title: Low use of contraception among poor women in Africa: an equity issue.
abstract: OBJECTIVE
  To examine the use of contraception in 13 countries in sub-Saharan Africa; to assess changes in met need for contraception associated with wealth-related inequity; and to describe the relationship between the use of long-term versus short-term contraceptive methods and a woman's fertility intentions and household wealth.
  
  
  METHODS
  The analysis was conducted with Demographic and Health Survey data from 13 sub-Saharan African countries. Wealth-related inequities in the use of contraception were calculated using household wealth and concentration indices. Logistic regression models were fitted for the likelihood of using a long-term contraceptive method, with adjustments for: wealth index quintile, fertility intentions (to space births versus to stop childbearing), residence (urban/rural), education, number of living children, marital status and survey year.
  
  
  RESULTS
  The use of contraception has increased substantially between surveys in Ethiopia, Madagascar, Mozambique, Namibia and Zambia but has declined slightly in Kenya, Senegal and Uganda. Wealth-related inequalities in the met need for contraception have decreased in most countries and especially so in Mozambique, but they have increased in Kenya, Uganda and Zambia with regard to spacing births, and in Malawi, Senegal, Uganda, the United Republic of Tanzania and Zambia with regard to limiting childbearing. After adjustment for fertility intention, women in the richest wealth quintile were more likely than those in the poorest quintile to practice long-term contraception.
  
  
  CONCLUSIONS
  Family planning programmes in sub-Saharan Africa show varying success in reaching all social segments, but inequities persist in all countries.
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, United States of America. acreanga@jhsph.edu
authors.forename: Andreea A
authors.initials: AA
authors.lastname: Creanga
authors.forename: Duff
authors.initials: D
authors.lastname: Gillespie
authors.forename: Sabrina
authors.initials: S
authors.lastname: Karklins
authors.forename: Amy O
authors.initials: AO
authors.lastname: Tsui
mesh_terms: D017954:Africa South of the Sahara; D003268:Contraception Behavior / Q000706:statistics & numerical data* / Q000639:trends; D003270:Contraceptive Agents; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D012959:Socioeconomic Factors; D016387:Women's Health
chemical_list: D003270:Contraceptive Agents