Determinants of change in contraceptive use among women with disabilities in Uganda for the period 2011-2016.

Abstract

The use of modern contraceptives among Women With Disabilities (WWDs) in Uganda stays remarkably low with only 16% of WWDs compared to the national average of 35% in 2016, yet they continue to bear the burden of mistimed and unwanted pregnancies, that often result into abortions. The study objective was to decompose the determinants of change in contraceptive use among Women With Disabilities (WWDs) for the period 2011 to 2016. The changes were decomposed into components attributed to variations in characteristics and variations in the effect of coefficient using WWDs’ demographic and socio-economic factors. The Univariate, logistic regression and a multivariate decomposition analysis were used to quantify the impact of change. The assessment was based on data sourced from Uganda Demographic and Health Surveys (UDHS) conducted among a total of 4290 WWDs aged 15-49 years in 2011 to 2016. The variation in the characteristics of WWDs were significantly associated (p<0.05) with parity, education level, wealth index and marital status. Thus, overall 3.1% of the gap in the use of modern contraceptives was attributed to differences in the characteristics of WWDs that would respectively be increased by 10.1%, 11.4%, 3.9% and 6.1% if WWDs in 2011 had similar composition to that of their counterparts in 2016. Therefore, 96.9% of the gap was attributed to differences in effects of compositional factors (coefficient). The overall gap in the use contraceptives for the study period was attributed to the change in characteristics of Women With Disabilities. Designing of interventions with emphasis on government and other stakeholders should promote comprehensive education to promote sensitization and empower them with knowledge. As Uganda continues to focus on harnessing the Sustainable Development Goals (SDGs), social behavioral change communication (SBCC) interventions to change the mindset and enhance self-efficacy and empowering household wealth status through the Operation wealth creation Programs and “Emyooga” as initiated by the government of Uganda if well implemented presents an opportunity for the country to achieve faster family planning increase.