Afghanistan Mortality Survey 2010 - Measure DHS

There are substantial differences in the use of contraceptive methods among subgroups ofcurrently married women. Urban women are twice as likely to use a method of family planning as arerural women (36 percent and 18 percent, respectively), probably reflecting wider availability and easieraccess to methods in urban areas than in rural areas. The contraceptive prevalence rate for modernmethods is 31 percent in urban areas, compared with 17 percent in rural areas.Contraceptive use is more than twice as high in the Central zone as in the North and South zones.Use is lowest in the South Eastern region (10 percent) and highest in the Central Highland region (36percent), with use higher than the national average in four of the eight regions (Western, CentralHighland, Capital, and Southern regions). The low use in the South Eastern region may be due not only tothe limited availability of contraceptives but also difficulty in gaining access to methods and lowerawareness and educational level, coupled with the prevailing cultural and traditional barriers in thisregion.The relationship between education and contraceptive use is strong. Use increases rapidly from20 percent among married women with no education to 45 percent among women with higher education.Even a small amount of schooling can make a difference. One-third of women with some primaryeducation use contraception. The most popular methods among women who have no education areinjectables (7 percent) and pills (5 percent). As women’s level of education increases they are more likelyto use IUDs and condoms.Wealth has a positive relationship with women’s contraceptive use. Contraceptive use increasesmarkedly with household wealth, from 17 percent among currently married women in the lowest wealthquintile to 34 percent among those in the highest wealth quintile.There is a direct association between use of family planning methods and the number of childrenthat women have. Less than 1 percent of married women with no living children use contraception; thispercentage increases to 29 percent among women with five or more children. Use of female sterilizationincreases somewhat with the number of living children a woman has, but pills and injectables remain themost popular methods for women with three or more children.Not surprisingly, remoteness has a negative effect on women’s contraceptive use. Contraceptiveuse decreases markedly as remoteness increases, from 29 percent among currently married women in theleast remote quintile to 18 percent among those in the most remote quintile.3.4.4 Trend in Current Use of ContraceptionInformation on contraceptive prevalence from the AMS 2010 can be compared with similar datafrom earlier surveys conducted in Afghanistan (Figure 3.5). However, these comparisons have to beinterpreted carefully because of coverage differences and differences in the way the questions oncontraceptive knowledge and use were asked between these surveys. In addition, when reviewing thechanges in the use of modern versus traditional methods between surveys, consideration must be given tothe fact that in the AMS 2010 LAM is tabulated as a modern method in contrast to the NRVA 2007/8 andthe AHS 2006 in which LAM is treated as a traditional method. There has been a marked increase in theuse of a contraceptive method among currently married women in the past 7 years with the increase morerapid between 2003 and 2006 than in the more recent years. The AHS 2006 survey found 16 percent ofcurrently married rural women using a modern method of contraception (JHUBSPH and IIHMR, 2008), athree-fold increase in use of modern methods in rural Afghanistan since 2003 (CSO and UNICEF, 2004).However, since 2006, the use of modern methods among currently married rural women appears to have58 | Fertility, Marriage, and Family Planning