8

CHAPTER 2

Review of Related Literature and Studies

This chapter reviews the vast body of literature that navigates the topics and

issues related to the objectives and problems of the research. The chapter first outlines

the related policies that address contraceptive use, particularly the RH Law, its related

policies and implementing rules and regulations for it. It then explores the different

theories that researchers used to explain the dynamics of demand for contraception.

Finally, the chapter reviews the related empirical tests and the corresponding

methodologies in reaching such findings.

I. Policy Issues

In order to further contextualize the paper’s objectives, the researchers situate

their research within the context of two main policies: RH Law and the Executive Order

No. 12 s. 2017 (henceforth known as EO 12).

RH Law (2012) was passed back in 2012 in the Philippines to promote women

empowerment, gender equality, as well as openness to life, similar to the SDGs. It aims

to do this by giving people of the country access to information, supplies, and services

relevant to the goals. Through this policy, the government can better protect the welfare

and rights of women.

The Philippine government aims to implement this policy through a multi-

faceted approach: information dissemination, campaigning, and supplying the

appropriate services (The Responsible Parenthood And Reproductive Health Act 2012).

One way they wish to promote the three goals is through information. Specifically, they

wish to educate the people about their right to making informed decisions in health care

and family planning. Educating the populace was planned to be done through working

with organizations and health facilities. By cooperating with organizations, they can
 9

gain more information on the efficacy of the implementation. Through health facilities,

the government can better reach their targeted audience of those in need of family

planning. To do so, private hospitals who opt in the program and public hospitals will

be equipped with personnel knowledgeable on the topic of family planning and

maternal and child health.

Before they can educate the population, the government first needs to make

them aware that the people have rights to information and services for maternal and

reproductive health, including family planning. The Implementing Rules and

Regulations of Republic Act 10354 (2013) stated that this would be done through a

“heightened nationwide multimedia-campaign” to be carried out by the Department of

Health (DOH) and Local Government Units (LGUs). Once the population is informed,

the next step is to educate them. Which is also done through a curriculum created by

the Department of Education (DepEd) that is age- and development-appropriate for

those to be educated. In terms of collection of information, the DOH works with

province-, city-, or municipality-wide health systems to determine the need for family

planning of the people.

Furthermore, the government must also implement the policy through

campaigning. The government works with organizations to promote programs that fall

in line with the goals of the policy (The Responsible Parenthood And Reproductive

Health Act 2012). Specifically, programs that advocate for family planning, analysis of

demographic trends, and scientific studies that determine the safety and efficacy of

medications and methods in relation to reproductive health. The campaign focuses on

reproductive health, rather than population control.

One thing the government needed to do to be able to implement the policy well

was to supply the proper facilities that promote the goals of the policy (Implementing
 10

Rules and Regulations of Republic Act 10354 2013). Through the policy, they planned

to supply the population with effective and quality health care for women and children.

This would be done by properly allocating supplies and providing medically-safe

reproductive health care services, including care for post-abortive complications that

may arise. The contraceptives and other medical supplies are procured by the DOH and

distributed and monitored by LGUs. The funding is taken care by the DOH and other

related agencies.

While the law had passed and was deemed constitutional, some sections had

previously faced contention. In a memorandum released by the Public Information

Office about the Supreme Court’s session on the topic, the constitutionality of certain

sections of the RH Law were called into questioned (Mendoza 2014). In G.R. NO.

204819, sections punishing non-public health facilities and health care workers who

refuse to direct patients to the proper facilities for reproductive and maternal health

services were deemed unconstitutional by the Justices (Mendoza 2014).

Meanwhile, EO 12 supplements the RH Law for its aim of “zero unmet need

for modern family planning” (2017). With a budget of P186.5 million, it aims to

decrease the actual fertility rate of 3 to the desired rate of 2.2 through improvement of

family planning programs and services, targeting women in the 1st to 3rd wealth

quintiles. To properly implement it, the government aimed to map areas to locate unmet

need and partner up with the proper organizations. The DOH also released AO NO.

2017-0005 to help meet the desired family size through demand-generating activities

to identify unmet need and training of family planning personnel.

EO 12 stipulated that overall implementation of the policy is headed by the

DOH, while the Commission on Population (POPCOM) is in charge of training the

personnel. DepEd, on the other hand, is in charge of creating the policy on

 11

Comprehensive Sexuality Education (CSE) for public and private schools. Lastly, the

Food and Drug Administration (FDA) is in charge of certification of family planning

products. Other departments of the government and organizations were also tasked with

assisting in the implementation of the policy, such as the Office for Technical Services

of the DOH who set up workshops throughout the Philippines to help the personnel

better understand the provisions of the policy.

