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Studies of maternal health seeking behaviour have focused on individual and household level factors. This analysis examines community level influences on the decision to deliver a child in a health facility across six African countries. Demographic and Health Survey data are linked with contextual data, and multilevel models are fitted to identify the determinants of childbirth in a health facility in the six countries. There are strong community level influences on a woman’s decision to deliver her child in a health facility. Several pathways of influence between the community and individual were identified. Community economic development, the climate of female autonomy, service provision and fertility preferences all exert an influence on a woman’s decision to seek care during labour, although significant community variation remains unexplained.

Family planning programmes are costly to implement, so it is critical to determine their effect. This study uses a quasi-experimental design to determine the impact of new family planning clinics on knowledge, contraceptive use and unmet need for family planning, amongst married women in urban poor areas of six secondary cities of Pakistan. Baseline (n=5,338) and end-line (n=5,502) population surveys were conducted in four study sites and two control sites. Client exit interviews identified the socio-demographic and geographic characteristics of clinic users. The results show that the clinics contributed to a 5% increase in overall knowledge of family planning methods, and an increase in knowledge of female sterilisation and the IUD of 15% and 7% respectively. There were distinct effects on contraceptive uptake, with an 8% increase in female sterilisation and 7% decline in condom use. Unmet need for family planning declined in two sites, while there were variable impacts on the other sites. Although the new clinics are located within urban poor communities, users of the services are not the urban poor themselves but select sub-groups of the local population

This study was conducted to identify the poorest and other vulnerable sub-groups being served least by family planning providers. The study was set in three countries in sub-Saharan Africa, namely, Ghana, Tanzania and Zimbabwe. This region generally has a low but increasing uptake of modern contraceptive methods. As the use of family planning providers increases, there is a need to understand who is not being served and why. Logistic regression analyses of demographic and health survey data were conducted to identify the characteristics and geographical areas of women who are not using modern contraceptive methods. The results show some similarities among the countries in those using modern methods the least. However, a number of groups were country specific. Identifying the poorest women with the lowest use of modern methods is best done by assessing their household amenities or their partner's status rather than theirs. (Afr J Reprod Health 2004; 8[2]: 124-136 )

Preliminary research findings are presented for the determinants of the use of modern contraception in three East African countries (Kenya, Malawi and Tanzania) and the importance of these determinants in accounting for the areal variation in contraceptive use. This study analyses Demographic and Health Surveys data for each country using multilevel logistic regression models. The findings show that there are similarities in the factors associated with modern contraceptive use in each country. The individual / household factors do account for some areal variation in contraceptive use, but significant variation remains. There is evidence that this unexplained variation is accounted for by unobserved contextual factors.