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

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

site.icomp.org.my
from site.icomp.org.my More from this publisher
30.07.2015 Views

TableTable8Percentage of ong>theong> total demong>andong> for family plannong>inong>g that is satisfied ong>inong> selected ong>Pacificong> islong>andong>countries, by socio-economic characteristics (currently married women)*Variable Tuvalu 2007 Nauru 2007MarshallIslong>andong>s 2007SolomonIslong>andong>s 2007Samoa2009Kiribati2008Papua NewGuong>inong>ea 2006Age group15-19 -- -- 43.0 56.6 -- 5.0 37.020-24 46.3 42.5 68.8 62.9 35.2 37.6 44.225-29 54.7 51.6 81.7 62.8 37.4 47.0 41.830-34 49.8 62.7 86.4 71.0 45.4 45.3 41.435-39 61.2 68.7 95.4 84.0 42.7 51.8 36.240-44 62.0 -- 97.6 94.6 41.4 46.9 29.445-49 58.8 -- 100.0 98.5 30.7 41.5 16.315-49 55.8 60.3 84.6 75.6 38.6 44.2 36.5ResidenceUrban 54.5 na 85.4 78.1 39.9 38.0 42.8Rural 56.8 na 83.4 75.3 38.4 50.0 35.7EducationNo education na na -- 71.0 Na 100.0 23.9Primary or less 62.2 na 84.8 75.7 27.2 49.4 37.2Secondary 50.1 61.0 85.1 75.9 39.5 41.1 39.7More than secondary+57.7 -- 81.8 93.8 39.5 39.3 54.0WealthQuong>inong>tile 1 (highest) 56.9 57.1 87.7 84.6 46.1 40.2 naQuong>inong>tile 2 50.4 67.2 91.1 79.2 35.8 34.7 naQuong>inong>tile 3 55.5 49.9 82.8 70.3 37.7 43.0 naQuong>inong>tile 4 61.9 65.3 80.0 75.6 36.1 46.0 naQuong>inong>tile 5 (lowest) 53.0 64.1 75.4 70.0 37.6 57.0 naSource: DHS reports for specified countries.Note: -- means number ong>inong> sample too small.*In Papua New Guong>inong>ea, women who want more children are excluded from ong>theong> calculation.Unmet need ong>andong> socio-economicfactors at ong>theong> microlevelIn ong>theong> ong>Pacificong>, unmet need by country among marriedwomen ranges from 7.7 per cent ong>inong> Solomon Islong>andong>s to45.6 per cent ong>inong> Samoa (Table 7). Marshall Islong>andong>s ong>andong>Solomon Islong>andong>s seem to be ong>inong> a group of ong>theong>ir own,with much lower levels of unmet need (8.1 ong>andong> 7.7%,respectively) compared with ong>theong> oong>theong>r countries. As alreadynoted, Solomon Islong>andong>s has a low level of unmet needbecause fertility preferences remaong>inong> high. This may alsobe ong>theong> case ong>inong> Marshall Islong>andong>s, although that country hasone of ong>theong> highest CPRs ong>inong> ong>theong> region (42.4%). SolomonIslong>andong>s has ong>theong> highest TFR ong>inong> ong>theong> region but ong>theong> lowestlevel of unmet need.Patterns of unmet need by age vary widely betweencountries. For several countries (Kiribati, Nauru ong>andong>Samoa) ong>theong>re are ong>inong>sufficient married women aged 15-19ong>inong> ong>theong> sample to provide a valid measure of unmet need. InKiribati, Marshall Islong>andong>s ong>andong> Solomon Islong>andong>s, this agegroup has ong>theong> highest rate of unmet need. In ong>theong> countrieswith low unmet need, ong>theong> highest levels are found ong>inong>younger age groups ong>andong> ong>theong> lowest ong>inong> older age groups.In Kiribati, Papua New Guong>inong>ea, Samoa ong>andong> Tuvalu ong>theong>differences between age groups is not large. In Papua NewGuong>inong>ea ong>andong> Samoa, ong>theong> highest levels of unmet need are ong>inong>ong>theong> 45-49 age group.A surprisong>inong>g fong>inong>dong>inong>g ong>inong> Table 7 is that unmet need is similarong>inong> urban ong>andong> rural areas withong>inong> countries. Although unmetneed is slightly higher ong>inong> rural areas ong>inong> four countries, ong>theong>differences are small. In Kiribati ong>andong> Tuvalu unmet need ishigher ong>inong> urban than rural areas. The relationship betweeneducation ong>andong> unmet need is also quite different ong>inong> eachcountry. The highest levels of unmet need are among88

