The Role of Individual and Community Normative Factors

A Multilevel Analysis of Contraceptive Use Among Women in Union in Mali
Esther B. Kaggwa, Nafissatou Diop and J. Douglas Storey
International Family Planning Perspectives, 2008


Unlike other African countries, Mali’s fertility rate remains at a relatively high rate of 6.8 births per woman. Little research exists on the role that community norms play in use of family planning, particularly in low prevalence countries. Data on 7,671 women from the 2001 Mali Demographic and Health Survey were analyzed to assess the effects of individual and community factors on the adoption of modern contraceptive methods. Only 5% of women were using a modern contraceptive method in 2001. The odds of contraceptive use were elevated among women in the highest wealth quintile, women who approved and whose partner approved of family planning, those who had had recent discussions on family planning with their partner or others, and those exposed to family planning messages. At the community level, the odds of modern contraceptive use rose with the proportion of women who were exposed to family planning messages, and decreased as the mean number of births per woman rose. In the final model, which included both individual- and community-level factors, the community factors were no longer significant. Because approval of family planning and discussion of family planning with partners were shown to be the factors most strongly associated with modern contraceptive use in the multi level model, programs that seek to increase individual approval and those that teach communication between partners could be particularly helpful to increasing contraceptive use in Mali.

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  • MLI Voices

    Jun 22 2009 - 4:25pm

    Sierra Leone

    Even though I have worked in Sierra Leone in the past, the role of MLI Country Lead has given me the opportunity to build upon these previous experiences and to work closely with members of the Ministry of Health and Sanitation (MOHS), to support the implementation of health policies and reforms that they have prioritized.


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