title: The role of place in shaping contraceptive use among women in Africa.
abstract: BACKGROUND
  Contraceptive prevalence is low in the African region despite considerable family planning programmatic efforts. This study is the first to examine how community factors shape contraceptive use for married women in an entire region, comparing results across 21 African countries with a DHS in the last 5 years. The analysis builds on previous studies through an examination of the individual, household and community level factors that shape contraceptive use.
  
  
  METHODS
  The data used in this analysis were from nationally representative Demographic and Health Surveys completed between 2005 and 2009. A separate multi-level logistic model was fitted for the outcome of current modern contraceptive use in each country.
  
  
  RESULTS
  After controlling for individual and household level factors, community level factors of demographics and fertility norms, gender norms and inequalities, and health knowledge remain significantly associated with contraceptive use, although the magnitude and direction of these community effects varied significantly across countries.
  
  
  CONCLUSIONS
  The results highlight the importance of harnessing community level factors in planning interventions for increasing access to and utilization of modern contraceptive methods.
authors: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America.
authors: K Miriam
authors: KM
authors: Elfstrom
authors: Rob
authors: R
authors: Stephenson
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa / Q000453:epidemiology; D003146:Communications Media; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003710:Demography; D005191:Family Characteristics; D005260:Female; D005298:Fertility; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016013:Likelihood Functions; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D018401:Sample Size; D012959:Socioeconomic Factors; D055815:Young Adult