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Measuring the success of family planning initiatives in Rwanda: a multivariate decomposition analysis

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Abstract

Rwanda has experienced a dramatic increase in contraceptive use and concomitant fertility decline between 2005 and 2010. The contraceptive prevalence rate has increased from 17 to 52 %. During this period, Rwanda was strongly promoting family planning and making socio-economic progress. This study analyses the shift in contraceptive use by investigating the contribution attributable to the family planning program and that resulting from socio-economic progress. Using data from the 2005 and 2010 Rwanda Demographic and Health Surveys, we apply the Blinder-Oaxaca decomposition technique to separate the increase in contraceptive use due to population composition change, which result mostly from socio-economic and attitudinal developments, from the increase attributable to changes (improvement) in contraceptive behaviour. The contraceptive increase is mainly attributable to contraceptive behavioural change (78 %). Factors that show a significant contribution are women’s education, experience of child mortality, and place of residence. The contribution of changes in population composition is limited (12 %). Effects are relatively higher for exposure to family planning messages and husband’s desire for children compared to that of his wife’s. Contraceptive uptake improved mostly in the low socio-economic stratum of the population, among the rural and less educated population. This finding suggests that a strong family planning program supported by political leaders can remove persistent socio-economic and cultural barriers and enable a massive popular contraceptive uptake.

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Notes

  1. In 2007 the President of the Republic declared family planning a national priority. Created in 2003, the Rwandan Parliamentarians’ Network for Population and Development engaged in several grassroots campaigns at district and sector level.

  2. Even though progress in access to contraceptives is not demonstrated in this analysis, reports from the Ministry of Health indicate an increase in the number of health facilities, an improvement in the quality of service through staff training and provision of health facilities (MOH 2009, 2011).

References

  • Ainsworth, M., Beegle, K., & Nyamete, A. (1996). The impact of women’s schooling on fertility and contraceptive use: A study of fourteen sub-Saharan African countries. World Bank Economic Review, 10, 85–122.

    Article  Google Scholar 

  • Alkema, L., Kantorova, V., Menozzi, C., & Biddlecom, A. (2013). National, regional, and global rates and trends in contraceptive prevalence and unmet need for family planning between 1990 and 2015: a systematic and comprehensive analysis. The Lancet, 381(9878), p1642–1652.

    Article  Google Scholar 

  • Behrman, R. J., Kohler, H.-P., & Watkins, S. C. (2002). Social networks and changes in contraceptive use over time: evidence from a longitudinal study in rural Kenya. Demography, 39(4), 713–738.

    Article  Google Scholar 

  • Blinder, S. A. (1973). Wage discrimination: Reduced form and structural estimates. The Journal of Human Resources, 8, 436–455.

    Article  Google Scholar 

  • Bongaarts, J. (2014). The impact of family planning programs on unmet need and demand for contraception. Studies in Family Planning, 45(2), 247–262.

    Article  Google Scholar 

  • Demeny, P. (1990). World Population Growth and Prospects, The Earth as Transformed by Human Action, (Ed.), B. L. Turner, II. NY: Cambridge University Press.

  • Fairlie, W. R. (2005). An Extension of the blinder-oaxaca decomposition technique to logit and probit models. Journal of Economics and Statistics, 86, 1034–1036.

    Google Scholar 

  • Freedman, R. (1990). Family planning programs in the third world. Annals of the American Academy of Political and Social Science, 510, 3.

    Article  Google Scholar 

  • Gertler, J. P., & Molyneaux, J. W. (1994). How economic development and family planning programs combined to reduce Indonesian fertility. Demography, 31(1), 33–63.

    Article  Google Scholar 

  • Gordon, C., Sabates, R., Bond, R., & Wubshet, T. (2011). Women’s education and modern contraceptive use in Ethiopia. International Journal of Education, 3(1), 1948–5476.

    Article  Google Scholar 

  • Hewage, A. (1987). Effective communication breaks through socio-cultural barriers in family planning: the Sri Lankan experience. JOICFP Review, 13, 33–36.

    Google Scholar 

  • Jain, K. A., & Ross, A. J. (2012). Fertility differences among developing countries: Are they still related to family planning program efforts and social settings? International Perspectives on Sexual and Reproductive Health, 38(1), 15–22. doi:10.1363/3801512.

    Article  Google Scholar 

  • Lapham, J. R., & Mauldin, P. W. (1985). Contraceptive prevalence: the influence of organized family planning programs. Studies in Family Planning, 16(3), 117–137.

    Article  Google Scholar 

  • Madsen, L. E. (2011). Rwanda: Dramatic uptake in contraceptive use spurs unprecedented fertility decline. http://www.newsecuritybeat.org/2011/11/building-commitment-to-family-planning-rwanda. Accessed on 19 Nov 2014.

  • Ministry of Education (MINEDUC) [Rwanda]. (2012). Rwanda Education statistics. Kigali: MINEDUC. http://www.mineduc.gov.rw/IMG/pdf/2011_Rwanda_Education_Statistics.pdf. Accessed on 25 Jun 2014.

  • Ministry of Finance and Economic Planning (MINECOFIN) [Rwanda]. (2000). Rwanda vision 2020. Kigali: MINECOFIN.

    Google Scholar 

  • Ministry of Health (MOH) [Rwanda]. (2006). National family planning policy and Its five-year strategies, 2006-2010. Kigali: MOH.

    Google Scholar 

  • Ministry of Health (MOH) [Rwanda]. (2009). Annual report 2008. Kigali: MOH.

