Measuring the success of family planning initiatives in Rwanda: a multivariate decomposition analysis

Rwanda has experienced a dramatic increase in contraceptive use and concomitant fertility decline between 2005 and 2010. The contraceptive prevalence rate has increased from 17 to 52 %. During this period, Rwanda was strongly promoting family planning and making socio-economic progress. This study analyses the shift in contraceptive use by investigating the contribution attributable to the family planning program and that resulting from socio-economic progress. Using data from the 2005 and 2010 Rwanda Demographic and Health Surveys, we apply the Blinder-Oaxaca decomposition technique to separate the increase in contraceptive use due to population composition change, which result mostly from socio-economic and attitudinal developments, from the increase attributable to changes (improvement) in contraceptive behaviour. The contraceptive increase is mainly attributable to contraceptive behavioural change (78 %). Factors that show a significant contribution are women's education, experience of child mortality, and place of residence. The contribution of changes in population composition is limited (12 %). Effects are relatively higher for exposure to family planning messages and husband's desire for children compared to that of his wife's. Contraceptive uptake improved mostly in the low socio-economic stratum of the population, among the rural and less educated population. This finding suggests that a strong family planning program supported by political leaders can remove persistent socio-economic and cultural barriers and enable a massive popular contraceptive uptake.