women with only primary education ong>inong> Samoa (54.8%)ong>andong> women with no education ong>inong> Papua New Guong>inong>ea(51.4%). In Solomon Islong>andong>s, ong>theong> highest level of unmetneed is also among women with no education or onlyprimary education.There is no clear relationship between unmet need ong>andong>household wealth. Only ong>inong> Marshall Islong>andong>s is unmet needhighest ong>inong> ong>theong> poorest fifth of ong>theong> population. Elsewhereunmet need is highest ong>inong> ong>theong> middle wealth quong>inong>tile, exceptfor Kiribati where ong>theong> second highest quong>inong>tile has ong>theong>highest unmet need.In summary, as was ong>theong> case with CPR, unmet need isnot strongly associated with socio-economic factors at ong>theong>microlevel on a cross-country basis. While unmet need isgenerally higher ong>inong> rural areas, this is not true ong>inong> all countries.Similarly, ong>inong> some countries unmet need is higher amongwomen with secondary education but ong>inong> oong>theong>r countriesuneducated women have higher unmet need. Furong>theong>rmore,neiong>theong>r high nor low wealth is associated with unmetneed. The strongest relationship ong>inong> most countries is age,although it is not long>inong>ear. In Marshall Islong>andong>s ong>andong> SolomonIslong>andong>s, countries with ong>theong> lowest level of unmet need,ong>theong> highest levels were found ong>inong> younger age groups. Thiswas also ong>theong> case ong>inong> Kiribati ong>andong> Nauru with much higheroverall unmet need.Anoong>theong>r measure of ong>theong> extent to which ong>theong> family plannong>inong>gneeds of a country or subgroups withong>inong> a country are beong>inong>gmet is ong>theong> “total demong>andong>” for family plannong>inong>g. This is ong>theong>sum of women currently usong>inong>g contraception ong>andong> thosewho have an unmet need. The proportion of ong>theong> totaldemong>andong> that is met is current users divided by ong>theong> totalof users ong>andong> non-users. Where unmet need is low, it canbe expected that ong>theong> proportion of ong>theong> total demong>andong> thatis met will be high. This can be confirmed with referenceto ong>theong> ong>Pacificong> islong>andong> countries with ong>theong> recent DHS (Table8). The two countries with ong>theong> lowest level of unmet need(Marshall Islong>andong>s ong>andong> Solomon Islong>andong>s) have ong>theong> highestproportion of total demong>andong> satisfied – 84.6 per cent ong>andong>75.6 per cent, respectively – as might be expected.As was found with oong>theong>r fertility ong>andong> contraceptiveong>inong>dicators, ong>theong> percentage of total demong>andong> for contraceptionthat is satisfied is not clearly associated with ong>theong> socioeconomiccharacteristics of women at ong>theong> microscale. Tosome extent, ong>theong> proportion of demong>andong> satisfied is higherong>inong> urban than rural areas, but not ong>inong> all countries. Womenwith a primary or lower level of education are more likelyto have lower proportions of ong>theong>ir total demong>andong> satisfied,but agaong>inong> this is not true ong>inong> all countries. In general, as withong>theong> oong>theong>r ong>inong>dicators, women younger than 30 years of agehave a smaller proportion of ong>theong>ir total demong>andong> satisfied,thus demographic factors have a stronger impact thansocio-economic ones.Explaong>inong>ong>inong>g patterns of unmet needAs Bhushan (1997), Casterlong>inong>e ong>andong> Song>inong>dong>inong>g (2000), ong>andong>oong>theong>rs have poong>inong>ted out, from a programme perspectiveong>theong> key issue ong>inong> respondong>inong>g to unmet need is to identifyong>theong> country-specific causes of it. As Casterlong>inong>e ong>andong> Song>inong>dong>inong>galso note, ong>theong>re is a temptation for policymakers to addressunmet need by focusong>inong>g almost exclusively on improvong>inong>gaccess to services, but lack of access is not always ong>theong>primary reason for unmet need. Detailed research maybe required to uncover ong>theong> actual reasons among variousgroups of women.Although DHS are not generally fong>inong>ely adapted to ong>theong>specific country ong>inong> which ong>theong>y are conducted, ong>theong>ir resultsprovide a useful poong>inong>t of departure for more detailedresearch on ong>theong> underlyong>inong>g causes of unmet need. Astong>andong>ard DHS question asked of currently married womenwho are not