Abstract |
This study considers whether recent increases in modern contraceptive use in Uganda are likely reflecting the impacts of reproductive health interventions related to health facilities. We employ data from the 1999 Delivery of Improved Services for Health (DISH) Evaluation Surveys, which provide quantitative information on the reproductive health status of individuals and services in the districts served by the DISH project. The surveys consisted of a Household Questionnaire administered to a representative sample of women of reproductive age, and a Facility Questionnaire implemented in all health facilities serving the sampled population. Multivariate logistic regressions were used drawing on both individuals' background characteristics as well as representative characteristics of health facilities to assess the independent impact of the quality of the health service environment on individual-level differences in contraceptive use. After controlling for a number of socio-demographic characteristics, access to a greater choice of family planning supply methods in rural areas remained significantly associated with women’s increased usage. A positive association between the number of DISH-trained family planning service providers and contraceptive use was found in urban areas. However unexpected findings of negative associations between certain indicators of programme efforts and actual family planning practices point to the need for a better understanding of any potential targeting of publicly-funded resources. |