Abstract
This is the 1st reported analysis comparing the role of family planning programs versus that of socioeconomic change in contributing to increases in contraceptive use. Data from the Malaysian Family Life Survey were subjected to logistic regression on the micro level, by defining each woman's person-years of exposure to risk of pregnancy or contraceptive use. The relative importance of actual change in each explanatory variable between 1956-65 and 1966-75 in contributing to the change in contraceptive use between the 2 periods was computed. During this time interval the proportion of at-risk time of women aged 30 or under that was protected by contraception rose from 6 to 43%, and the total fertility rate dropped from 6.2 to 4.2. In this analysis, the substantial growth in family planning clinics accounts for more of the increase in contraceptive use than all other variables considered, i.e., education, income, desire for no more children, age and ethnicity. The availability of clinics accounted for 30% of the actual increase in use of modern methods. 45% of the increase in modern contraceptive use could not be explained by these variables, and may have been due to such effects as costs of children, informal information sources and media, and the self-reinforcing nature of contraception. The availability of services is especially effective for those least likely to resort to contraception, and it reduces the educational differences in contraceptive use. The study suggests that both family planning clinics and development are important in furthering contraceptive use.