Patterns and trends of postpartum family planning in Ethiopia, Malawi, and Nigeria: evidence of missed opportunities for integration

Figures & data

Fig. 1 Trends in average percent modern postpartum family planning use (% PPFP) at 3 months, all women 15–49 years old, with 95% confidence intervals in Ethiopia, Malawi, and Nigeria. Source: DHS.

Fig. 2 Distribution of modern postpartum family planning at 3 months, all women 15–49 years old, by age, with 95% confidence intervals in Ethiopia, Malawi, and Nigeria. Source: DHS.

Table 1 Postpartum use of modern family planning at 3 months among women 15–49 years old disaggregated by education, place, and wealth quintile in Ethiopia, Malawi, and Nigeria

	Ethiopia				Malawi				Nigeria
	2005	2005 SDV	2011	2011 SDV	2004	2004 SDV	2010	2010 SDV	2008	2008 SDV	2013	2013 SDV
Education
No education	1.6	0.2	6.8	0.3	7.2	0.6	12.7	0.6	2.5	0.2	0.9	0.1
Primary	5.7	0.7	13.9	0.7	10.0	0.4	14.2	0.3	6.7	0.4	4.4	0.3
Secondary >	26.4	1.9	42.3	2.4	13.0	1.2	19.8	0.9	10.7	0.4	8.2	0.3
Place
Urban	21.2	1.3	34.4	1.2	12.1	1.1	22.1	1.1	10.1	0.4	7.0	0.3
Rural	1.9	0.2	6.3	0.3	9.1	0.3	13.5	0.3	4.1	0.2	2.1	0.1
Wealth quintiles
Lowest	0.8	0.2	2.7	0.3	6.8	0.6	11.7	0.5	2.8	0.2	0.6	0.1
Second	0.9	0.3	6.6	0.6	7.6	0.6	13.0	0.6	3.4	0.3	1.4	0.2
Middle	2.2	0.4	6.1	0.6	8.8	0.6	14.6	0.6	4.2	0.3	2.5	0.2
Fourth	2.6	0.5	9.5	0.7	10.7	0.8	16.8	0.7	7.0	0.4	6.4	0.4
Highest	13.2	0.9	31.6	1.1	14.9	1.0	18.9	0.9	14.3	0.7	10.5	0.5
All	5.0	0.2	11	0.3	9.5	0.3	14.7	0.3	5.9	0.1	3.8	0.2

SDV, standard deviation of the mean percent using modern family planning at 3 months postpartum in the latest Demographic and Health Surveys; primary, primary completed; secondary >, above primary school.

Table 2 Prevalence of modern postpartum family planning at 3 months among women 15–49 years old by parity and birth interval (preceding birth)

	Ethiopia 2011 DHS		Malawi 2010 DHS		Nigeria 2013 DHS
Countries Covariates	Mean postpartum family planning	SDV	Mean postpartum family planning	SDV	Mean postpartum family planning	SDV
Parity
One	16.8	0.9	13.1	0.6	3.7	0.3
Two or three	11.8	0.6	14.7	0.5	4.7	0.2
Four or five	6.0	0.5	15.2	0.6	3.9	0.3
Six or more	6.1	0.5	15.8	0.7	2.7	0.2
Birth intervals (preceding birth)
<24 months	8.1	0.7	18.7	0.9	3.2	0.3
≥24 months	8.3	0.4	14.5	0.3	4.1	0.2

DHS, Demographic and Health Survey; SDV, standard deviation of the mean percent using modern family planning at 3 months postpartum in the two latest DHS.

Fig. 3 Equiplots of modern postpartum family planning at 3 months, all women 15–49 years old, by education, place, and wealth quintile in Ethiopia, Malawi, and Nigeria.

Fig. 4 Mapping of prevalence of modern postpartum family planning use at 3 months, all women 15–49 years old, by region, Ethiopia. Source: 2011 DHS.

Fig. 5 Mapping of prevalence of modern postpartum family planning use at 3 months, all women 15–49 years old, by district, Malawi. Source: 2010 DHS.

Fig. 6 Mapping of prevalence of modern postpartum family planning use at 3 months, all women 15–49 years old, by state, Nigeria. Source: 2013 DHS.

Table 3 Multivariate analysis of effect of contacts with the health system on modern postpartum contraception use

Variables	Adjusted OR	Lower CI	Higher CI
Ethiopia (2011)
Antenatal care (1–3 visits)	1.12	0.89	1.41
Antenatal care (4 visits)^a	1.92	1.54	2.39
Institutional delivery (yes)^a	2.04	1.63	2.56
Child immunisation^a (completion of DTP3)	1.85	1.56	2.20
Education (primary)^a	1.63	1.36	1.96
Education (higher)^a	1.34	1.03	1.75
Residence (urban)^a	0.68	0.52	0.90
Wealth quintiles – second^a	3.04	2.02	4.57
Wealth quintiles – third^a	3.55	2.38	5.30
Wealth quintiles – fourth^a	4.48	3.06	6.57
Wealth quintiles – fifth^a	7.48	4.94	11.33
Malawi (2010)
Antenatal care (1–3 visits)	0.96	0.75	1.23
Antenatal care (4 visits)	1.08	0.85	1.39
Institutional delivery (yes)^a	1.31	1.16	1.47
Child immunisation^a
(completion of DTP3)	1.47	1.29	1.69
Education (primary)	1.05	0.92	1.20
Education (higher)	1.12	0.94	1.34
Residence (urban)^a	0.66	0.57	0.77
Wealth quintiles – second^a	1.16	1.01	1.34
Wealth quintiles – third	1.13	0.98	1.30
Wealth quintiles – fourth	1.14	0.98	1.33
Wealth quintiles – fifth^a	1.20	1.01	1.43
Nigeria (2013)
Antenatal care (1–3 visits)	0.85	0.63	1.15
Antenatal care (4 visits)	1.15	0.94	1.42
Institutional delivery (yes)^a	1.24	1.04	1.48
Child immunisation^a
(completion of DTP3)	1.34	1.14	1.57
Education (primary)^a	1.96	1.51	2.53
Education (higher)^a	2.20	1.70	2.83
Residence (urban)	1.00	0.84	1.18
Wealth quintiles – second^a	2.83	1.76	4.57
Wealth quintiles – third^a	3.70	2.30	5.96
Wealth quintiles – fourth^a	5.81	3.60	9.38
Wealth quintiles – fifth^a	8.52	5.19	13.99

^aSignificant at the 5% level. OR, odds ratio; CI, confidence interval; DTP3, diphtheria–tetanus–pertussis. Adjusted OR calculated from a multivariate logistic regression adjusting for socio-economic variables. Reference categories are no antenatal care visit (antenatal care), no education (education), no health facility delivery (skilled attendance), rural area (residence), no completion of DTP3 (child immunisation), and lowest quintiles (wealth quintiles).