Equity and achievement in access to contraceptives in East Africa between 2000 and 2010

Abstract

Objective: To examine trends in equity in contraceptive use, and in contraceptive-prevalence rates in six East African countries.

Methods: In this repeated cross-sectional study, Demographic and Health Surveys Program data from women aged 15-49 years in Ethiopia, Kenya, Malawi, Rwanda, Tanzania, and Uganda between 2000 and 2010 were analyzed. Individuals were ranked according to wealth quintile, stratified urban/rural populations, and calculated concentration index-a statistic integrating information from all wealth quintiles to analyze disparities.

Results: Equity and contraceptive-prevalence rates increased in most country regions over the study period. Notably, in rural Rwanda, contraceptive-prevalence rates increased from 3.9 to 44.0, and urban Kenya became the most equitable country region, with a concentration index of 0.02. The Pearson correlation coefficient between improvements in concentration index and contraceptive-prevalence rates was 0.52 (P=0.011).

Conclusion: The results indicate that countries seeking to increase contraceptive use should prioritize equity in access to services and contraceptives.

Keywords: Africa; Contraception; Disparity; Equity; Social determinants.