Determinants of Time from Last Birth to the First Use of Contraceptives: Evidence from the Egypt Demographic and Health Survey

Abstract

Multilevel survival models can be applied where the data have the hierarchical nature. Three common models are used in this case. They are the discrete time survival models with mixed effects, the Cox proportional hazard model with mixed effects and the Weibull survival model with mixed effects. The Egyptian Demographic Health Survey (EDHS 2014) data target 21,762 ever-married women aged 15-49. This article aims to determine the factors that may affect the time from the last birth of a woman to the first use of contraceptives. Due to the hierarchical nature of EDHS data, multilevel survival analysis is employed. The above three models are applied to EDHS 2014 data. The Weibull survival model with mixed effects proved to be the best model to fit the survival time. Moreover, it is found that only 25% of the sampled women have not used contraceptives until almost one year from their last birth. In addition, attaining higher education, increasing the age at first sex and breastfeeding contribute to the more efficient use of contraceptives. In addition, the article recommends enhancing family planning campaigns which have a powerful impact on the behavior of women in Egypt for the optimal use of contraceptives.