usong>inong>g contraception is wheong>theong>r ong>theong>y ong>inong>tendto use contraception ong>inong> ong>theong> future. The responses to thisquestion ong>inong> seven ong>Pacificong> countries are shown ong>inong> Table 9.Raong>theong>r than employ ong>theong> stong>andong>ard DHS format, however,ong>theong> data ong>inong> Table 9 have been arranged accordong>inong>g toong>theong> previously mentioned “ready, willong>inong>g, ong>andong> able”conceptualization of Lesthaeghe ong>andong> Vong>andong>erhoeft. Becausewomen who are already practisong>inong>g contraception can beconsidered as fulfillong>inong>g all three conditions, ong>theong>y are excludedfrom ong>theong> table. The two remaong>inong>ong>inong>g categories of womenare those who eiong>theong>r are unable to use contraception or areunwillong>inong>g to do so. The ong>inong>ability to use contraception maybe caused by lack of knowledge, ong>theong> difficulty of locatong>inong>g asource, or ong>theong> lack of money to pay for transportation orfor ong>theong> method itself.Unwillong>inong>gness to practise contraception arises from anumber of factors, rangong>inong>g from religious objections,spousal opposition to fear of side effects ong>andong> general healthconcerns. A third category “not specified” is ong>inong>cluded toshow ong>theong> extent to which respondents give oong>theong>r reasonsor are unable to give a response.It is clear from Table 9 that lack of knowledge of, oraccess to, contraception is a significant impediment tocontraceptive use only ong>inong> Papua New Guong>inong>ea, where 50.9per cent of women who say that ong>theong>y do not ong>inong>tend to usecontraception ong>inong> ong>theong> future give this reason. Only ong>inong> Nauru(12.7) ong>andong> Solomon Islong>andong>s (13.5) does ong>theong> percentageof women citong>inong>g this reason rise above a few percentagepoong>inong>ts.It appears that ong>inong>ability to access contraception is not amajor cause of unmet need ong>inong> most of ong>theong> ong>Pacificong> countriesrecently conductong>inong>g a DHS. That a majority of women ong>inong>Papua New Guong>inong>ea would cite this reason is understong>andong>ablegiven ong>theong> low level of female literacy, low urbanization89

TableTable8Percentage of <str<strong>on</strong>g>the</str<strong>on</strong>g> total dem<str<strong>on</strong>g>and</str<strong>on</strong>g> for family plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g that is satisfied <str<strong>on</strong>g>in</str<strong>on</strong>g> selected <str<strong>on</strong>g>Pacific</str<strong>on</strong>g> isl<str<strong>on</strong>g>and</str<strong>on</strong>g>countries, by socio-ec<strong>on</strong>omic characteristics (currently married women)*Variable Tuvalu 2007 Nauru 2007MarshallIsl<str<strong>on</strong>g>and</str<strong>on</strong>g>s 2007Solom<strong>on</strong>Isl<str<strong>on</strong>g>and</str<strong>on</strong>g>s 2007Samoa2009Kiribati2008Papua NewGu<str<strong>on</strong>g>in</str<strong>on</strong>g>ea 2006Age group15-19 -- -- 43.0 56.6 -- 5.0 37.020-24 46.3 42.5 68.8 62.9 35.2 37.6 44.225-29 54.7 51.6 81.7 62.8 37.4 47.0 41.830-34 49.8 62.7 86.4 71.0 45.4 45.3 41.435-39 61.2 68.7 95.4 84.0 42.7 51.8 36.240-44 62.0 -- 97.6 94.6 41.4 46.9 29.445-49 58.8 -- 100.0 98.5 30.7 41.5 16.315-49 55.8 60.3 84.6 75.6 38.6 44.2 36.5ResidenceUrban 54.5 na 85.4 78.1 39.9 38.0 42.8Rural 56.8 na 83.4 75.3 38.4 50.0 35.7Educati<strong>on</strong>No educati<strong>on</strong> na na -- 71.0 Na 100.0 23.9Primary or less 62.2 na 84.8 75.7 27.2 49.4 37.2Sec<strong>on</strong>dary 50.1 61.0 85.1 75.9 39.5 41.1 39.7More than sec<strong>on</strong>dary+57.7 -- 81.8 93.8 39.5 39.3 54.0WealthQu<str<strong>on</strong>g>in</str<strong>on</strong>g>tile 1 (highest) 56.9 57.1 87.7 84.6 46.1 40.2 naQu<str<strong>on</strong>g>in</str<strong>on</strong>g>tile 2 50.4 67.2 91.1 79.2 35.8 34.7 naQu<str<strong>on</strong>g>in</str<strong>on</strong>g>tile 3 55.5 49.9 82.8 70.3 37.7 43.0 naQu<str<strong>on</strong>g>in</str<strong>on</strong>g>tile 4 61.9 65.3 80.0 75.6 36.1 46.0 naQu<str<strong>on</strong>g>in</str<strong>on</strong>g>tile 5 (lowest) 53.0 64.1 75.4 70.0 37.6 57.0 naSource: DHS reports for specified countries.Note: -- means number <str<strong>on</strong>g>in</str<strong>on</strong>g> sample too small.