Regional Analysis of Contraceptive Use Transition in Sub-Saharan Africa: Commonality and Divergence (2000-2022)

Million Phiri, University Of Zambia
Emmanuel Musonda, University of Zambia
Robert Zulu, University of Zambia
Clifford O. Odimegwu, University of the Witwatersrand

Despite a significant transition in modern contraceptive use in sub-Saharan Africa (SSA), from 13% in 1990 to 33% in 2020, there remains considerable variation in transition rates at the country and sub-regional levels. Little research effort has been made to examine sub-regional commonalities and divergence in drivers of contraceptive use transition in SSA. Therefore, a paucity in knowledge exist in understanding sub-regional level commonalities and divergence in drivers of transitions. Here, we applied a Blinder-Oaxaca multivariable decomposition analysis approach on Demographic and Health Survey data collected in 21 countries between 2000 and 2022. We found that change in women’s contraceptive behaviour and an increase in proportion of women attaining secondary education were the main drivers of transitions across SSA while an increase in the proportion of women attaining tertiary education was a key driver in East and Southern Africa. Child survival was a key driver in Southern and West Africa. Community health worker visits was key in West Africa. Change in women’s contraceptive behaviour and access to media FP messages were major drivers across all sub-regions. These observations highlight the need to enhance family planning programs to boost access to and utilisation of modern contraception, particularly in countries with slow transition.

Keywords: Family Planning and Contraception, Sexual and Reproductive Health and Rights, Decomposition analysis

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