Community and Health Facility Influences on Contraceptive Method Choice in the Eastern Cape, South Africa

Author(s): Stephenson R, Beke A, Tshibangu D

Year: 2007

Abstract:
Although there have been a growing number of studies that examine how community factors influence contraceptive use, there is a lack of studies that examine how community actors shape contraceptive method choice. This paper uses linked individual and health facility data from the 1998 South Africa Demographic and Health Survey and the 1998 Eastern Cape Facility Survey to explore community and health facility influences on the choice of contraceptive methods other than the injection (the most commonly used method in South Africa). Several pathways of influence between the community and individual contraceptive method choice are identified. Health facility staffing levels and clinic preparedness are significant influences on contraceptive method choice. Other non-health facility related community factors that influence contraceptive method choice include the climate of female autonomy, levels of education, and community socio-economic status. The residual variation in contraceptive use highlights the deficits that exist in current data sets for capturing community influences on contraceptive behavior.