The impact of family planning service provision on contraceptive-use dynamics in Morocco

This article uses linked data from the 1995 Morocco DHS calendar and the 1992 Morocco DHS service-availability module to study the effect of service environment on contraceptive discontinuation, switching, and adoption of a modern method following a birth. The 1995 Morocco DHS also collected information on the source of supply for each episode of use of a modern method recorded in the calendar, allowing study of the association between the source of supply and discontinuation and switching rates. Multilevel went-history models are used to evaluate the impact of individual-level sociodemographic characteristics and community-level indicators of family planning service provision. The findings show that the presence of a nearby public health center is associated with higher modern-method adoption after a birth and lower method-failure rates; the presence of a pharmacy is associated with lower discontinuation due to side effects or health concerns. The degree of method-choice potential has a positive impact on both the rate of switching from the pill to another modern method and on modern-method adoption after a birth.