MODERNIZATION AND CONTRACEPTION IN KENYA FROM 1998 TO 2008-2009 by DIANA ALAKA OPOLLO Presented to the Faculty of the Graduate School of Social Work The University of Texas at Arlington in Partial Fulfillment of the Requirements for the Degree of DOCTOR OF PHILOSOPHY THE UNIVERSITY OF TEXAS AT ARLINGTON December 2011 Copyright © by Diana Alaka Opollo 2011 All Rights Reserved DEDICATION This dissertation is dedicated to the most special people in my life, with whom I have been able to achieve my dreams: my father, the Late Mr. Phillip Ochara Opollo and my mother, Mrs. Joyce A. Opollo. ACKNOWLEDGEMENTS Pursuing a doctorate degree requires extreme dedication, tenacity, and perseverance. Equally required and certainly very important, more times than others, are support and the right guidance. While this page is not enough to mention each person who has supported me in my academic journey, I would like to specially thank a few who significantly influenced my life, and helped me to complete my higher education and achieve my dreams. My academic journey began at a very young age; the vision and desire of pursuing a doctorate degree was instilled in me by my family at an early age, but that was just a dream. With the consistent support and unconditional love from my family; I was able to complete my education. I would like to start by thanking my immediate family for their constant support and encouragement throughout the years; my father, the late Phillip Ochara Opollo, my mother Mrs. Joyce Opollo, my sisters Nancy Achieng, Winnie Aguko, Leah Vaughn, Rachel Tschann, Jakki Opollo, and my brothers Ken Opollo and Bobby Opollo. Successful completion of a dissertation requires guidance and support from one’s committee. I was especially blessed and highly favored to have had an extremely supportive and well-wishing committee, who encouraged me from the beginning and guided me to the end. I thank my dissertation chair Dr. Vijayan Pillai, whose dedication and support far exceeded the expectations of a dissertation committee chair. He is the best mentor any student could ask for. Extra special thanks also go to rest of my committee members who together served as an excellent team: Dr. Randall Basham, Dr. Maria Scannapieco, Dr. Doreen Elliott, and Dr. Rashmi Gupta. Additionally, I would also like to thank Rita Hay, John Dillard, and Jaime Palma for their constant assistance and support throughout the program. Outside academics, a great support system of friends and family enable you to go on, cheering you on and encouraging you when you are down. I have been blessed with such great and wonderful friends, a few of whom require special mention: Dr. Sisay Teketele, Fatma Gheorghe, Lydia Adundo, Dr. Grace Virtue, Dr. Consoler Teboh, Roshanda McLemore, Benjamin Gant, and Fangshun Wei. iv Lastly, I would like to give special thanks to my fiancé Michael Salako, whose patience and continued support enabled me to successfully pursue my doctoral studies. November 26, 2011 v ABSTRACT MODERNIZATION AND CONTRACEPTION IN KENYA FROM 1998 TO 2008-2009 Diana Alaka Opollo, PhD The University of Texas at Arlington, 2011 Supervising Professor: Dr. Vijayan K. Pillai The objective of this study is to examine the factors that influence contraceptive use in Kenya. More specifically, the study focuses on the determinants of membership in two categories of contraceptive use: modern contraception methods and other contraception methods. Additionally, the study will describe the differences in contraceptive use between 1998 and 2008-2009 and attempt to examine what factors caused and propelled changes. In order to explain the categorical variations, this study uses two theories: modernization theory and human capital theory. In describing changes between 1998 and 2008-2009, this study will examine both individual as well as societal factors related to contraceptive use in Kenya, using Ryder’s theory on social change. This study utilizes two data sets from the 1998 Kenya Demographic Health Survey (KDHS) which surveyed a total of 7,881 women, and the 2008-2009 KDHS which surveyed 8,444 women. This study utilizes several data analyses techniques such as descriptive analysis, binary logistic regression, and decomposition analysis. The findings of these analyses will be reported followed by a discussion on the findings. Additionally, this study will address implications for social work practice, policy, research, and education. Moreover, this study will address utilize the National Association of Social Workers (NASW) values and ethics assessments. Lastly, this paper will address the limitations faced, future directions, and a conclusion tying together the entire study. vi The study results indicate that, women with some education and higher education were found to be more likely to use modern contraceptives than women with no education. Women who live in urban areas are more likely to use modern contraceptives compared to women who live in rural areas. Additionally, women who earn an income are more likely to use modern contraceptives compared to women who do not earn an income. The proposed hypotheses are strongly supported by the chi square associations of the selected determinants on contraceptive use. The hypotheses are also supported by the regression analyses net effects with independent variables only, and net effects with both independent and control variables. Additionally, statistically significant compositional changes addressed by the Phi Coefficient values supported the compositional changes within cohorts of selected variables over the two time periods, 1998 and 2008-2009. Moreover, the effect or processual changes indicated support for the proposed hypotheses showing change in the selected determinants over time across cohorts, between the two time periods, 1998 and 2009. Lastly, the decomposition analysis suggests that all variables contributed to the overall change of selected determinants over the two survey periods 1998 and 2008-2009. vii TABLE OF CONTENTS ACKNOWLEDGEMENTS ........................................................................................................ ……………..iv ABSTRACT ................................................................................................................................................... vi LIST OF ILLUSTRATIONS ........................................................................................................................... x LIST OF TABLES ......................................................................................................................................... xii Chapter Page 1. INTRODUCTION……………………………………..………..….. ................................................. .1 2. LITERATURE REVIEW............................................................................................................... 5 2.1 Social and Cultural Factors ......................................................................................... 15 2.2 Policy and Political Factors ......................................................................................... 22 2.3 Legal Factors .............................................................................................................. 25 3. CONCEPTUAL FRAMEWORK ................................................................................................. 29 3.1 Modernization Theory ................................................................................................. 30 3.1.1 Urban versus Rural Residence ................................................................... 34 3.1.2 Age at Marriage .......................................................................................... 36 3.1.3 Income ........................................................................................................ 38 3.2 Human Capital Theory ................................................................................................ 40 3.2.1. Education ................................................................................................... 44 3.3 Social Change Theory ................................................................................................ 45 4. METHODOLOGY ...................................................................................................................... 49 4.1 Operationalization of Variables ................................................................................... 50 4.2 Data Analysis Techniques .......................................................................................... 56 5. DATA ANALYSIS AND RESULTS ............................................................................................ 60 5.1 Section I Descriptive Analysis ..................................................................................... 61 5.2 Section II Chi Square Associations ............................................................................. 98 viii 5.3 Section III Logistic Regression .................................................................................. 101 5.4 Section IV Decomposition Analysis .......................................................................... 119 5.5 Compositional Analysis ............................................................................................. 119 5.6 Processual Changes ................................................................................................. 135 5.7 Decomposition Analysis Formula .............................................................................. 139 6. DISCUSSION