Determinants of Contraceptive Use in Bangladesh: A Hierarchical Modeling Approach (original) (raw)
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Identifying factors influencing contraceptive use in Bangladesh: evidence from BDHS 2014 data
BMC Public Health, 2018
Background: Birth control is the conscious control of the birth rate by methods which temporarily prevent conception by interfering with the normal process of ovulation, fertilization, and implantation. High contraceptive prevalence rate is always expected for controlling births for those countries that are experiencing high population growth rate. The factors that influence contraceptive prevalence are also important to know for policy implication purposes in Bangladesh. This study aims to explore the socioeconomic , demographic and others key factors that influence the use of contraception in Bangladesh. Methods: The contraception data are extracted from the 2014 Bangladesh Demographic and Health Survey (BDHS) data which were collected by using a two stage stratified random sampling technique that is a source of nested variability. The nested sources of variability must be incorporated in the model using random effects in order to model the actual parameter effects on contraceptive prevalence. A mixed effect logistic regression model has been implemented for the binary contraceptive data, where parameters are estimated through generalized estimating equation by assuming exchangeable correlation structure to explore and identify the factors that truly affect the use of contraception in Bangladesh. Results: The prevalence of contraception use by currently married 15-49 years aged women or their husbands is 62.4%. Our study finds that administrative division, place of residence, religion, number of household members, woman's age, occupation, body mass index, breastfeeding practice, husband's education, wish for children, living status with wife, sexual activity in past year, women amenorrheic status, abstaining status, number of children born in last five years and total children ever died were significantly associated with contraception use in Bangladesh. Conclusions: The odds of women experiencing the outcome of interest are not independent due to the nested structure of the data. As a result, a mixed effect model is implemented for the binary variable 'contraceptive use' to produce true estimates for the significant determinants of contraceptive use in Bangladesh. Knowing such true estimates is important for attaining future goals including increasing contraception use from 62 to 75% by 2020 by the Bangladesh government's Health, Population & Nutrition Sector Development Program (HPNSDP).
Medicine Science , 2017
Contraceptive use among married women of reproductive age has showed a substantial progress over the last few decades in Bangladesh. This study explores the sociodemographic factors associated with contraceptive use among ever-married women of reproductive age in Bangladesh by utilizing the information extracted from three of the Bangladesh Demographic and Health Surveys (BDHSs) in 1993-1994, 2004 and 2014. Bivariate analysis was conducted by performing chi-squared test of independence to explore the relationship between selected sociodemographic factors and dependent variables. To know the adjusted effects of covariates, a popular binary logistic regression model was considered. Respondents' current age, place residence, division religion, education, age at first marriage, family planning (FP) media exposure, ideal number of children and fertility preferences are the significant determinants according to the most recent survey, BDHS 2014. However, wealth index and a respondent's current working status were found to be significant factors only in BDHS 2004. The results of the study strongly recommend efforts to increase the education level among poor people, particularly among women in Bangladesh. Program interventions, including health behavior education and family planning services and counselling, are especially needed for some categories of the population, including those living in rural areas, Sylhet, Chittagong and Dhaka divisions, as well as illiterate and Muslim ever-married women.
Determinants of Contraceptive Use in Bangladesh
Ibrahim Medical College Journal, 2016
Background: Bangladesh is experiencing a plateau phase in fertility decline after its dramatic reduction in early nineties. Aspects of contraceptive use dynamics have important influences on fertility. Methods: This study used data from the 2004 Bangladesh Demographic and Health Survey and applied Multinomial Logistic Regression model to examine the determinants of use of modern methods of contraception. Results: The results showed that individual level characteristics had strong influence on contraceptive use. These variables included educational level of the couples, autonomy of woman, male child preference, woman's membership with an NGO, visit by family planning worker, region and type of residence. Conclusion: The analysis indicated that further increase of contraceptive prevalence rate to achieve decline in fertility level depended on the improvement of educational status of couples and as well as increase in societal value of girl child. It was evident that household visit by a family planning worker was a significant factor in contraceptive use. Influences of Muslim religion were found to be declining in the case of several methods of contraception use. NGOs could take this opportunity to advocate condom use among their credit clients, which would also benefit the country as a policy against sexually transmitted diseases and AIDS.
