Education and Nonuse of Contraceptives Among Poor Women in Chiapas, Mexico

Nazar-Beutelspacher, Austreberta; Molina-Rosales, Dolores; Izaba, Benito Salvatierra; Martelo, Emma Zapata; Halperin, David

doi:10.2307/2991962

Cited by 16 publications

(12 citation statements)

References 3 publications

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“…Basic demographic characteristics identified in the literature [5,11] that could mediate women's contraceptive use over the course of the reproductive life cycle include urban/rural place of residence, women's age in years, health insurance (no/yes), marital status categorised into two groups (single/married-cohabiting) and number of children ever born categorised into three groups (<2/3-4/>5) (Table 1). …”

Section: Methodsmentioning

confidence: 99%

Comparison of physical, public and human assets as determinants of socioeconomic inequalities in contraceptive use in Colombia - moving beyond the household wealth index

González

Houweling

Marmot

et al. 2010

International Journal for Equity in Health

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BackgroundColombia is a lower-middle income country that faces the challenge of addressing health inequalities. This effort includes the task of developing measures of socioeconomic position (SEP) to describe and analyse disparities in health and health related outcomes. This study explores the use of a multidimensional approach to SEP, in which socioeconomic inequalities in contraceptive use are investigated along multiple dimensions of SEP. We tested the hypothesis that provision of Public capital compensated for low levels of Human capital.MethodsThis study used the 2005 Colombian Demographic and Health Survey (DHS) dataset. The outcome measures were 'current non-use' and 'never use' of contraception. Inequalities in contraceptive behaviour along four measures of SEP were compared: the Household wealth index (HWI), Physical capital (housing, consumer durables), Public capital (publicly provided services) and Human capital (level of education). Principal component analysis was applied to construct the HWI, Physical capital and Public capital measures. Logistic regression models were used to estimate relative indices of inequality (RII) for each measure of SEP with both outcomes.ResultsSocio-economic inequalities among rural women tended to be larger than those among urban women, for all measures of SEP and for both outcomes. In models mutually adjusted for Physical, Public and Human capital and age, Physical capital identified stronger gradients in contraceptive behaviour in urban and rural areas (Current use of contraception by Physical capital in urban areas RII 2.37 95% CI (1.99-2.83) and rural areas RII 3.70 (2.57-5.33)). The impact of women's level of education on contraceptive behaviour was relatively weak in households with high Public capital compared to households with low Public capital (Current use of contraception in rural areas, interaction p = < 0.001). Reduced educational inequalities attributable to Public capital were partly explained by differences in household wealth but not at all by health insurance cover.ConclusionsA multidimensional approach provides a framework for disentangling socioeconomic inequalities in contraceptive behaviour. We provide evidence that material circumstances indexed by Physical capital are important socioeconomic determinants while higher provision of Public capital may compensate for low levels of Human capital with respect to modern contraceptive behaviour.

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Section: Methodsmentioning

confidence: 99%

Comparison of physical, public and human assets as determinants of socioeconomic inequalities in contraceptive use in Colombia - moving beyond the household wealth index

González

Houweling

Marmot

et al. 2010

International Journal for Equity in Health

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“…10,13,14 Although some studies have found no association between contraceptive use and employment, 10,14 others have found that women working outside the home are more likely to report use than those who do not. 8,15 Higher socioeconomic status also has been related to adoption of a modern method. 7,15 Other research has shown that number of children ever born, 16 discussion of family planning with a partner, 10,13,17,18 approval of family planning use 14,18 and desire for no more children 9,17,19 are associated with higher odds of contraceptive use.…”

mentioning

confidence: 99%

“…8,15 Higher socioeconomic status also has been related to adoption of a modern method. 7,15 Other research has shown that number of children ever born, 16 discussion of family planning with a partner, 10,13,17,18 approval of family planning use 14,18 and desire for no more children 9,17,19 are associated with higher odds of contraceptive use. Findings on whether ideal family size and family planning use are associated have been mixed.…”

mentioning

confidence: 99%

The Role of Individual and Community Normative Factors: A Multilevel Analysis of Contraceptive Use Among Women in Mali

