Birth control is the conscious control of the birth rate by methods which temporarily prevent conception by interfering with the normal process of ovulation, fertilization, and implantation.
High contraceptive prevalence rate is always expected for controlling births for those countries that are experiencing high population growth rate. The factors that influence contraceptive prevalence are also important to know for policy implication purposes in Bangladesh. This study aims to explore the socio-economic, demographic and others key factors that influence the use of contraception in Bangladesh.
The contraception data are extracted from the 2014 Bangladesh Demographic and Health Survey (BDHS) data which were collected by using a two-stage stratified random sampling technique that is a source of nested variability. The nested sources of variability must be incorporated in the model using random effects to model the actual parameter effects on contraceptive prevalence.
A mixed-effect logistic regression model has been implemented for the binary contraceptive data, where parameters are estimated through generalized estimating equation by assuming exchangeable correlation structure to explore and identify the factors that truly affect the use of contraception in Bangladesh.
The prevalence of contraception use by currently married 15–49 years aged women or their husbands is 62.4%. Our study finds that administrative division, place of residence, religion, number of household members, woman’s age, occupation, body mass index, breastfeeding practice, husband’s education, wish for children, living status with wife, sexual activity in past year, women amenorrheic status, abstaining status, number of children born in last five years and total children ever died were significantly associated with contraception use in Bangladesh.
The odds of women experiencing the outcome of interest are not independent due to the nested structure of the data. As a result, a mixed effect model is implemented for the binary variable ‘contraceptive use’ to produce true estimates for the significant determinants of contraceptive use in Bangladesh.
Knowing such true estimates is important for attaining future goals including increasing contraception use from 62 to 75% by 2020 by the Bangladesh government’s Health, Population & Nutrition Sector Development Program (HPNSDP).
The experts anticipate that this framework shall help the policy makers and researchers to incorporate additional intervention or components in their existing family planning program since our model framework compiled all relevant factors that could potentially affect the use of contraception and would be useful to identify the gap of family planning related public health intervention.