PLOS ONE, 2020
This study advances current knowledge on contraceptive use in Bangladesh by providing new insights into the extent of regional variations in contraceptive use across rural and urban areas of Bangladesh. We examined the regional variations in contraceptive use among 15,699 currently married women ages 15–49 years using data from the 2014 Bangladesh Demographic and Health Survey (BDHS). Multivariate logistic regression models of contraceptive use were calibrated with sociodemographic attributes and cultural factors. Based on the aggregate sample (i.e., rural and urban combined), we found significant regional variations in contraceptive use across the administrative divisions in Bangladesh. Based on a disaggregate sample (i.e., rural and urban separately), we found that there were significant differences in divisional variations in contraceptive use in rural areas. In contrast, no significant variation in contraceptive use across divisions in urban areas of Bangladesh was found. More specifically, among women living in rural areas, the Rajshahi and Rangpur divisions had higher odds of contraceptive use than the Barisal division, whereas the Chittagong and Sylhet divisions had much lower odds of contraceptive use even after adjusting for selected sociodemographic attributes and cultural factors. A separate analysis of the divisional variations in usage of modern methods of contraception also revealed similar findings with only one exception. Findings of this study provide an evidence-based direction for adapting a pragmatic approach to reducing the divisional disparity of contraceptive use in rural areas of Bangladesh.
2016
Bangladesh has highest Contraceptive Prevalence Rate (CPR) after Sri Lanka and Bhutan in South Asia but still lagged behind with the developed countries. This paper uses data from Bangladesh Demographic and Health Survey 2011 to examine different socio-economic and demographic factors which are correlates to current contraception use among currently married women in urban and rural areas in Bangladesh. Bivariate and multivariate logistic regression analyses have been used to estimate the factors affected on contraception use in city and countryside of Bangladesh. The results show that current age of respondent, number of living children, respondent currently working, fertility preference, visited by FP field worker, marital duration and region have most significant effect on current contraception use in urban and rural areas by both cross-tabulation and logistic regression analyses. Moreover, respondent’s education and husband’s occupation have been found significant association wit...
Determinants of Contraceptive Use in Rural Bangladesh
2016
Effective implementation of family planning plays a major role in reducing the total fertility rate in Bangladesh. The desired level of fertility could be achieved in near future if the contraceptive prevalence rate can be raised. Using the nationally representative data of Bangladesh Demographic and Health Survey 2011, this study focuses on the determinants of contraceptive use among the currently married women in rural Bangladesh. A series of multivariate logistic regression analyses were performed to assess the effect of fertility preference, women empowerment, exposure to family planning messages and programmatic interventions on contraceptive use in rural setting, after controlling for socio-demographic characteristics of the respondents. Multivariate logistic regression analyses suggest that desire to have more children reduces the likelihood of using contraception, while exposure to family planning messages significantly elevates the likelihood of the same, after adjusting fo...
A Study on the Factors Affecting the Use of Contraception in Bangladesh
2011
Adolescents represent approximately one-fourth of the Bangladesh population. This large group is not adequate prepare for reproductive and sexual life, since its members lack basics information about their bodies, sexuality, contraception and sexually transmitted infections including HIV/AIDS. So, the main purpose of this study is to identify the social, economic and demographic characteristics which are responsible for the selection of contraception methods. To do so, required data have been used from Bangladesh Demographic and Health Survey, 2004. The statistical techniques, Chi-square test has been used to find the association among the variables and logistic regression analysis has been used to identify among those factors which are responsible for the use of contraception among ever-married women in their reproductive age. The study results reveal that most of the women (57.40%) used contraception, and the administrative areas, educational level, visits of health workers, religion, place of residence, number of living children, age, and employment status have significant effects on the use of contraception.
