Alex C. Ezeh, Drexel University
John G. Cleland, London School of Hygiene and Tropical Medicine (LSHTM)
Previous studies have documented significant differences in health and reproductive health outcomes between the poor and non-poor across various countries in sub-Saharan Africa. However, a number of these studies is dated, and the past decade has witnessed significant shifts in health and reproductive health outcomes in many African countries. Using recent DHS data, this paper updates and extends the literature by examining patterns in contraceptive practice among poor married women in urban settings in 19 African countries. First, we analyze changes in the rich-poor gaps in modern Contraceptive Prevalence Rate (mCPR) in urban Africa; then we determine the sources of supply and how the sources may have changed over a ten-year period. The findings show that, in eastern/southern Africa, previous rich-poor gaps in mCPR have disappeared. Countries in central/western Africa, however, continue to have significant gaps in mCPR between rich and poor women in urban areas. Additional analysis shows that public sector FP programs have contributed to bridging the rich-poor gaps in mCPR in the selected southern/eastern African countries. This paper contributes to our understanding about sub-regional dynamics in reproductive health outcomes among the urban poor in sub-Saharan Africa, and the impact public-sector FP programs may have on these outcomes.
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