One program to support the policy is the Philippine Population Management

Program (PPMP). Through this program, the government aimed to help Filipinos

achieve their desired family size as well as reduce incidence of teenage pregnancies

through its two components: Responsible Parenthood and Family Planning (RPFP) and

Adolescent Health and Development (AHD) (Executive Order No. 12 s. 2017 2017).

RPFP aims to help families meet their desired number of children through timing and

spacing depending on the family’s socio-economic and other related factors. AHD, on

the other hand, aims to reduce incidence of teenage pregnancies through teaching the

youth about sexual and reproductive health and life skills to handle pregnancies.

Realizing the goal of zero unmet need for family planning requires funding. In

accordance to EO 12 (2017), the government must procure the materials needed for

modern family planning, such as contraceptives, and fund any activities related to

family planning, such as training, conferences, and monitoring. The majority of the

budget, 87%, must go to the procurement of materials while the remaining, 13%, must

go to the activities. The funds are allocated by the DOH for regional offices to be able

to meet the needs of each region, such as having at least one nurse trained in demand

generation, service provision, and monitoring in every municipality and city.

 12

II. Theoretical Issues

Though there is no unified corpus of literature regarding the demand of

contraceptives vis-a-vis the models and theoretical approaches used, researchers often

referred to the theories and models of Easterlin (1975; Ahmed 1987) or Grossman

(Tshiswaka-Kasalala & Koch 2015) in deriving the demand for contraceptives.

Furthermore, other researchers relied on discrete choice dynamic models (Carro and

Mira 2002), the conditional demand framework (Rosenzweig and Seiver 1982), the

theory of planned behavior (Emens 2008), or derived the demand from the utility

function (Radhakrishnan 2010; Brunborg 1984).

Ahmed (1987) identified three variables from Easterlin’s (1975) synthesis

framework that determines contraceptive use: (1) motivation for fertility regulation, (2)

attitude or notion of acceptability of family planning, and (3) access to contraceptive

methods. These three categories may be clustered further into two: (1) motivation for

fertility regulation, which encompasses the first determinant; and (2) cost of fertility

regulation, which encompasses the latter determinants.

The motivation for fertility is quantifiable by looking into the relationship of the

demand for children, 𝐶𝑑 , and the potential output for children, 𝐶𝑛 (Easterlin 1975). A

couple is more motivated to regulate fertility when the condition is:

(𝐶𝑛 − 𝐶𝑑 ) > 0 (2.2.1)

The demand for children is further determined by the tastes, preferences, and

the norms that the couple subscribe to, while the potential output for children is

determined by the frequency of sexual intercourse, fecundity, and fetal mortality

(Easterlin 1975). However, vis-a-vis the costs of fertility regulation, should it be greater

than the motivation for fertility regulation, then the couple would still opt not to utilize
 13

any contraceptive methods (Ahmed 1987). Thus, Ahmed (1987) modelled the concepts

of Easterlin (1975) in this way:

𝑈 = 𝑈(𝐶𝑛 − 𝐶𝑑 , 𝑅𝐶) (2.2.2)

where U pertains to contraceptive use and is a function of the difference between the

potential output for children and the demand for children, and the cost of fertility

regulation, RC.

Emens (2008) used Easterlin (1975) as a take-off point in analyzing the demand

for fertility regulation. However, Emens used a disaggregated form on the cost of

fertility regulation, which in Easterlin’s hypothesis, included the attitude or norms on

contraceptive use and the access to contraceptive methods. Using the Theory of Planned

Behavior, as shown in Figure 2.1, Emens highlighted that both the intention of using

and behavior of actually using contraception are endogenous to the attitude of a woman

towards using any method, the subjective societal norms prevailing, and even the

perceived behavioral control of a woman.

Figure 2.1. Theory of Planned Behavior. Illustrated by Emens [2008].

In contrast with Easterlin’s (1975) framework, Emens (2008) highlighted the

perception on the intervention of her partner in using contraceptives. This is captured

by third box named “Perceived behavioral control.” With this, Emens hypothesized that

woman are more likely to use contraceptive methods when they think that their husband

would approve on using such methods.

