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. 2017 Jun;95(6):549-557.
doi: 10.1016/j.contraception.2017.01.005. Epub 2017 Jan 23.

Contraceptive knowledge and use among women living in the poorest areas of five Mesoamerican countries

Diego Rios-Zertuche  1 , Laura C Blanco  2 , Paola Zúñiga-Brenes  3 , Erin B Palmisano  4 , Danny V Colombara  5 , Ali H Mokdad  6 , Emma Iriarte  7
Affiliations

Contraceptive knowledge and use among women living in the poorest areas of five Mesoamerican countries

Diego Rios-Zertuche et al. Contraception. 2017 Jun.

Abstract

Objective: To identify factors associated with contraceptive use among women in need living in the poorest areas in five Mesoamerican countries: Guatemala, Honduras, Nicaragua, Panama and State of Chiapas (Mexico).

Study design: We analyzed baseline data of 7049 women of childbearing age (15-49 years old) collected for the Salud Mesoamérica Initiative. Data collection took place in the 20% poorest municipalities of each country (July, 2012-August, 2013).

Results: Women in the poorest areas were very poorly informed about family planning methods. Concern about side effects was the main reason for nonuse. Contraceptive use was lower among the extremely poor (<$1.25 USD PPP per day) [odds ratio (OR): 0.75; confidence interval (CI): 0.59-0.96], those living more than 30 min away from a health facility (OR 0.71, CI: 0.58-0.86), and those of indigenous ethnicity (OR 0.50, CI: 0.39-0.64). Women who were insured and visited a health facility also had higher odds of using contraceptives than insured women who did not visit a health facility (OR 1.64, CI: 1.13-2.36).

Conclusions: Our study showed low use of contraceptives in poor areas in Mesoamerica. We found the urgent need to improve services for people of indigenous ethnicity, low education, extreme poverty, the uninsured, and adolescents. It is necessary to address missed opportunities and offer contraceptives to all women who visit health facilities. Governments should aim to increase the public's knowledge of long-acting reversible contraception and offer a wider range of methods to increase contraceptive use.

Implications: We show that unmet need for contraception is higher among the poorest and describe factors associated with low use. Our results call for increased investments in programs and policies targeting the poor to decrease their unmet need.

Keywords: Contraceptive knowledge; Family planning; Health inequalities; Poverty; Salud Mesoamerica; Unmet need.

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Figures

Fig. 1
Fig. 1
Knowledge about and use of contraceptive methods among women in the poorest areas in Mesoamerica (2012–2013). Survey-weighted knowledge and use of contraceptives among partnered women in need from the poorest areas. Modern methods include: permanent methods (male and female sterilization), short-acting hormonal methods (pill, injectables and vaginal ring), long-acting reversible contraception (implants and IUDs), barrier methods (male and female condoms, diaphragm, sponge), and emergency contraception. Traditional methods include: fertility awareness-based methods (rhythm) lactational amenorrhea, and withdrawal.
Fig. 2
Fig. 2
Source of family planning methods among women using contraception in Mesoamerica. Values are survey-weighted percentages for sources of family planning methods among women using contraception from the poorest areas.
See this image and copyright information in PMC

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