Health Policy Project

The Health Policy Project ended in 2016. Work continued under Health Policy Plus (HP+) until 2022.


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Inconsistencies in the Total Fertility Rate and Contraceptive Prevalence Rate in Malawi
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Author(s): Aparna Jain, John Ross, Erin McGinn, Jay Gribble

Primary Language: English

Date: 10/15/2014


Two commonly used measures of population policy effectiveness and family planning programs are the total fertility rate (TFR) and the contraceptive prevalence rate (CPR). Over the past 18 years in Malawi, CPR increased dramatically from 13 percent in 1992 to 46.1 percent in 2010 among reproductive-age women in union. Surprisingly, this dramatic increase in CPR resulted in only a modest decline in TFR from 6.7 to 5.7 births per woman in the same period. According to international correlations, the increase of 33 points in CPR would have lowered TFR by 2 births.

This study, conducted by the USAID-funded Health Policy Project (HPP), uses available data from the Demographic and Health Surveys (DHS) to explore why the rise in CPR has not translated into significant reductions in TFR in Malawi. It employs the Proximate Determinants of Fertility Model developed by Bongaarts to estimate TFR at the national level, and urban and rural levels in 2000, 2004 and 2010. The observed (as calculated from DHS data) and estimated (as calculated by HPP) TFR values are compared and explanations of any differences are explored.

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Family Planning/Reproductive Health (FP/RH)    Modeling    Malawi  
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The Health Policy Project is a five-year cooperative agreement funded by the U.S. Agency for International Development under Agreement No. AID-OAA-A-10-00067, beginning September 30, 2010. The project's HIV-related activities are supported by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). It is implemented by Futures Group, in collaboration with Plan International USA, Avenir Health (previously Futures Institute), Partners in Population and Development, Africa Regional Office (PPD ARO), Population Reference Bureau (PRB), RTI International, and White Ribbon Alliance for Safe Motherhood (WRA). The information provided on this Web site is not official U.S. Government information and does not represent the views or positions of the U.S. Agency for International Development or the U.S. Government.

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