Inequity and unwanted fertility in developing countries

Shah, Iqbal; Chandra-Mouli, Venkatraman

doi:10.2471/blt.06.037366

Cited by 10 publications

(11 citation statements)

References 5 publications

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“…Even in Spain, a country with universal health service access, we have found sources of inequity. These results agree with the arguments proposed by Creanga [22], Davis [20], Igbal [19] and Gillespie [21], in the sense that although the use of family planning methods is first and foremost influenced by knowledge of and access to the same, gender roles, moral and/or cultural type reasons and individuals’ socioeconomic context also play an important role in this decision. This inequity is difficult to address from a solely medical point of view, as barriers to accessing family planning methods (difficulty with the language, dealing with health professionals, lack of information, etc.)…”

Section: Resultssupporting

confidence: 91%

“…However, talking about inequities in the use of family planning methods is more difficult than talking about health inequities in general [19-21], because, in addition to objective factors regarding knowledge of and access to said methods, there is also the influence of moral issues, such as the fear of transgressing certain taboos, cultural factors and even religious impediments. In developing countries, and particularly African countries, it is important to take into account that the attitudes towards and use of contraception may vary due to a multitude of factors, including the quality of the health service and its professionals, availability of and access to family planning methods [22], level of wealth [23], gender roles and the socioeconomic context of the country [20] .…”

Section: Introductionmentioning

confidence: 99%

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Factors determining family planning in Catalonia. Sources of inequity

Saurina

Vall-llosera

Sáez

2012

Int J Equity Health

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IntroductionIn recent decades, the foreign population in Spain has increased significantly, particularly for Catalonia, an autonomous region of Spain (2.90% in 2000 and 15.95% in 2010) and in particular Girona province (6.18% in 2000 and 21.55% in 2010). Several studies have shown a lower use of family planning methods by immigrants. This same trend is observed in Spain. The objective of this paper is to determine the existence of differences and possible sources of inequity in the use of family planning methods among health service users in Catalonia (Spain) by sex, health status, place of birth and socioeconomic conditions.MethodsData were taken from an ad-hoc questionnaire which was compiled following a qualitative stage of individual interviews. Said questionnaire was administered to 1094 Catalan public health service users during 2007. A complete descriptive analysis was carried out for variables related to public health service users’ sociodemographic characteristics and variables indicating knowledge and use of family planning methods, and bivariate relationships were analysed by means of chi-square contrasts. Considering the use (or non-use) of family planning methods as a dependent variable and a set of demographic, socioeconomic and health status variables as explanatory factors, the relationship was modelled using mixed models.ResultsThe analysed sample is comprised of 54.3% women and 45.7% men, with 74.3% natives (or from the EU) and 25.7% economic immigrants. 54.8% use some method of family planning, the condom (46.7%) and the pill (28.0%) being the two most frequently used methods. Statistical modelling indicates that those factors which most influence the use of family planning methods are level of education (30.59% and 39.29% more likelihood) and having children over 14 (35.35% more likelihood). With regard to the origin of the user, we observe that patients from North Africa,sub. Saharan Africa and Asia are less likely to use family planning methods (36.68%, 38.59% and 70.51%, respectively).ConclusionsThe use of family planning methods is positively related to a higher level of education and having children over 14. Factors such as sex, age, income and self-perceived health do not appear to influence their use. Furthermore, being a native of this country, the European Union or Central/South America represents a greater likelihood of use than being African or Asian. Although no general differences in use were found between sexes, the difference found in the case of Asian women stands out, with a higher likelihood of use.

