Demand for Modern Contraception in Sub-Saharan Africa: New Methods, New Evidence

<h3>Project Overview</h3>

<p>West and Central Africa have the highest fertility rates in the world. These high birthrates are largely a function of desired fertility and continued allegiance to large families. Recent survey data on the desired number of children for 41 countries in sub-Saharan Africa (SSA) shows a median value of 4.8 children, with only one-quarter of the countries characterized by a mean value under 4.0 and more than one-quarter with a mean value above 5.0. From survey data we know nothing about what satisfactions and returns men and women seek in childbearing, and how they assess the costs and benefits of large versus small families.</p>

<p>Despite the high demand for children, unintended pregnancy is common in SSA. Between two and three pregnancies per woman on average (including induced abortions) over the entire reproductive career are unintended. The unintended pregnancy rate is twice as high in SSA as it is in Europe, North America, and Asia.</p>

<p>The advantages of using modern contraception are recognized, but perceptions of the advantages of use co-exist with uncertainties about whether taking this step is prudent, all things considered. There are competing rationales, in tension with one another. Moreover, there are multiple actors – both the woman and her male partner, and possibly other near-kin, as well as influential community leaders – whose views figure into contraception decision-making.</p>

<p>By comparison with the large volume of research on how to strengthen family planning services in this region, there has been relatively little probing research on the demand for modern contraception. This qualitative data collection conducted as part of a larger program of research aimed to correct this imbalance through a multi-faceted investigation of fertility desires and their bearing on the demand for modern contraception.</p>

<p>The objective of the qualitative data collection was to explore men’s and women’s fertility desires and demand for modern contraception through in-depth investigation of the complex set of factors that argue for and against avoiding pregnancy in the Nigerian context, and the social, psychological and dyadic processes that translate the desire to avoid pregnancy into decisions to use (or not use) modern contraception.</p>