Early Life Course Transitions and Their Impact on Later Life Maternal Reproductive Choices: A Case of Contraceptive Use Behavior in Uganda

Christabellah Namugenyi, Makerere University
Claire Ashaba, Makerere University
Douglas Candia, Makerere University
Peter Kisaakye, Makerere University
John Bosco Asiimwe, Makerere University
Shaheen Memon, Makerere University
Zabibu Afazali, Makerere University
John A Mushomi, Makerere University
Odur Benard, Makerere University

Poor maternal health outcomes characterized by poor maternal choices remains a significant public health challenge in Uganda, often influenced by early life course transitions and reproductive behaviors. Understanding the interplay between key early life events such as a woman’s sequencing of first marriage, first sexual activity, and first childbirth and their impact on later contraceptive use is crucial for developing strategies that enhance maternal reproductive health choices, outcomes and reduce mortality rates. This study investigated how four distinct sequences of early life events i.e. Marriage-Sex-Birth (MSB), Sex-Marriage-Birth (SMB), Sex-Birth-Marriage (SBM), and Sex-Birth-no Marriage (SBnoM) affect contraceptive behavior among 13,740 parous women in Uganda with implications for maternal mortality prevention. We utilized data from the 2016 Uganda Demographic and Health Survey, a multistage, cross-sectional household survey. A multinomial logistic regression model was applied to identify the factors that influence contraceptive behavior among parous women and by extension, their potential impact on maternal mortality rates. Women who followed the MSB sequence (RRR=1.23;CI=1.01-1.51) were more likely to use modern contraception compared to those in the SBnoM sequence, which is critical for spacing births and reducing maternal mortality risks. These findings highlight the importance of a life course approach in reproductive health policies.

Keywords: Family Planning and Contraception, Fertility, Population Policies, Sexual and Reproductive Health and Rights

See extended abstract.