The Impact of Family Planning Service Provision on Contraceptive-use Dynamics in Morocco

This article uses linked data from the 1995 Morocco DHS calendar and the 1992 Morocco DHS service-availability module to study the effect of service environment on contraceptive discontinuation, switching, and adoption of a modern method following a birth. The 1995 Morocco DHS also collected informa...

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Bibliographic Details
Published in:Studies in family planning 1999-03, Vol.30 (1), p.28-42
Main Authors: Steele, Fiona, Curtis, Siân L., Choe, Minja
Format: Article
Language:English
Subjects:
Adolescent
Adoption
Adult
Birth Control
Child
Communities
Community Pharmacy Services
Contraception Behavior - psychology
Contraception Behavior - statistics & numerical data
Contraceptives
Delivery Systems
Estimation methods
Factors
Family Planning
Family planning services
Family Planning Services - organization & administration
Female
Health Care Services
Health Care Utilization
Health Knowledge, Attitudes, Practice
Health Services Accessibility - organization & administration
Health surveys
Humans
Longitudinal Studies
Medical service
Middle Aged
Models, Statistical
Morocco
Multilevel models
Oral contraceptives
Pharmacies
Population
Population policy
Pregnancy
Program Evaluation
Public Health Practice
Social impact
Socioeconomic Factors
Surveys
Surveys and Questionnaires
Use
Womens Health Care
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Summary:This article uses linked data from the 1995 Morocco DHS calendar and the 1992 Morocco DHS service-availability module to study the effect of service environment on contraceptive discontinuation, switching, and adoption of a modern method following a birth. The 1995 Morocco DHS also collected information on the source of supply for each episode of use of a modern method recorded in the calendar, allowing study of the association between the source of supply and discontinuation and switching rates. Multilevel event-history models are used to evaluate the impact of individual-level sociodemographic characteristics and community-level indicators of family planning service provision. The findings show that the presence of a nearby public health center is associated with higher modern-method adoption after a birth and lower method-failure rates; the presence of a pharmacy is associated with lower discontinuation due to side effects or health concerns. The degree of method-choice potential has a positive impact on both the rate of switching from the pill to another modern method and on modern-method adoption after a birth.
ISSN:0039-3665
1728-4465
DOI:10.1111/j.1728-4465.1999.00028.x