title: Differential effect of wealth quintile on modern contraceptive use and fertility: evidence from Malawian women.
abstract: BACKGROUND
  High fertility and wide inequality in wealth distribution are phenomenal problems in sub-Saharan Africa. Modern Contraceptives (MC) are useful for limiting fertility, but are not always easily accessible in Malawi. This study examines the gap in MC use and fertility between women in the richest and poorest Wealth Quintile (WQ).
  
  
  METHODS
  The study was cross-sectional in design and utilized Malawi DHS dataset, 2010. It focused on women of reproductive age. The dependent variables are ever and current use of MC. Chi-square and multinomial logistic regression were used for the analysis.
  
  
  RESULTS
  Mean children ever born by women in the poorest and richest WQs were 3.94 ± 2.7 and 2.82 ± 2.3 respectively (p < 0.001). The adjusted total fertility rate (Adj.TFR) was higher among women in the poorest (Adj.TFR = 7.60) WQ than the richest (Adj.TFR = 4.45). The prevalence of ever use of MC was higher among women in the richest WQ (82.4%) than the poorest (66.8%) (p < 0.001). Similar pattern exists for current use of MC; 58.5% and 45.9% for women in the richest and poorest WQs respectively (p < 0.001). Women in the richest WQ were more likely to ever use (OR = 2.36; C.I = 2.07-2.69, p < 0.001) and currently using (OR = 1.66; C.I = 1.40-1.97, p < 0.001) MC than their counterparts in the poorest WQ. Slight reduction in odd-ratio of MC use among women in richest WQ resulted when socio-demographic variables were used as control.
  
  
  CONCLUSIONS
  Fertility was higher and the use of MC was lower among women in the poorest than their counterparts in the richest WQ. Ensuring availability of MC at little or no cost may bridge the gap in contraceptive use between women in the poorest and richest WQ in Malawi.
authors.affiliation: Population Training and Research Unit, Faculty of Humanities and Social Sciences, North-West University, Mafikeng, South Africa. Adehamilt2008@yahoo.com.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Adebowale
authors.forename: Sunday A
authors.initials: SA
authors.lastname: Adedini
authors.forename: Latifat D
authors.initials: LD
authors.lastname: Ibisomi
authors.forename: Martin E
authors.initials: ME
authors.lastname: Palamuleni
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001723:Birth Rate; D002410:Catholicism; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D005298:Fertility; D006801:Humans; D007514:Islam; D008295:Malawi; D008393:Marriage; D008875:Middle Aged; D010298:Parity; D011203:Poverty; D012111:Residence Characteristics; D012923:Social Class; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female