Demand and Unmet Need to Space Births in Rwanda: A Two-Step Analysis of Determinants

Abstract

Rwanda has recently experienced an impressive success in family planning leading to less unmet need and a lower fertility rate. Despite this achievement unmet need remains a demographic and health issue. Because the interval between births has a strong effect on infant and maternal morbidity and mortality and because long intervals lead to a further fertility decline, this study seeks to identify the barriers to the use of contraceptives by women who want to space births. The study uses a pooled dataset from the 2005 and 2010 RDHSs which enables an assessment of changes in both demand for and use of family planning. In order to take into account the latent demand in the analysis of unmet need, we applied the Heckman probit model that simultaneously estimates two probit equations: one for demand, another for unmet need. The results show that the demand to postpone the next birth is correlated with the desired family size, the health status of the index child and the experience of infant mortality. Socio-economic factors have a limited role in the demand for spacing. The level of unmet need has dramatically declined between 2005 and 2010, especially among lower educated and cultivators. Bio-demographic factors such as being in amenorrhea and cultural factors, especially religious attitudes, still hamper the use of contraception. The strong commitment of the government to reproductive health may have been the main factor in increasing the uptake of contraception. To further increase contraceptive prevalence, continued advocacy is needed. Key words: unmet need, family planning, birth spacing, heckprobit, Rwanda