Dissertation: CONTRACEPTIVE USE DYNAMICS. APPLICATION TO THE BANGLADESH DEMOGRAPHIC AND HEALTH SURVEY
Author: Mohsina Khatun
Mohsina Khatun studied the contraceptive histories, i.e. the sequence of adoption, switching, and discontinuation of contraceptive methods, of women in Bangladesh. For this purpose, longitudinal data derived from the ‘contraceptive use calendars’ of close to 10000 ever-married women were reconstructed from three subsequent rounds (1993-1994, 1996-1997, 1999-2000) of the Bangladesh Demographic and Health Survey. To these data innovative analytical methods were applied. To assess life-course indicators of unmet need and consequences of contraceptive failure, multistate life table techniques were used. Market segmentation techniques were used to identify groups of women with similar histories of contraceptive choice
and use behavior. The technique accounts for unobserved characteristics of women.
Contraceptive use increases with age, is higher among women with a higher education and among women in urban areas. Over one third of women switch to another contraceptive method. 11% of Bangladeshi women opt for sterilization. Contraceptive failure is widespread in Bangladesh and has increased over time. Age, education and previous contraceptive use proved important determinants of contraceptive failure. Improving contraceptive methods and their use can reduce the TFR from 3.33 to 2.14.
Unmet need varies during the reproductive career, and is highest at age 30. After age 30, unmet need for postponing children changed to unmet need for limiting family size occurs. In relatively older and wealthier women, years of schooling, family composition, and fertility intention are more important determinants of contraceptive method choice, whereas in younger women and women from rural areas, family planning program factors and couples’ attitudes towards family planning prove more important.
It is recommended that intervention programs take into account the differences in contraceptive choice and use behavior between couples and between phases of reproductive life, and target specific segments of the population according to their reproductive demand and use.
