise, PhD

Rob Stephenson and Monique Hennink are with the Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Ga. Angela Baschieri is with the Center for Population Studies, London School of Hygiene and Tropical Medicine, London, England. Steve Clements is with the Center for Sexual Health Research, Department of Psychology, University of Southampton, Southampton, England. Nyovani Madise is with the African Population and Health Research Center, Nairobi, Kenya.

Correspondence: Requests for reprints should be sent to Rob Stephenson, PhD, Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322 (e-mail: rbsteph{at}sph.emory.edu).

Objectives. We examined the role of community-level factors in explaining geographic variations in modern contraceptive use in 6 African countries.

Methods. We analyzed Demographic and Health Survey and contextual data sources with multilevel modeling techniques to identify factors contributing to geographic variations in women’s use of modern contraceptives.

Results. We found significant associations between several community-level factors and reported use of modern contraceptive methods. We also identified several pathways of influence between the community and the individual.

Conclusions. Aspects of a community’s sociocultural and economic environment appear to influence a woman’s use of modern contraceptive methods.






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