    Google Scholar 

  • Ministry of Health (MOH) [Rwanda]. (2011). Annual report 2010-11. Kigali: MOH.

    Google Scholar 

  • Muhoza, N. D., Broekhuis, A., & Hooimeijer, P. (2014). Variations in desired family size and excess fertility in East Africa. International Journal of Population Research, 2014, 1–11. doi:10.1155/2014/486079.

    Article  Google Scholar 

  • Mwaikambo, L., Speizer, I. S., Schurmann, A., Morgan, G., & Fikree, F. (2011). What works in family planning interventions: A systematic review. Studies in Family Planning, 42(2), 67–82.

    Article  Google Scholar 

  • Najafi-Sharjabad, F., Zainiyah, S., Yahya, S., Rahman, A. H., Hanafiah, M., & Manaf, A. R. (2013). Barriers of modern contraceptive practices among Asian women: A mini literature review. Global Journal of Health Science, 5(5), 1916–9736.

    Article  Google Scholar 

  • National Institute of Statistics of Rwanda (NISR). (2012). Third integrated household living conditions survey report. Kigali: NISR.

    Google Scholar 

  • National Institute of Statistics of Rwanda (NISR), Ministry of Health and ICF International. (2012). Rwanda demographic and health survey 2010. Calverton: NISR, MOH and ICF International.

    Google Scholar 

  • Ndaruhuye, M. D., Broekhuis, A., & Hooimeijer, P. (2009). Demand and unmet need for means of family limitation in Rwanda. International Perspectives on Sexual and Reproductive Health, 35(3), 122–130.

    Article  Google Scholar 

  • Oaxaca, R. (1973). Male-female wage differentials in urban labour markets. International Economic Review, 14, 693–709.

    Article  Google Scholar 

  • Osotimehin, B. (2012). The Word on Women: African leaders renew commitment to family planning. http://www.trust.org/alertnet/blogs/the-word-on-women/african-leaders-renew-commitment-to-family-planning/. Accessed 25 Nov 2012.

  • Powers, A. D., & Pullum, T. W. (2006). Multivariate decomposition for nonlinear models. The Stata Journal, 11(4), 556–576.

    Google Scholar 

  • Powers, A. D., & Yun, M. S. (2009). Multivariate decomposition for hazard rate models. Sociological Methodology, 39(1), 233–263.

    Article  Google Scholar 

  • Richey, C., & Salem, R. M. (2008). Elements of success in family planning programming. Population reports, Series J. No. 57. Baltimore: Johns Hopkins Bloomberg School of Public Health.

  • Saleem, S., & Bobak, M. (2005). Women’s autonomy, education and contraceptive use in Pakistan: a national study. Reproductive Health, 2(8), 1–8.

    Google Scholar 

  • Schuler, S. R., Syed, M. H., & Jenkins, A. H. (1995). Bangladesh’s family planning success story: A gender perspective. International Family planning Perspectives, 21, 132–166.

    Article  Google Scholar 

  • Shapiro, D., & Tambashe, O. B. (1994). The impact of women’s employment and education on contraceptive use and abortion in Kinshasa. Zaire. Studies in Family Planning, 25(2), 96–110. doi:10.2307/2138087.

    Article  Google Scholar 

  • Sinha, N. (2005). Fertility, child work, and schooling consequences of family planning programs: Evidence from an experiment in rural Bangladesh. Economic Development and Cultural Change, 54, 1.

    Article  Google Scholar 

  • Tabassum, A., Khan, A. E., Arif, M., & Ali, M. W. (2014). Exploring the socio-cultural barriers to modern contraceptive use among Pakistani women. IOSR Journal of Humanities and Social Science (IOSR-JHSS), 19(5), 98–102.

    Article  Google Scholar 

  • USAID/Africa Bureau, USAID/Population and Reproductive Health, Ethiopia Federal Ministry of Health, Malawi Ministry of Health, & Rwanda Ministry of Health. (2012). Three successful sub-Saharan Africa family planning programs: Lessons for meeting the MDGs. USAID, Washington: Africa Bureau.

    Google Scholar 

  • USAID-RWANDA & TWUBAKANE. (2008). Decentralization and health program in Rwanda: Quarterly performance monitoring report #15, July-September 2008. Kigali: USAID/Rwanda and Twubakane Team Partners.

    Google Scholar 

  • USAID-Rwanda Twubakane. (2009). Contributions to Rwanda’s results in decentralization and health. Report presented at the end of Project Ceremony, #18, December 2009. Kigali: USAID/Rwanda and Twubakane Team Partners.

  • Vahidnia, F. (2007). Case study: Fertility decline in Iran. Population and Environment, 28(4–5), 259–266.

    Article  Google Scholar 

  • World Health Organization. (2013). Sexual and reproductive health: Contraceptive prevalence. http://www.who.int/reproductivehealth/topics/family_planning/contraceptive_prevalence/en/.

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Authors and Affiliations

  1. Department of Applied Statistics, College of Business and Economics, University of Rwanda, Huye, Rwanda

    Dieudonne Ndaruhuye Muhoza & Pierre Claver Rutayisire

  2. School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda

    Aline Umubyeyi

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  1. Dieudonne Ndaruhuye Muhoza
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  2. Pierre Claver Rutayisire
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  3. Aline Umubyeyi
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Correspondence to Dieudonne Ndaruhuye Muhoza.

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Muhoza, D.N., Rutayisire, P.C. & Umubyeyi, A. Measuring the success of family planning initiatives in Rwanda: a multivariate decomposition analysis. J Pop Research 33, 361–377 (2016). https://doi.org/10.1007/s12546-016-9177-9

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