Individual, household, and community-level predictors of modern contraceptive use among black women in South Africa

Abstract

Background: The main objective of the study is to determine the multilevel determinants of modern contraceptive use among sexually active black women in South Africa. Modern contraceptive use is a global social problem and affects women. Therefore, in this study, modern contraceptive includes women’s educational status, employment status, marital status, provinces, and parity. Methods: This study utilises secondary data from the 2016 South Africa Demographic and Health Survey to examine the multilevel determinants of modern contraceptive use among sexually active black women in South Africa. The following analyses were conducted, the univariate analyses, which includes frequencies, as well as the bivariate analysis. The bivariate analysis included a chi-square test to test the association between the selected independent variables and the dependent variable. A multivariate logistic regression analysis was conducted to measure the relationship between the selected factors and the outcome variable. Results: The findings of the study confirmed that age, marital status, level of education, parity and province were statistically associated with modern contraceptive use. In terms of parity, the findings indicated that the prevalence of modern contraception increased with parity. Women with no parity had (48.0%) prevalence of modern contraception, those in one-to-two parity had (60.6%) and those with three plus had (65.4%) prevalence of modern contraception. In terms of exposure to family planning messages, women that had no exposure to family planning messages had (60.3%) prevalence to modern contraception than women who had exposure to family planning messages with (58.3%). With regards to household wealth, women from well-to-do households had high prevalence of contraceptive use(61.5%), followed by those in the average household wealth (58.7%) and those in the poor household wealth had the least (59.5%) prevalence of modern contraception. The findings also showed that women from urban areas had higher prevalence (60.2%) of modern contraception than those in rural areas (59.5%). The findings further illustrated that sexually active black women less than age twenty 1.84 [95% CI: 1.27-2.65], and those in their twenties 1.32 [95% C.I: 1.09-1.59] had higher odds of using modern contraception compared to those in their thirties (aged 30-39). Women aged 40-49 had lower odds [AOR 0.51, 95% C.I: 0.42-0.63] of using modern contraception compared to those aged 30-39.In terms of level of education, women with secondary education or more had higher odds [AOR 1.57, 95% C.I: 1.23-2.0] of using modern contraception compared to those with primary education. Moreover, the findings showed that the use of modern contraception increased with parity. Women with zero parity had the lower odds [AOR 0.19, 95% CI: 0.15- 0.26] of using modern contraception compared to those with parity three or more. Women with parity one-to-two had lower odds [AOR 0.53, 95% C.I: 0.44-0.64] of using modern contraception compared to those with parity three and more. Conclusion: Several strategies could play a role in increasing modern contraceptive use among black women in South Africa. These strategies could include (a) enhancing women’s skills and encouraging them to finish their basic education, (b) empowering women through the creation of jobs opportunities, especially those from poor backgrounds as a way to increase modern contraceptive use.