Kaggwa¹,

Diop²,

Storey³

2008

IFPP

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With a gross national income of US$380 per capita in 2005, Mali is one of the poorest and least developed countries in the world. 1 Seventy percent of the population is rural. In 2001, as many as 80% of women had no education, 43% were in polygamous unions and just 4% had access to newspapers, television or radio. Additionally, only about one-half of women had consulted a health professional at least once during their last pregnancy. 2 The country's total fertility rate (TFR) of 6.8 births per woman has remained fairly stable over the past decade and is one of the highest in Africa. 2 With an infant mortality rate of 120 deaths per 1,000 live births in 2005 and a maternal mortality ratio of 1,200 deaths per 100,000 births in 2000, the country faces significant maternal and child health challenges. 3 Family planning was introduced in Mali in the late 1960s. In 1967, the Association Malienne pour la Promotion et la Protection de la Famille began a small family planning pilot project in the capital city, Bamako. However, the government of Mali did not establish an official family planning policy until 1972, when a decree authorizing voluntary birth regulation was issued. 4 Between 1972 and 1990, family planning services were limited to Bamako and other major urban areas. In 1990, however, the government embarked on a family planning promotion campaign. 5 Nationwide campaigns to promote family planning have continued since then. Despite these efforts, contraceptive use in Mali is still very low. For example, the pill, which is the most widely adopted method, is used by only 3% of women in union. Yet, by 2001, 76% of women knew of a modern method of contraception and nearly 29% were considered to have an unmet need for family planning. 2 In addition to reporting Mali's high TFR, the 2001 Demographic and Health Survey (DHS) indicates that only 22% of women in Mali reported an ideal family size of four or fewer children. 2 In light of the widespread desire for large families and other common pronatalist attitudes, understanding why individuals who practice family planning choose to do so is an important area of research. Additionally, understanding the extent to which a pronatalist environment inhibits adoption of contraceptives is critical in efforts to promote family planning in Mali and other low-prevalence countries.There is increased interest in exploring the importance of the environment in health behavior changes. Research on this topic generally seeks to look at the relative influences on health behavior of characteristics of the individuals in a community and the environment in which these individuals reside.A number of theories have been presented to explain

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“…6 Among poorer women in some regions in Mexico, lack of education independently predicted non-use of contraceptives, with illiterate women 1.6 times more likely to have never used contraception than those who had attended secondary school; most illiteracy among women occurs in the southern rural regions in Mexico. 35,36 Additional socioeconomic variables associated with nonuse of contraceptives include having given birth at home, having experienced the death of at least two children, and not having a paid job. 35 Thus for many women in Mexico, advances in family planning have served to strengthen their role in Mexican society, expanding their abilities, and enabling them to better care for themselves and for others.…”

Section: Reproductive Health and Well-beingmentioning

confidence: 99%

“…35,36 Additional socioeconomic variables associated with nonuse of contraceptives include having given birth at home, having experienced the death of at least two children, and not having a paid job. 35 Thus for many women in Mexico, advances in family planning have served to strengthen their role in Mexican society, expanding their abilities, and enabling them to better care for themselves and for others. But for a group of women already at risk due to stressors of poverty, malnutrition, and illness -the poorer in rural regions of Mexico-these opportunities and positive changes have not occurred.…”

Section: Reproductive Health and Well-beingmentioning

confidence: 99%

Women as primary caregivers in Mexico: challenges to well-being

DiGirolamo

Snyder

2008

Salud pública Méx

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DiGirolamo AM, Salgado de Snyder VN. Las mujeres como cuidadoras principales en México: retos para su bienestar Salud Publica Mex 2008;50:516-522. ResumenEl propósito de esta contribución fue revisar la literatura publicada en los últimos 20 años con respecto al papel que tienen las mujeres mexicanas en el ámbito familiar y describir los retos psicosociales y de salud que cotidianamente enfrentan. Se analizan los problemas actuales y las mejoras que han ocurrido en tres áreas: salud reproductiva, nutrición y salud mental; se discute cómo el papel de cuidadora de otros influye o es influido por estos temas de salud. Se enfatiza el entorno cultural, su rol como cuidadoras, los retos que enfrentan y la fortaleza y resistencia que demuestran. Se concluye que es imperativo modificar la manera en que las necesidades de la mujer mexicana están siendo evaluadas, interpretadas y confrontadas, junto con una necesidad impostergable de concretar propuestas que tomen en cuenta retos y fortalezas, así como el contexto cultural y la realidad nacional. Palabras clave: mujeres mexicanas, roles de género, bienestar, salud reproductiva, nutrición, salud mental DiGirolamo AM, Salgado de Snyder VN. Women as primary caregivers in Mexico: challenges to well-being. Salud Publica Mex 2008;50:516-522. AbstractThe purpose of this contribution is to review the peer reviewed literature from the last 20 years regarding the role of Mexican women in the family, and to describe the psychosocial and health challenges they face. We analyze the current problems and recent improvements in three areas: reproductive health, nutrition, and mental health, and we discuss how the role of caregiver may influence or be influenced by these health issues. We emphasize the cultural context, women's role as caregivers, the challenges they face, and the strength and resilience these women exhibit. We conclude that it is imperative that we modify the way in which Mexican women's needs are assessed, interpreted, and confronted, along with a definite need for concrete proposals that take into account both women's challenges and strengths, and the cultural context and national reality.

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Education and Nonuse of Contraceptives Among Poor Women in Chiapas, Mexico

Cited by 16 publications

References 3 publications

Comparison of physical, public and human assets as determinants of socioeconomic inequalities in contraceptive use in Colombia - moving beyond the household wealth index

Comparison of physical, public and human assets as determinants of socioeconomic inequalities in contraceptive use in Colombia - moving beyond the household wealth index

The Role of Individual and Community Normative Factors: A Multilevel Analysis of Contraceptive Use Among Women in Mali

Women as primary caregivers in Mexico: challenges to well-being

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