 14

On the other hand, in contrast with Easterlin (1975) and Emens (2008),

Tshiswaka-Kashalala and Koch (2015) adapted the Grossman approach, wherein health

is viewed as a consumer and investment capital. The proposition in a pure investment

model was that good health gives rise to better time for wage earning opportunities,

yielding the earnings function:

𝑦(𝑡) = 𝑤(𝑡)𝑞(𝑘(𝑡)) (2.2.3)

where w(t) pertains to the wage rate, while q(k(t)) pertains to the working time

production as a function of a single health capital. Meanwhile, change of health capital

k with respect to time is given by the investment on health, g(m(t)), and the deterioration

of the current health stock n(k(t)):

𝜕𝑘
= 𝑔(𝑚(𝑡)) − 𝑛(𝑘(𝑡)) (2.2.4)
𝜕𝑡

These investments on health is generally characterized by investing in health

resources such as medical care, or devoting time for health-producing activities, e.g.,

exercise (Santerre and Neun 2013). Furthermore, health production is also determined

by education, as it allows the individuals to be efficient in their production (Santerre

and Neun 2013).

By applying the pure investment model in deriving the demand for reproductive

health, that is, by viewing the activity as an investment in reproductive health, then

Tshiswaka-Kashalala and Koch (2015) determined a woman’s demand for

contraceptive efficiency, given by

𝜋
𝑚𝐼∗ (𝑡) = 1 − (2.2.5)
𝜑𝑝2 (𝑡)𝑥 2 (𝑡)

where the demand for contraceptive efficiency is directly proportional with a woman’s

natural fecundity 𝑝2 (𝑡) and the frequency of intercourse 𝑥 2 (𝑡). Tshiswaka-Kashalala

and Koch assumed that a woman’s fecundity is uncertain, and thus her contraceptive
 15

behavior will allow her to have control over such uncertainty. Furthermore, the

researchers also assumed that childbearing and child-rearing are time-intensive, and

thus will have an effect on the woman’s earning opportunities in the face of a trade-off

with labor and child-rearing.

Rosenzweig and Seiver (1982) used the consumer optimization problem, also

in analyzing the demand for contraceptive use by maximizing the utility function in one

planning period, particularly on the conditional effects of education on a contraceptive

technique. The contraceptive techniques lie on the index of 𝜌. The index ranked the

techniques based on their total costs and efficiency in birth spacing. Furthermore, this

utility function is associated with the number of live births n, the aggregated

consumption good Z, the level of education E, the level of excess or deficit fertility X

from the previous planning period, and other random characteristics 𝜀. Thus, the

maximization problem is given by

𝑈 = 𝑈(𝑛, 𝑍; 𝐸, 𝑋, 𝜀)
(2.2.6)
subject to 𝐹 = 𝑛̅𝐶(𝜌) + 𝜓(𝜌, 𝐸, 𝜀) + 𝑛(𝑝𝑛 − 𝐶(𝜌)) + 𝑍𝑝𝑍

where F is the total income, 𝑛̅𝐶(𝜌) is the total variable cost associated with the average

live births in a planning period 𝑛̅ and the variable cost due to the usage of the

contraception technique 𝜌.

Rosenzweig and Seiver (1982, 174) classified these variable costs as those

which do not “contain time and direct expenditure components related to consultations,

installation, and monitoring of contraceptive performance,” such as condoms.

Conversely, 𝜓(𝜌, 𝐸, 𝜀) is the fixed cost associated with the contraceptive method 𝜌, the

level of education E and other unobserved characteristics 𝜀. Lastly, pn is the cost of

child-rearing, pz is the price of the consumption goods.

 16

Rosenzweig and Seiver (1982) was mainly concerned in the allocative

efficiency of education, that is, education lowers the associated cost when an individual

or couple wants to know some information about new contraceptive techniques. Thus,

they hypothesized that education lowers the fixed costs on obtaining these information

on technique 𝜌, given by 𝜓𝜌𝐸 < 0. With the lowering of fixed costs related to obtaining

information on the technique, the consumer may opt to use a higher technique for a

lower fixed cost.

Meanwhile, similar to Rosenzweig and Seiver (1982), Carro and Mira (2002)

derived also the demand for contraceptive methods using the utility function. However,

they situated the model for contraceptive choice within the framework of dynamic

stochastic discrete choice model by assuming that couples do face uncertainty vis-a-vis

their “maximum potential duration of their fertile life T and … ignore the risks of their

own and their children’s mortality” (3). Furthermore, the researchers also assumed that

within the duration of their marriage up to the stopping period, [t, τ], couples may do

three possible mutually exclusive actions: do not use contraceptives (j = 1), use

temporary contraceptives (j = 2), or be sterile (j = 3).

