The Association of Fertility Preferences and Contraceptive Use Intentions With Timing of Adoption and Discontinuation: A Four-Year Longitudinal Follow-up of a National Sample of Ugandan Women

Dana Sarnak , Johns Hopkins Bloomberg School of Public Health
Frederick Makumbi, Makerere University
Simon P. S. Kibira, Makerere University
Saifuddin Ahmed, Johns Hopkins University
Amy Tsui, Johns Hopkins University

This study assesses the influence of fertility preferences and contraceptive use intentions on the subsequent adoption and discontinuation of contraception in a Ugandan cohort of women. The data are derived from a 2018 follow-up survey of a 2014 national sample of 3,800 female respondents of childbearing age. The survey re-interviewed 1,716 women (45.8%) and used a five-year contraceptive calendar for collecting data on pregnancy, births, contraceptive use dynamics, and the causes of discontinuation. With baseline measures on fertility preferences and contraceptive intentions, we estimate the hazards of adoption and discontinuation behavior, adjusting for competing pregnancy risk. We find women’s fertility preferences are not significantly associated with time to adoption or discontinuation, but contraceptive intentions are. Women discontinue short-acting methods more quickly than long-acting ones. A distinctive finding is women appear able to use contraception to satisfy their demand to space births but discontinue while still exposed to pregnancy risk.

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 Presented in Session 228. Fertility Intentions: Causes and Consequences