Reproductive health in Francophone sub-Saharan Africa
Background As a region, Francophone sub-Saharan Africa (SSA) continues to have among the highest fertility rates and lowest contraceptive prevalence rates in the world. As of the latest Demographic and Health Survey (DHS) data available for each country, total fertility rates range from 4.1 (Gabon 2012) to 7.6 births per woman (Niger 2012). Modern contraceptive prevalence rates for married women range from a low of 3.3% (Guinea 2012) to a high of 20.1% (Senegal 2014). Methods Three analyses were completed utilizing nationally representative DHS data available for each Francophone SSA country. For each paper, bivariate and multivariate analyses were performed with weighted data to take into account the two-stage cluster sampling design of the DHS survey. In paper one, we determine whether being Muslim and/or being in a polygynous union impacts the use of modern contraceptives. In paper two, we provide detailed information on the characteristics that define users of specific contraceptive methods in this region. In the final paper, we provide a clearer picture of the reproductive health dynamic in young never married women in Francophone SSA. Results In paper #1, we found that religion and marital type generally were not predictive of modern contraceptive use. The typical predictors – education, age, residence (urban/rural) – were consistently significant across the included countries. In paper #2, profiles of users of the most common contraceptive methods in each country were created. For example, condom users had the most consistent profile across the 12 countries, with marital status, parity and education being clearly associated with condom use. For paper #3, education level was found to be the key predictor of both sexual activity and becoming pregnant for young, never married women in this region. In general, those with primary or secondary and higher education were more likely to be sexually active than those with no education. Conclusion These findings provide valuable information to government, private and nongovernmental organizations working toward increasing the numbers of contraceptive users in Francophone SSA.