Regional Disparities in Fertility Preferences and Demand Satisfied for Family Planning by Modern Methods across Levels of Poverty

Research has highlighted disparities in family planning outcomes by wealth and by region separately. This analysis examines regional disparities within specific poverty groups. Twelve USAID family planning priority countries with recent DHS or AIS surveys were selected for the analysis, including 11 DHS surveys (Democratic Republic of Congo (DRC), Ethiopia, Ghana, Haiti, Malawi, Nepal, Nigeria, Pakistan, Rwanda Uganda, and Zambia) and one AIS survey (Mozambique). The measure of absolute poverty used in the analysis was comparable across the surveys. Households were divided into three groups to define the level of poverty: not extremely poor, extremely poor but not asset poor, and extremely poor and asset poor. Two outcomes were examined for women in union: ideal number of children and demand for family planning satisfied by modern contraceptive methods. The analysis examined regional disparities in these outcomes within each of the three poverty groups using descriptive statistics, maps, and regression analyses. The results showed patterns specific to individual countries. In some countries, including Haiti, Malawi, and Rwanda, few or no regional disparities were apparent. In others, one or a few clustered regions stood out from the rest by having worse outcomes across all poverty groups (for example, Somalia region in Ethiopia). Other countries showed more regional variability in just one of the three poverty groups. This was especially true in several countries for demand for family planning satisfied by modern methods among the extremely poor and asset poor group. These results highlight the need for family planning programs to focus on specific regions where disparities exist, and on poverty groups where little of the demand for family planning is satisfied by modern methods.