Contemporary use of traditional contraception in sub-Saharan Africa.

In this chapter we use DHS data to explore patterns of traditional contraceptive method use in sub-Saharan Africa. In so doing we must work with the assumption that any bias in the reporting of these methods is fairly constant across categories of women and that it will not distort comparisons across groups. While this assumption imposes an important limitation on our study smaller studies on traditional methods tend to corroborate the differentials documented here. For example in the detailed survey conducted in Ouagadougou in 2010 better-educated women and women born in the capital are more likely to use periodic abstinence (Rossier Senderowicz and Soura 2014) as shown in the DHS data for the same city and year. The characterization of these informal methods as “traditional” is somewhat misleading. “Traditional” contraception implies a method used in the past and likely to be abandoned with the spread of modern contraception and the advance of socioeconomic development (Johnson-Hanks 2002; Basu 2005). This term may have been appropriate for describing the Western fertility transition as when modern methods were introduced in these countries traditional methods had been in use there for a long time and were indeed largely replaced by newer methods. In contemporary developing countries however it is not clear how widespread the practices of periodic abstinence and withdrawal were prior to the introduction of modern contraception and thus the designation of “traditional” may be less accurate in these settings. Further it is uncertain whether the pattern of method switching seen in Western countries will play out similarly in these regions. A number of recent studies have questioned the appropriateness of considering these informal methods as traditional as they have found that better-off urban women are the greater “traditional” method users in Cameroon (Johnson-Hanks 2002) India (Basu 2005) and Ghana (Machiyama and Cleland 2014). (excerpt)