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Section: Resultssupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Factors determining family planning in Catalonia. Sources of inequity

Saurina

Vall-llosera

Sáez

2012

Int J Equity Health

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“…These studies have shown that women residing in poorer households are less likely to use contraception than richer women 38,39 . Poor women have the lowest contraceptive use resulting in the highest unmet need, unwanted pregnancies and hence fertility rates 40-42 . Few studies have examined the impacts of community factors, such as neighborhood type (e.g., slum or non-slum), on women's contraceptive use 43,44 .…”

Section: Introductionmentioning

confidence: 99%

Relationship Characteristics and Contraceptive Use Among Couples in Urban Kenya

Irani¹,

Speizer²,

Fotso³

2014

IPSRH

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Background Few studies have used couple data to identify individual- and relationship-level characteristics that affect contraceptive use in urban areas. Using matched couple data from urban Kenya collected in 2010, this study determines the association between relationship-level characteristics (desire for another child, communication about desired number of children and FP use) and contraceptive use and intention to use among non-users. Methods Data were collected from three Kenyan cities: Nairobi, Mombasa and Kisumu. Baseline population-based survey data from the Measurement, Learning & Evaluation Project were used to identify 883couples (weighted value=840). Multivariate regressions used the couple as the unit of analysis. Results Almost two-thirds of couples currently used contraception. Adjusting for individual- and environmental-level characteristics, couples who desired another child were less likely to use contraception than couples wanting more children. In addition, couples where both partners reported communicating with each other regarding desired number of children and FP use were more likely to use contraception compared to couples that did not communicate. Analyses testing the association of relationship-level characteristics and intention to use contraception, among non-users, resembled those of current contraceptive users. Conclusion Couple-level characteristics are associated with current contraceptive use and future intent to use. Couples that discussed their desired number of children and FP use were more likely to use contraception than couples that did not communicate with each other. FP programs should identify strategies to improve communication in FP among couples and to ensure better cooperation between partners.

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“…Facilitating access to modern contraceptives for women with unmet needs for family planning has the potential benefit of improving maternal and child health and reducing mortalities [9-13] by lowering the annual number of unintended pregnancies [5]. However, differences exist in contraceptive use trends between and within countries [14], and this calls for examining country specific trends to guide local policy makers and interventionists on proper policies, resource allocations, and interventions that take into account the unmet needs of the most vulnerable women [15]. …”

Section: Introductionmentioning

confidence: 99%

Inequality in fertility rate and modern contraceptive use among Ghanaian women from 1988–2008

Asamoah

Agardh

Östergren

2013

International Journal for Equity in Health

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BackgroundIn most resource poor countries, particularly sub-Saharan Africa, modern contraceptive use and prevalence is unusually low and fertility is very high resulting in rapid population growth and high maternal mortality and morbidity. Current evidence shows slow progress in expanding the use of contraceptives by women of low socioeconomic status and insufficient financial commitment to family planning programs. We examined gaps and trends in modern contraceptive use and fertility within different socio-demographic subgroups in Ghana between 1988 and 2008.MethodsWe constructed a database using the Women’s Questionnaire from the Ghana Demographic and Health Survey (GDHS) 1988, 1993, 1998, 2003 and 2008. We applied regression-based Total Attributable Fraction (TAF); we also calculated the Relative and Slope Indices of Inequality (RII and SII) to complement the TAF in our investigation.ResultsEquality in use of modern contraceptives increased from 1988 to 2008. In contrast, inequality in fertility rate increased from 1988 to 2008. It was also found that rural–urban residence gap in the use of modern contraceptive methods had almost disappeared in 2008, while education and income related inequalities remained.ConclusionsOne obvious observation is that the discrepancy between equality in use of contraceptives and equality in fertility must be addressed in a future revision of policies related to family planning. Otherwise this could be a major obstacle for attaining further progress in achieving the Millennium Development Goal (MDG) 5. More research into the causes of the unfortunate discrepancy is urgently needed. There still exist significant education and income related inequalities in both parameters that need appropriate action.

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Inequity and unwanted fertility in developing countries

Cited by 10 publications

References 5 publications

Factors determining family planning in Catalonia. Sources of inequity

Factors determining family planning in Catalonia. Sources of inequity

Relationship Characteristics and Contraceptive Use Among Couples in Urban Kenya

Inequality in fertility rate and modern contraceptive use among Ghanaian women from 1988–2008

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