Use of family planning in Lesotho: the importance of quality of care and access

This paper aims to identify social and demographic factors affecting contraceptive use and methods choice and also explore whether, net of these factors, contraceptive behaviour of Basotho women is affected by the family planning environment in which they reside. The study uses multilevel models and data from three sources: 1995 Lesotho Safe Motherhood Initiative Women's Health Survey, information collected in 1997/98 on the facilities of family planning clinics in some areas of Lesotho, and focus group discussions of users of contraceptives. Women aged 20-29, with at least two living children, and those with secondary or higher education have the highest probability of using modern methods. Community differences in use of contraception are explained by provider bias, access to a facility, and the type of facility. Excerpts from focus group discussions indicate that the quality of care is also important in influencing the decision by women to use contraception