Carro and Mira (2002) also defined the probability that birth b, will occur at

time t + 1, given the state (i.e. recent history of contraceptive choice) and action of the

contraceptive choice in time t as 𝐹𝑗𝑡 = 𝐹𝑗 (𝑏𝑡+1 = 1|𝑆𝑡 ). When j = 1 or 2, then 0 <𝐹𝑗𝑡 <

1 as there is no perfect control on fertility. When j = 3, 𝐹3𝑡 = 0: there is no probability

for a sterile individual to bear a child. Whenever one or both of the couples choose to

be sterile, that moment in time is the stopping period, τ; otherwise, the stopping period

will be at T, the maximum duration of their fertile life, i.e., menopausal.

Thus, Carro and Mira (2002) posited that contraceptive plans within t are chosen

to maximize the intertemporal utility function below:

 17

𝐸 (∑ 𝑑𝑠𝑗 𝑢𝑠𝑗 (𝑆𝑠 )) + 𝛽𝜏+1−𝑡 𝐸(𝑊(𝜏, 𝑆𝜏+1 )) (2.2.7)

𝑗=1

subject to the technology of birth control given by 𝐹𝑗𝑡 . E pertains to the expectation

operator, while the function of ∑3𝑗=1 𝑑𝑠𝑗 𝑢𝑠𝑗 (𝑆𝑠 ) contains the sum of the utility flows

from the number of children 𝑆𝑠 and the disutility associated with the current method of

contraception 𝑑𝑠𝑗 . The model also accounts for the terminal value, or the present value

at the stopping period 𝜏 and thereafter, of the number of children.

The same dynamics of deriving a demand from the utility function can be seen

from the model employed by Radhakrishnan (2010). The economic model assumes a

married woman making discrete choices at every time period from two choice sets:

contraceptive method (modern, m = 1; traditional, m = 2; none, m = 3) and sector of

employment (formal, k = 1; informal, k = 2; unemployed, k = 3).

Radhakrishnan (2010) used the utility function of a woman 𝑉(𝑑𝑘𝑚𝑡 ), where

𝑑𝑘𝑚𝑡 is the decision made by a woman at time t on which sector k she will be employed

in, and which contraceptive method m she will use. The utility function 𝑉(𝑑𝑘𝑚𝑡 ) was

separated between 𝑈(𝑐𝑡 ), the utility from consuming commodities c at time t, and
t

𝑄(𝑁𝑡 , 𝑟𝑡 , 𝑂𝑡 , 𝑀𝑡 ), the utility from the total number of births 𝑁𝑡 , the age of the youngest

child 𝑟𝑡 , and the duration 𝑂𝑡 of a woman working in a specific sector k and the duration

𝑀𝑡 of a woman using a contraceptive method m. The consumer was also assumed to

experience a choice-specific random shock 𝜁𝑘𝑚𝑡 . Thus, the consumer faces the

maximization problem,

𝑉(𝑑𝑘𝑚𝑡 ) = 𝑈(𝑐𝑡 ) + 𝑄(𝑁𝑡 , 𝑟𝑡 , 𝑂𝑡 , 𝑀𝑡 ) + 𝜁𝑘𝑚𝑡

(2.2.8)
subject to 𝑓(𝑌𝑡𝑘+ℎ , 𝑚𝑡𝑚 , 𝑁𝑡 )
 18

where Y is the husband’s income and income of a woman working at sector k, and where

there are associated costs 𝑃𝑚 in using contraceptive method m, and 𝑃𝑁 associated with

the expenses for child-rearing.

Finally, Brunborg (1984) used similar methods of contraceptive demand

derivation from the utility function. However, compared to the theories above that

derived the demand from a utility function, his framework explicitly permitted the

usage of dichotomous and polytomous quantity demanded for contraceptives in cross-

sectional analyses. Brunborg’s framework shall be further discussed in the following

chapter, as his framework shall be the foundation of this research.

III. Empirical Issues

To study and understand the reason behind the low use of contraceptives in

Bangladesh, Ahmed (1987) used binary multivariate logistic regression, given by

𝑃
𝐿 = log ( ) = 𝑿T 𝜷 (2.3.1)
1−𝑃

where L is the log of the odds ratio and the matrix 𝑿T 𝜷 determines the probability P of

using contraceptives. Other researches that use the multivariate logistic regression used

this empirical model for estimation, but with different variables (Aragaw 2015; Okech,

Wawire, and Mburu 2011; Bizuneh, Shiferaw, and Melkamu 2008).

