177687 Strategies for meeting the family planning needs of women in rural Africa: Evidence from Uganda and Malawi

Monday, October 27, 2008: 12:50 PM

Jacob A. Adetunji, PhD , Global Health Bureau, USAID, Washington, DC
Bamikale Feyisetan, PhD , C-Change, Academy for Educational Development, Washington, DC
Chunnong Saeger , Global Health Bureau, USAID, Washington, DC
Lisa Maniscalco , Global Health Bureau, USAID, Washington, DC
Krista Stewart, PhD , Global Health Bureau, USAID, Washington, DC
Although the family planning and reproductive health program in Uganda has a much longer history and enjoys more donor support than that in Malawi, the contraceptive prevalence rate in Malawi is almost double the prevalence in Uganda. Similarly, while Malawi's fertility levels are declining, they have stagnated at high levels in Uganda. This paper investigates the reasons for the greater family planning program success in Malawi.

Datasets from three rounds of the Demographic and Health Surveys project were analyzed for each country. The key determinants investigated include education, rural-urban composition, risk of childhood mortality, source of family planning methods and family planning method mix.

The results show that the success of Malawi in narrowing the wide rural-urban gaps that existed in these indicators in the 1990s was a major explanation of its better family planning program performance. This is understandable given that 85% of the population of both Uganda and Malawi lives in rural areas. Malawi narrowed the rural-urban gaps by making modern contraceptives more accessible to rural areas through subsidized public service delivery points. However, Uganda sourced family planning methods mainly through the private sector. Hence, while unmet need for family planning continues to rise in rural Uganda, it is falling in Malawi.

The paper concludes that efforts to boost the adoption of modern family planning methods in Uganda must remove barriers to contraceptive methods among rural dwellers. The distribution of modern family planning methods through public health facilities seems better able to do this than the private sector.

Learning Objectives:
By the end of this session, participants will be able to: 1. Identify the two major factors that account for the greater uptake of modern contraceptive methods in Malawi. 2. Recognize that in a predominatly rural African country, depending mainly on the private sector to meet family planning needs will lead to slow service coverage. 3. Identify population composition and cultural attributes as essential elements in choosing appropriate family planning service delivery strategy.

Keywords: Family Planning, Reproductive Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I possess relevant academic qualifications, skills and professional experience.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.