Factors affecting contraceptive use among married women of reproductive age in Bangladesh
Background: Contraceptive prevalence rate is low in Bangladesh. It needs to increase contraceptive prevalence rate in order to achieve the health related targets of Sustainable Development Goals (SDGs) by reducing pregnancy and pregnancy related outcomes. Aim of this study is to observe the factors which affect contraceptive use among Bangladeshi women. The hypothesis is that contextual factors along with individual and fertility related factors contribute to the use of contraceptives. Materials and Methods: Bangladesh Demographic and Health Survey (BDHS) of 2014 is the seventh DHS undertaken from June to December, 2014. 18,245 ever-married women were identified and 17,863 were interviewed. Finally, 12,042 women were eligible for analysis after excluding pregnant women, women who were not married, with hysterectomy, postpartum amenorrheic, infertile or subfecund and sexually inactive. Main outcome measure was current use of contraception by married non-pregnant women. Results: Contraceptive prevalence rate was 81.27%. Logistic regression was applied to calculate odds ratios (OR), 95% confidence interval (CI) and P value. Contraceptive use was affected by contextual factors along with individual and fertility related factors. Visits by a family planning worker (FPW) within the previous six months had the biggest impact on contraceptive use (the adjusted OR, 2.06; 95% CI, 1.61-2.64; p<0.001). Education level (adjusted OR, 1.67; 95% CI, 1.10-2.37; p<0.05 in the group with higher education) and number of children who are alive were also positively associated with contraceptive use (p<0.001). Contraceptive use was lower among Muslims (adjusted OR, non-Muslims vs. Muslims, 1.68; 95% CI, 1.27-2.22; p<0.001), desire for a son (adjusted OR, 0.69; 95% CI, 0.59-0.79; p<0.001), living in rural area (adjusted OR of rural vs. urban, 0.7; 95% CI, 0.59-0.84; p<0.001) and Sylhet Division (adjusted OR of Sylhet vs. Barisal, 0.54; 95% CI, 0.40-0.71; p<0.001). Conclusion: Providing service through FPW, increasing the education level of women, intervention in rural areas and in Sylhet division, targeting Muslim population and women with higher age could increase the use of contraceptives among Bangladeshi women.
Factors affecting use of contraception in Matlab, Bangladesh
Journal of Biosocial Science, 1996
SummaryThis study examines the relationship between family planning, perceived availability of contraceptives, and sociodemographic factors in rural Bangladesh. Data are from the 1990 KAP survey in the Matlab treatment and comparison areas, using a sample of about 8500 married women of reproductive age. The contraceptive prevalence rate was 57% in the treatment area but substantially lower in the comparison area where mainly traditional methods of family planning were used by women who did not know of a source of supply of contraceptives. Education has no effect on contraceptive use in the treatment area but in the comparison area, modest but consistent differentials in use by level of education were found. Number of living children is the best predictor for contraceptive use, followed by number of living sons, and the attitude of respondents and their husbands towards family planning.
World Journal of Advance Healthcare Research, 2005
Objectives: The aim of our study was to explore the factors associated with unmet need for contraception among currently married fecund women under age 25, in Bangladesh. Methods: This study utilised a cross-sectional data (n ¼ 4982) extracted from the Bangladesh Demographic and Health Survey (BDHS) 2011. Multinomial logistic regression was used to identify the determinants of unmet need for contraception among currently married fecund young women. Results: The unmet need for contraception was 17% and contraceptive prevalence was 54% in this young group. Total demand for contraception was 71% and the proportion of demand satisfied was 77%. The results suggest that region, place of residence, religion, husband's desire for children, visits of FP workers, decision-making power on child health care, reading about FP in newspaper/ magazine and number of births in three years preceding the survey were significant predictors of unmet need for contraception. Conclusions: The BDHS of 2011 found that unmet need for contraception among currently married, fecund women under 25 years old is higher than the national level, and hence different or more intensive programme initiatives are required for them than for older women. The present study identifies important predictors of unmet need for contraception among fecund married Bangladeshi women under age 25.