Ahmed (1987) found that the distance to a family planning clinic and wife’s

education made women more likely to use contraceptives. Studying the variables

behind the low use rate, Ahmed found that a higher desired number of children led to

an decrease in use of contraceptives While the desired number of children is expected

to be significant and cause contraceptive use to decrease, as stated in Easterlin’s

framework (1975), not all sub-variables under desired family size were found to be

significant in Ahmed’s research. Education was found to increase contraceptive use,

possibly due to the cost of a child being perceived as higher than contraceptives while
 19

distance to a family planning clinic was found to increase the use of contraceptives the

nearer a woman or family is to a clinic.

In contrast with the findings of Ahmed (1987), Aragaw (2015) found that the

decreasing desire for children also lessened the likeliness of a woman to use modern

contraceptives. The study was focused on use of modern contraceptives in Ethiopia to

be able to lessen population growth as it poses a threat to the economic and

environmental sustainability of the country. The results were reported using the odds

ratio. The analysis of odds ratio was done to be able to compare the likelihood of an

outcome compared to the absence of the variable (Szumilas 2010). Thus, Aragaw

(2015) found that women who wanted no more children were 36% less likely to use

contraceptives, a result that seems to disagree with Easterlin’s framework (1975).

Aragaw (2015) also found that age played a factor in modern contraceptive use,

with the likeliness to use increasing when a woman is younger. Women of ages 15-19

were 8 times more likely to use contraceptives than 45-49 year olds, while 20-24 year

olds are almost 7 times more likely to use. The research also found that uneducated and

women with only primary education were less likely to use modern contraceptives by

23% and 3%, respectively, compared with women with higher education.

Another study was conducted by Bizuneh, Shiferaw, and Melkamu (2008) on

Ethiopia as well but this time on unmet need for family planning. The researchers found

that the likelihood of having unmet need for family planning increases at younger ages.

While Aragaw (2015) argued younger women are more likely to demand modern

contraceptives, Bizuneh, Shiferaw, and Melkamu (2008) argued that their demand are

unfortunately unmet. Moreover, women who are more educated were also less likely to

have unmet need, with women who have no education and women with primary

education being 2.3 times and 1.7 times more likely, respectively, to have unmet need
 20

than women with secondary education. They also found that women who lived in urban

areas were 0.5 times less likely to have unmet demand than women who lived in rural

areas.

Meanwhile, Bizuneh, Shiferaw, and Melkamu (2008) found that having a higher

ideal number of children lowered the likeliness of having unmet need for modern

contraceptives, where women who desired for 5 children were 0.3 times less likely to

have unmet need than women who wished for no children. This is in consonance with

Aragaw (2015), where having a higher ideal number of children lowered the likeliness

of using modern contraceptives, as evident in the analysis of the woman’s desire for

children.

An increasing number of living children in the family, on the other hand,

increased the likeliness of a woman to have unmet need for modern contraceptives.

Women with 1-2 children and 3-4 children were 0.4 times and 0.1 times, respectively,

less likely to have unmet need than women with more than 5 children. Similar results

was found in a study conducted on unmet demand for family planning in Cameroon

(Ajong et al. 2016), where they also found that having more than 5 children increased

the odds of having unmet demand, increasing likeliness by 2.8 times more.

Ajong et al. (2016) also found that partner’s influence also played a factor in

the unmet demand of a woman for modern contraception, with her partner’s approval

of contraceptives and discussion of family planning having odds ratios of 0.5 and 0.4,

respectively. These meant that women who have their partner’s approval were 0.5 times

less likely to have unmet demand and those who discussed family planning were 0.6

times less likely to have unmet demand than women who did not discuss and garner

their partner’s approval.

 21

Previous papers relied on the usage of regression coefficients and odds ratio in

analyzing the influence of different factors to the usage of modern contraceptive

methods and to having an unmet demand for these methods. However, in the study by

Okech, Wawire, and Mburu (2011) on the usage of family planning services in Kenya,

they looked at the marginal effects of the independent variables. This allowed the

researchers to interpret the regression results through the marginal effects of their

independent variables on the dependent variables, which are easier to interpret than the

typical regression coefficients (Leeper 2018).

