Factors associated with contraceptive use in Angola.

After emerging from decades of civil war, Angola's economy has rapidly grown, yet its reproductive health outcomes have not improved at a commensurate level. At the time of this study, Angola had one of the highest rates of maternal mortality and fertility in the world. Only 6 percent of women aged 15-49 used contraception, with substantial differences in use and access across the different provinces of the country. This study uses a mixed-methods approach, combining analyses of a nationwide cross-sectional survey to assess which factors are associated with contraceptive use, with data from qualitative, semi-structured interviews of health care providers and internally displaced women to better understand and illuminate the survey data. High educational level and living in the capital region were strongly associated with contraceptive use, while age below 20 years was negatively associated with use. During qualitative interviews, health professionals commonly mentioned rural living, young age, cultural beliefs, and power imbalances as reasons for not using contraception. Internally displaced women often described difficulty paying for services, lack of nearby services, and limited knowledge of methods as barriers to use.