title: Women's fertility desires and contraceptive behavior in three peri-urban communities in sub Saharan Africa.
abstract: BACKGROUND
  Fertility desires and contraceptive behavior often change over time. This study examined the influence of change in fertility desires on change in modern contraceptive use over time in three peri-urban communities in sub-Saharan Africa.
  
  
  METHODS
  This multi-site study includes baseline and follow up data from 3 sites in the Family Health and Wealth Study. Following a census in each site, a probability sample of at least 500 households was obtained. Generalized linear models were employed.
  
  
  RESULTS
  Modern contraceptive use increased in Ipetumodu, Nigeria (29.4% to 36.7%), but declined slightly in Sebeta, Ethiopia (66.9% to 61.3%) and Asawase, Ghana (12.6% to 10.8%). Across sites, at baseline and follow up, women who wanted no more children reported more contraceptive use, compared with those who wanted more children, and were more likely to shift to being contraceptive users in Ipetumodu [aOR(95% CI):1.55 (1.07,2.26)].
  
  
  CONCLUSIONS
  Women's fertility desires influenced their contraceptive behavior, although there were cross-site differences. Changing contraceptive demand and program factors will be important to enable peri-urban women to frame and act on their fertility desires.
authors.affiliation: Department of Community Medicine, College of Medicine, University of Ibadan, Queen Elizabeth Road, P.M.B. 5116, U.C.H., Ibadan, Nigeria. fmolaolorun@gmail.com.
authors.forename: Funmilola
authors.initials: F
authors.lastname: OlaOlorun
authors.affiliation: Department of Reproductive Health & Health Service Management, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Assefa
authors.initials: A
authors.lastname: Seme
authors.affiliation: Department of Community Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Easmon
authors.initials: E
authors.lastname: Otupiri
authors.affiliation: Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria.
authors.forename: Peter
authors.initials: P
authors.lastname: Ogunjuyigbe
authors.affiliation: Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Tsui
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara; D015331:Cohort Studies; D003268:Contraception Behavior / Q000208:ethnology / Q000639:trends; D000069216:Contraceptive Prevalence Surveys; D004522:Educational Status; D005191:Family Characteristics; D005193:Family Planning Services / Q000639:trends; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D010298:Parity; D043762:Reproductive Behavior / Q000208:ethnology; D012959:Socioeconomic Factors; D062211:Spatio-Temporal Analysis; D018881:Suburban Health / Q000208:ethnology / Q000639:trends; D055815:Young Adult