Socio-Economic Disparities in Use of Family Planning Methods among Pakistani Women: Findings from Pakistan Demographic and Health Surveys

Abstract

BackgroundSeveral developing countries like Pakistan step into Sustainable Development Goals period with crucial maternal and child health needs that need to be addressed for improving health outcomes among people. We aim to explore existent socio-economic disparities in use of family planning methods (FPM) among Pakistani women, and compare any such inequalities between the years 2006 and 2013.SettingPakistan Demographic and Health Surveys (PDHS) 2006–7 (n = 9177) and the most recent 2012–13(n = 13558) data were used to conduct secondary analysis. Participants were ever married women aged between 15 and 49 years. Socio-economic status was assessed by the education level and wealth index. Inequalities were measured through Odds Ratio (OR), Relative Index of inequality (RII), and Slope index of inequality (SII) on non-use of FPM.ResultsAlthough the prevalence of FPM use has increased over time (28% in 2006 versus 54% in 2013), the socio-economic inequalities persistently exist. Comparing results of PDHS 2006 with PDHS 2013, education related absolute inequalities among urban dwellers increased from -0.41 (95% CI -0.67, -0.13, p-value < 0.01) to -0.83 (95% CI -1.02, -0.63, p-value < 0.01); and increased from -0.93 (95% CI -1.21, -0.64, p-value < 0.01) to -0.98 (95% CI -1.20, -0.76, p-value < 0.01) among rural dwellers. Similarly wealth related absolute inequalities are also existent.ConclusionsAlthough the FPM use has increased over time, but it is important to note that socio-economic gap in use of FPM persists. Such differences have disadvantaged the poor and the illiterate. Family planning programs may target the disadvantaged subgroups for ensuring well-being of women and children in Pakistan.

Socio-Economic Related Inequalities in The Utilization of Family Planning Services Among Women in Zambia

“…This is not surprising since wealth is correlated with education which facilitates the increase to use (Ortayli & Malarcher, 2010). This nding supports previous studies that showed that higher socioeconomic status improves the use of family planning services (Aslam et Al., 2016). Studies show that economically self-su cient women are more likely to utilize contraception as it enhances their ability to make rational decisions on reproductive health issues (Ortayli, 2010).…”

“…The argument is that, the rural poor have less income compared to their urban counterparts leading to the parallel disparities that exists between them in family planning utilization. This nding supports the ndings of a previous study that showed that socio-economic gap or differences in family planning utilization exists and had persisted among women and this had disadvantaged the poor (Aslam et al, 2016).…”

“…Furthermore, Stanfors et al, 2014 found that educational level and higher income lead to an increase in demand for the resources involved in acquiring contraceptives. Other studies also revealed massive socioeconomic gap in health and health care utilization among women of reproductive age due to lower secondary and tertiary levels of education (Aslam et al, 2016;Groot et al, 2018).…”

“…There are signi cant differences in the use of family planning services between urban and rural areas of sub-Sahara Africa because family planning information and services were more often used by the urban women, wealthier households and empowerment less important in determining family planning utilization (Groot et al, 2018;Larsson & Stanfors, 2014). Some of the prominent factors among the rural-urban variations in family planning use include low levels of education (Larsson & Stanfors (2014) and lack of wealth (Aslam et al (2016).…”

Factors affecting contraceptive use and unmet need among currently married women in Afghanistan: further analysis of the 2015 Afghanistan Demographic and Health Survey

“…9 A study in Pakistan concluded that, despite a growing family planning program over time, a gap remained in use of family planning by socioeconomic factors linked to the poor and illiterate groups. 10 A study in West Bengal, India, revealed a positive association between the level of media exposure and the use of modern contraceptive methods among all age cohorts. 11 Furthermore, a study conducted in Benin Republic found that women's education, discussion about family planning, number of living children, fertility preference, marital status, household wealth index, sex of household head, religious membership, and place of residence were significant covariates of modern contraceptive use.…”