Secondary Analysis of DHS Data

Secondary analysis of DHS data from the four SFPS priority countries (Burkina Faso 1993, Cameroon 1991, Cote d’Ivoire 1994, and Togo 1988) was conducted by The POLICY Project in collaboration with SFPS/OR. The analysis is designed to assist the SFPS (Family Health AIDS Prevention Project) in the following ways:

1. Furnish SFPS partners and USAID/RESDO with critical information about FP/RH demand to help shape the strategies in services, training, IEC, and OR in the four priority countries.
2. Improve the policy environment by providing counterparts with analytical information about demand for FP/RH so they can reduce barriers and help target resources more precisely.
3. Promote strategic planning for expanded FP/RH access by furnishing counterparts with current, timely data to ensure implementation of policies.
4. Learn from available DHS surveys in order to better exploit existing data and plan for the analysis of the upcoming DHS surveys in the four countries.

Expected Results

The POLICY Project assumes that if analytical needs are met, policies would be formulated and then implemented through strategic planning. However, a critical question is how precisely programs can be changed to better meet client needs if information about demand is only available at the national level. It can be assumed that the following elements of national FP/RH programs can be tailored to specific characteristics of women in need even if the data is not available at sub-national levels:

• High level policy dialogue
• IEC programs (content of message, communications channels and styles, images)
• Use of "high risk" client profiles for facility-based and outreach workers
• Operations Research agenda and tools
• Design of urban-rural approaches
• Criteria for Allocation of Resources to National Program: e.g. urban-rural distribution,
• Geographic targeting where DHS sample is large enough to further characterize unmet need
• Training programs - content, level of personnel, location, duration

Priority Areas of Analysis

To meet the goal of increased contraceptive prevalence, given the fairly high unmet need and the potential for significant increases in modern method use, an analysis was conducted focusing on: converting traditional users to modern users, meeting needs of those who intend to use methods, and retaining those already using modern methods.

Within this group, the needs of those who are "prolonged abstinence" users is also explored. Prolonged abstinence users fit the profile of all other users regarding desire for more children yet they differ markedly with regard to many characteristics, which could provide clues for reaching out to this group with modern methods.

Conversion of Traditional Users to Modern Methods: Given the very large proportion of Traditional Users - and in some countries the widespread use of "abstinence prolongée" - a key challenge is how easily they can be converted to modern users.

• What is their level of knowledge of modern methods and source of methods; are there differences between those who know and those who don’t (e.g., urban and rural)
• What other services do they use which could reach them with modern method (pre and post natal care, delivery, vaccination)

Furnishing Modern Methods to Women Who Intend to Use Since many women intend to use family planning within 12 months and most prefer modern methods, we need to know how we could quickly meet their needs:

• What methods do they prefer, which ones do they know,, what proportion know a source, and how long do they think it will take them to get there.
• What other services do they use which could reach them with modern methods.

Drop-out Among Current Modern Method Users: There is evidence that there are a significant number of drop-outs. This may in part be due to failure to use a method that meets their needs at a given stage of reproductive life. It is therefore important to know if clients are using "appropriate" methods or are even given a "choice" of methods.

Overview of Findings

• The vast majority of current contraceptors are using traditional methods, primarily prolonged abstinence, and many of these users do not know a source for a modern method.

• In Burkina Faso, data reveal that lack of access to modern methods and inadequate information are clearly behind the low modern contraceptive use rather than any opposition or disapproval of family planning or desire for more children within the next two years.

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