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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Public Health 1/2018

Identifying factors influencing contraceptive use in Bangladesh: evidence from BDHS 2014 data

BMC Public Health > Ausgabe 1/2018
MB Hossain, MHR Khan, F Ababneh, JEH Shaw
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Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12889-018-5098-1) contains supplementary material, which is available to authorized users.



Birth control is the conscious control of the birth rate by methods which temporarily prevent conception by interfering with the normal process of ovulation, fertilization, and implantation. High contraceptive prevalence rate is always expected for controlling births for those countries that are experiencing high population growth rate. The factors that influence contraceptive prevalence are also important to know for policy implication purposes in Bangladesh. This study aims to explore the socio-economic, demographic and others key factors that influence the use of contraception in Bangladesh.


The contraception data are extracted from the 2014 Bangladesh Demographic and Health Survey (BDHS) data which were collected by using a two stage stratified random sampling technique that is a source of nested variability. The nested sources of variability must be incorporated in the model using random effects in order to model the actual parameter effects on contraceptive prevalence. A mixed effect logistic regression model has been implemented for the binary contraceptive data, where parameters are estimated through generalized estimating equation by assuming exchangeable correlation structure to explore and identify the factors that truly affect the use of contraception in Bangladesh.


The prevalence of contraception use by currently married 15–49 years aged women or their husbands is 62.4%. Our study finds that administrative division, place of residence, religion, number of household members, woman’s age, occupation, body mass index, breastfeeding practice, husband’s education, wish for children, living status with wife, sexual activity in past year, women amenorrheic status, abstaining status, number of children born in last five years and total children ever died were significantly associated with contraception use in Bangladesh.


The odds of women experiencing the outcome of interest are not independent due to the nested structure of the data. As a result, a mixed effect model is implemented for the binary variable ‘contraceptive use’ to produce true estimates for the significant determinants of contraceptive use in Bangladesh. Knowing such true estimates is important for attaining future goals including increasing contraception use from 62 to 75% by 2020 by the Bangladesh government’s Health, Population & Nutrition Sector Development Program (HPNSDP).
Additional file 1 2014 Bangladesh Demographic and Health Survey data. Description of data: The Bangladesh Demographic Health Survey (BDHS) 2014 was a nationally representative cross sectional survey conducted between June and November 2014, covering the entire population of Bangladesh. The survey was based on a two-stage stratified sample of households. In the first stage, 600 enumerations areas (EAs) were selected with probability proportional to EA size, with 207 EAs from urban areas and 393 from rural areas, where an EA is either a village, a group of small villages, or a part of a large village. In the second stage, a systematic sample of 30 households on average was selected per EA to provide statistically reliable estimates of the key demographic and health variables for the country as a whole, for urban and rural areas separately and each of the seven divisions which are the administrative regions of Bangladesh. The 2014 BDHS used three types of questionnaires: a household questionnaire, a women questionnaire and a community questionnaire. For the women questionnaire, a total of 18,000 ever married and 16858 currently married (when conducting the interview) women aged between 15-49 years were interviewed. For our study, we considered only currently married women to ensure similar prevalence as BDHS 2014 reported. Further details about the data set can be found from Methods Section. (CSV 24,064 kb)
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