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Equity and achievement in access to contraceptives in East Africa between 2000 and 2010
Chirag M Shah1, April M Griffith1, James Ciera2
1Stony Brook University School of Medicine, State University of New York (SUNY), Stony Brook, NY, USA; African Institute for Development Policy (AFIDEP), Nairobi, Kenya.
Objective:
To examine trends in equity in contraceptive use, and in contraceptive-prevalence rates in six East African countries.
Methods:
In this repeated cross-sectional study, Demographic and Health Surveys Program data from women aged 15-49 years in Ethiopia, Kenya, Malawi, Rwanda, Tanzania, and Uganda between 2000 and 2010 were analyzed. Individuals were ranked according to wealth quintile, stratified urban/rural populations, and calculated concentration index-a statistic integrating information from all wealth quintiles to analyze disparities.
Results:
Equity and contraceptive-prevalence rates increased in most country regions over the study period. Notably, in rural Rwanda, contraceptive-prevalence rates increased from 3.9 to 44.0, and urban Kenya became the most equitable country region, with a concentration index of 0.02. The Pearson correlation coefficient between improvements in concentration index and contraceptive-prevalence rates was 0.52 (P=0.011).
Conclusion:
The results indicate that countries seeking to increase contraceptive use should prioritize equity in access to services and contraceptives.
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