How access to contraception affects fertility and contraceptive use in Tunisia

To a great extent, fertility decline in Tunisia can be explained by the rise in the age at which women marry, probably because they are better educated and because social legislation has given them more rights. A second major factor in fertility decline was the increased use of contraception. The main focus of this paper is what determines the practice of contraception. The general increase in the use of contraception was the result of a strong family planning program as well as increases in education over time. The family planning program in Tunisia is considered one of the best in the world. There has been a substantial program to improve the access of the rural, poor, and least educated population groups to family planning. Although in the last 10 years contraceptive use increased the most among the least educated women, these groups are still served less well than the more privileged. The results of this paper show the central role of mortality decline and access to contraception. Health facilities, especially clinics, and good water are important in reducing mortality, which in turn increases the motivation to restrict fertility and the likelihood that people will act on that motivation. The structural model used is designed to distinguish such community variables as access to family planning from the channels through which they operate.