Explaining Inequity in the Use of Family Planning Services in Sub-Saharan Africa

David Hotchkiss, Tulane University
Mai Do, Tulane University

This study assesses the socio-economic inequity in family planning (FP) service use and explains it by contributions from health insurance coverage and individual- and household-level factors in selected sub-Saharan African countries. Concentration indices, standardized for FP needs, and decomposition methods are used. Analysis is completed for Nigeria, using its 2008 DHS and will be replicated for Kenya and Rwanda, using their latest DHS. Substantial inequity is found among 23,954 sampled Nigerian women in union, as well as among urban and rural women separately. Women’s education and wealth are significant contributors to inequity in both rural and urban, but health insurance is not. Partner’s education is important among rural women. The results suggest that educating women is still a strategic approach to improve FP equity. In rural, it is important to target men’s education. It may also be necessary to review the government’s health insurance program to better target the poor.