Family Planning in Asia and the Pacific - International Council on ...

data. The analysis <strong>in</strong> this section takes data from <strong>the</strong>sesurveys at face value without consideration of confidence<strong>in</strong>tervals <strong>and</strong> statistical significance.As <strong>in</strong>dicated <strong>in</strong> Table 4, 81 per cent of married womenknew of a modern method of contraception <strong>in</strong> 2006compared with 72 per cent <strong>in</strong> 1996. While this is animprovement <strong>in</strong> <strong>the</strong> right direction, it is a very modestrate of improvement for a 10-year period – less than 1 percent <strong>in</strong>crease per year. A somewhat faster rate of <strong>in</strong>crease<strong>in</strong> contraceptive awareness is evident among women withsome primary education (19% of <strong>the</strong> sample) – <strong>in</strong>creas<strong>in</strong>gfrom 70 to 80 per cent over <strong>the</strong> decade. By contrast, amongwomen with no education, knowledge of contraception<strong>in</strong>creased at a much slower rate: <strong>in</strong> 2006, 70 per cent ofwomen with no education had knowledge of a modernmethod of contraception, but only 62 per cent of womenwith no education knew of a source compared with 87 percent of women who had reached grade 7 or higher. The lackof education clearly rema<strong>in</strong>s an important impediment toknowledge of modern contraception <strong>and</strong> its sources.An unexpected result of <strong>the</strong> comparative analysis is that<strong>the</strong> proportion of women reach<strong>in</strong>g grade 7 <strong>and</strong> higher thatknew of a source of modern methods was lower (87%)<strong>in</strong> 2006 than <strong>in</strong> 1996 (90%). It is possible that <strong>the</strong> largersampl<strong>in</strong>g error <strong>in</strong> 1996 is responsible for this anomaly.As is evident from <strong>the</strong> data <strong>in</strong> Table 5, <strong>the</strong> use ofcontraception is positively associated with education.Whe<strong>the</strong>r all methods or modern methods alone areconsidered, contraceptive use among currently marriedwomen has <strong>in</strong>creased, by 20 <strong>and</strong> 24 per cent, respectively,over <strong>the</strong> decade. Among <strong>the</strong> most educated group, however,<strong>the</strong>re has been little change. Fur<strong>the</strong>rmore, <strong>the</strong> proportionof those us<strong>in</strong>g any method of contraception, that is,us<strong>in</strong>g a modern method, was no different <strong>in</strong> 2006 than<strong>in</strong> 1996 (about 75%). This is an unexpected f<strong>in</strong>d<strong>in</strong>g, asone would normally expect that contraceptive use amongmore educated women would <strong>in</strong>crease through time. Thisis not evident <strong>in</strong> Papua New Gu<strong>in</strong>ea. On <strong>the</strong> contrary,larger <strong>in</strong>creases <strong>in</strong> <strong>the</strong> use of contraception are evidentamong women with no education at all or some primaryeducation.At 24.4 per cent, <strong>the</strong> overall CPR <strong>in</strong> Papua New Gu<strong>in</strong>ea<strong>in</strong> 2006 must be considered as low relative to o<strong>the</strong>r lessdeveloped countries, <strong>in</strong> which <strong>the</strong> average CPR formodern methods is 45 per cent (PRB, 2008). Papua NewGu<strong>in</strong>ea’s current CPR puts it on a par with Haiti, one of<strong>the</strong> poorest countries <strong>in</strong> <strong>the</strong> world. 8 However, comparedwith o<strong>the</strong>r <strong>Pacific</strong> isl<strong>and</strong> countries (see Figure 4), PapuaNew Gu<strong>in</strong>ea’s CPR does not look unreasonably low whenaccount is taken of <strong>the</strong> very great logistical difficulties ofdeliver<strong>in</strong>g health services to <strong>the</strong> country’s large, widelyscattered population which faces such challenges as lowlevels of formal education, low <strong>in</strong>come <strong>and</strong> poor transport<strong>and</strong> communications. Papua New Gu<strong>in</strong>ea’s CPR iscurrently higher than that of Tuvalu or Kiribati, while itis similar to that of Nauru. Although all of <strong>the</strong>se countriesface logistical problems <strong>in</strong> <strong>the</strong> delivery of health services,none of <strong>the</strong>m face obstacles comparable to those fac<strong>in</strong>gPapua New Gu<strong>in</strong>ea’s health-care system. Fur<strong>the</strong>rmore,<strong>the</strong>se countries have an active NGO sector which providesalternative sources of family plann<strong>in</strong>g advice <strong>and</strong> supplies,a situation that is much rarer <strong>in</strong> Papua New Gu<strong>in</strong>ea.Geographical variationsPapua New Gu<strong>in</strong>ea is a country of contrast<strong>in</strong>g regions, eachwith somewhat dist<strong>in</strong>ctive culture, geography <strong>and</strong> history.Colonial history comb<strong>in</strong>ed with resource endowments hashad a particular impact on <strong>the</strong> levels of development with<strong>in</strong>regions <strong>and</strong> patterns of unequal development betweenregions <strong>and</strong> prov<strong>in</strong>ces have persisted to <strong>the</strong> present. Acomparison of regions provides some clue as to <strong>the</strong> impactof economic development on knowledge <strong>and</strong> use of familyplann<strong>in</strong>g.As might be expected, contraceptive knowledge <strong>and</strong>use is highest <strong>in</strong> <strong>the</strong> Isl<strong>and</strong>s region (see Table 6), whichgenerally has better social <strong>in</strong>dicators than o<strong>the</strong>r regionsTableTable4357