Quantifying the effect of migration status on family planning utilisation in Malawi. Evidence from 2019/20 Malawi Multiple Indicator Cluster Survey

Abstract

Abstract Background: Family planning (FP) is known to bring multiple benefits to people both individually and collectively. Individually, FP has been associated with reduction in risk of unintended pregnancy which also correlates well with low child mortality rates. Child mortality rates in women with child spacing of less than two years are reported to be 45% higher than their counterparts. Several factors that predict FP utilisation have been investigated but there is limited literature on the effect of migration status on FP utilisation in Malawi. Our study aimed at quantifying the effect of migration status on modern contraceptive use. Methods: Data for this study came from a nationally representative 2019/20 Malawi multiple cluster indicator survey (MICS). At total of 22,730 women aged 15 to 45 participated in the survey. We applied sampling weights to facilitate survey data analysis to correct unequal representation of participants at cluster, district, and regional level. We used multivariable binary logistic regression to assess the effect of migration status on any modern contraceptive use. The final model had participants age, age at first sex, age at marriage, region, marital status, levels of education, children ever born, residence and wealth index as confounders. Results: The overall CPR among women aged 15 to 45 was 53.16%. The contraceptive prevalence rates of participants by migration status were 48.38% for migrants and 53.40% for non-migrants. The fully adjusted effect of migration on modern contraceptive use was 0.77 (95% CI 0.67 – 0.91, p=0.001). Conclusions: Our study concludes that women migrants and adolescent girls have low CPR and are less likely to access modern contraceptives compared to non-migrant women. Deliberate efforts are required to increase CPR for migrants as well as for adolescent girls.