As with the results by Ahmed (1987) which found that being closer to a family

clinic increased the usage of modern contraceptives, Okech, Wawire, and Mburu (2011)

found that the further a woman was from family planning clinics lowered the likelihood

of using family planning services by 3.3%. On the other hand, unlike the studies

conducted on Bangladesh and Ethiopia (Ahmed 1987; Aragaw 2015; Bizuneh,

Shiferaw, and Melkamu 2008), education was not found to be significant.

Okech, Wawire, and Mburu (2011) also found that partner’s approval increased

the likeliness of the woman to use family planning services by 83%, having a positive

effect similar to the results found in Cameroon (Ajong et al. 2016). The researchers also

found that women who were wealthier and knew about family planning increased the

likeliness of using family planning services by 0.2% and 26%, respectively. Lastly,

women who were Catholic were found to be 28% less likely to use family planning

services than women who were not Catholic.

In contrast with all the empirical methodologies above, Pop-Eleches (2010)

used panel data fixed effects regression in studying the effects of the supply of birth

control, abortion and contraceptives on fertility behavior in Romania. The researcher

 22

wanted to see the effects of a policy change that made abortion and family planning

illegal in 1989 using panel data fixed effects regression that was modelled by,

𝑂𝑢𝑡𝑐𝑜𝑚𝑒𝑖𝑡 = 𝛽0 + 𝛽1 𝑒𝑑𝑢𝑐𝑎𝑡𝑖𝑜𝑛𝑖𝑡 + 𝛽2 𝑎𝑓𝑡𝑒𝑟𝑡

+ 𝛽3 𝑒𝑑𝑢𝑐𝑎𝑡𝑖𝑜𝑛𝑖𝑡 ∙ 𝑎𝑓𝑡𝑒𝑟𝑡

+ 𝛽4 𝑡𝑟𝑎𝑛𝑠𝑖𝑡𝑖𝑜𝑛𝑡 + 𝛽5 𝑒𝑑𝑢𝑐𝑎𝑡𝑖𝑜𝑛𝑖𝑡
(2.3.2)
∙ 𝑡𝑟𝑎𝑛𝑠𝑖𝑡𝑖𝑜𝑛𝑡 + 𝛽6 𝑎𝑔𝑒𝑔𝑟𝑜𝑢𝑝𝑖𝑡

+ 𝛽7 𝑎𝑔𝑒𝑔𝑟𝑜𝑢𝑝𝑖𝑡 ∙ 𝑎𝑓𝑡𝑒𝑟𝑡

+ 𝛽8 𝑎𝑔𝑒𝑔𝑟𝑜𝑢𝑝𝑖𝑡 ∙ 𝑡𝑟𝑎𝑛𝑠𝑖𝑡𝑖𝑜𝑛𝑡 + 𝜀𝑖𝑡

The data used were from before and after the policy change, to see how it

affected women. The results were compared to each other as well as data from

Moldova, where abortion and family planning were legal before, during, and after the

policy implementation in Romania. Pop-Eleches (2010) found that before the policy

change, educated women had more success with traditional forms of contraceptive

methods compared to uneducated women. For the failure rate of modern contraceptive

methods, however, educated women did not have a lower failure rate than that of

uneducated women before the policy change. These variables were not significant,

however, for women educated during and after the transition.

Overall, the empirical evidences of the different papers above showed that

education was found to affect the use of contraceptives and family planning services

and unmet demand. This shows that education plays a positive role in family planning

as a whole. It decreases unmet demand and increases use of modern contraceptives and

family planning services. Other demographic variables that were found to have a

positive effect on the dependent variables were age, residence, and wealth. As with age,

it was found that younger women were more likely to use contraceptives and unmet

need for family planning. Women who were wealthier and lived in urban areas were
 23

also less likely to have unmet need. Being closer to family planning services and clinics

were also found to increase likeliness of using contraceptives and family planning

services. Two studies (Ajong et al. 2016; Okech, Wawire, and Mburu 2011) also found

that there was an increase in the likeliness of using modern contraceptive methods for

women who discussed with their partners about contraceptives and garnered their

partner’s approval

For the number of living children, women were found to have more unmet need

when they have more than 5 children in both studies of Ajong et al. (2016) and Bizuneh,

Shiferaw, and Melkamu (2008). Lastly, for ideal number of children or desire for more

children, one study (Aragaw 2015) found that women who wanted less children were

less likely to use contraceptives while another study (Bizuneh, Shiferaw, and Melkamu

2008) found that women who wished for more children were less likely to have unmet

need.