Contraceptive use and desire for more children in two rural districts of Sierra Leone.

Data from a 1993 household survey in rural Sierra Leone revealed that, among women aged 12-49 with at least one child younger than 5, about 13% were using a contraceptive method and about 67% wanted more children. These rates differ from those reported for the 1980s and 1970s, when the contraceptive use rate was around 6% and more than 85% of women desired more children, suggesting a trend towards fertility limitation over the years. Logistic regression analysis showed that contraceptive use was positively associated with age, number of living children, age at marriage, education, and economic status, and negatively associated with Islamic and traditional religious affiliations. Government and other health clinics, hospital, and government paramedical personnel were the major sources of contraceptive supplies. The lower desire for more children might relate to demographic pressure from the recent improved child survival rate compounded by recent economic hardship.