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Contraceptive use in Eswatini: do contextual influences matter?

Published online by Cambridge University Press:  13 January 2020

Clifford Odimegwu  and
Garikayi B. Chemhaka Open the ORCID record for Garikayi B. Chemhaka [Opens in a new window]
Clifford Odimegwu
Affiliation:
Demography and Population Studies Programme, Schools of Social Sciences and Public Health, University of the Witwatersrand, South Africa
Garikayi B. Chemhaka*
Affiliation:
Demography and Population Studies Programme, Schools of Social Sciences and Public Health, University of the Witwatersrand, South Africa Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Eswatini
*
*Corresponding author. Email: bgchem@gmail.com
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Abstract

This study sought to investigate the determinants of current use of modern contraceptives beyond the individual level in Eswatini (formerly Swaziland). Previous studies have overlooked the role of community characteristics such as socioeconomic development, women’s empowerment and fertility norms in shaping contraceptive use. Hierarchical structured subsample data of 4112 sexually experienced women from the 2007 Eswatini Demographic Health Survey were analysed using multilevel logistic regression to identify factors contributing to community/cluster variations in women’s current use of modern contraceptives. Less than half (44.2%) of the sexually active women were using modern contraceptive methods in 2007. At the community level, the odds of contraceptive use decreased for rural women (AOR = 0.82, 95% CI: 0.68–0.98) and among women residing in communities with high-fertility norms (AOR = 0.77, 95% CI: 0.66–0.89). After adjusting for both individual- and community-level factors, no community-level variables considered for the study were significantly associated with contraceptive use. The findings highlight in all four models, from the empty to full model, that there is a small and decreasing significant variation in women’s contraceptive use across communities (MOR, 1.37–1.17). In 2007, the findings suggest individual rather than community factors account for some contextual variability in contraceptive use. The study proposes the use of ethnographic techniques to unravel community factors that promote modern contraceptive use in Eswatini.

Keywords

Contraceptive useCommunityCommunity-level factors
Type
Research Article
Information
Journal of Biosocial Science , Volume 53 , Issue 1 , January 2021 , pp. 20 - 37
Copyright
© Cambridge University Press 2020

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