*In Papua New Gu<str<strong>on</strong>g>in</str<strong>on</strong>g>ea, women who want more children are excluded from <str<strong>on</strong>g>the</str<strong>on</strong>g> calculati<strong>on</strong>.Unmet need <str<strong>on</strong>g>and</str<strong>on</strong>g> socio-ec<strong>on</strong>omicfactors at <str<strong>on</strong>g>the</str<strong>on</strong>g> microlevelIn <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>Pacific</str<strong>on</strong>g>, unmet need by country am<strong>on</strong>g marriedwomen ranges from 7.7 per cent <str<strong>on</strong>g>in</str<strong>on</strong>g> Solom<strong>on</strong> Isl<str<strong>on</strong>g>and</str<strong>on</strong>g>s to45.6 per cent <str<strong>on</strong>g>in</str<strong>on</strong>g> Samoa (Table 7). Marshall Isl<str<strong>on</strong>g>and</str<strong>on</strong>g>s <str<strong>on</strong>g>and</str<strong>on</strong>g>Solom<strong>on</strong> Isl<str<strong>on</strong>g>and</str<strong>on</strong>g>s seem to be <str<strong>on</strong>g>in</str<strong>on</strong>g> a group of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir own,with much lower levels of unmet need (8.1 <str<strong>on</strong>g>and</str<strong>on</strong>g> 7.7%,respectively) compared with <str<strong>on</strong>g>the</str<strong>on</strong>g> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r countries. As alreadynoted, Solom<strong>on</strong> Isl<str<strong>on</strong>g>and</str<strong>on</strong>g>s has a low level of unmet needbecause fertility preferences rema<str<strong>on</strong>g>in</str<strong>on</strong>g> high. This may alsobe <str<strong>on</strong>g>the</str<strong>on</strong>g> case <str<strong>on</strong>g>in</str<strong>on</strong>g> Marshall Isl<str<strong>on</strong>g>and</str<strong>on</strong>g>s, although that country has<strong>on</strong>e of <str<strong>on</strong>g>the</str<strong>on</strong>g> highest CPRs <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g> regi<strong>on</strong> (42.4%). Solom<strong>on</strong>Isl<str<strong>on</strong>g>and</str<strong>on</strong>g>s has <str<strong>on</strong>g>the</str<strong>on</strong>g> highest TFR <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g> regi<strong>on</strong> but <str<strong>on</strong>g>the</str<strong>on</strong>g> lowestlevel of unmet need.Patterns of unmet need by age vary widely betweencountries. For several countries (Kiribati, Nauru <str<strong>on</strong>g>and</str<strong>on</strong>g>Samoa) <str<strong>on</strong>g>the</str<strong>on</strong>g>re are <str<strong>on</strong>g>in</str<strong>on</strong>g>sufficient married women aged 15-19<str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g> sample to provide a valid measure of unmet need. InKiribati, Marshall Isl<str<strong>on</strong>g>and</str<strong>on</strong>g>s <str<strong>on</strong>g>and</str<strong>on</strong>g> Solom<strong>on</strong> Isl<str<strong>on</strong>g>and</str<strong>on</strong>g>s, this agegroup has <str<strong>on</strong>g>the</str<strong>on</strong>g> highest rate of unmet need. In <str<strong>on</strong>g>the</str<strong>on</strong>g> countrieswith low unmet need, <str<strong>on</strong>g>the</str<strong>on</strong>g> highest levels are found <str<strong>on</strong>g>in</str<strong>on</strong>g>younger age groups <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g> lowest <str<strong>on</strong>g>in</str<strong>on</strong>g> older age groups.In Kiribati, Papua New Gu<str<strong>on</strong>g>in</str<strong>on</strong>g>ea, Samoa <str<strong>on</strong>g>and</str<strong>on</strong>g> Tuvalu <str<strong>on</strong>g>the</str<strong>on</strong>g>differences between age groups is not large. In Papua NewGu<str<strong>on</strong>g>in</str<strong>on</strong>g>ea <str<strong>on</strong>g>and</str<strong>on</strong>g> Samoa, <str<strong>on</strong>g>the</str<strong>on</strong>g> highest levels of unmet need are <str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>the</str<strong>on</strong>g> 45-49 age group.A surpris<str<strong>on</strong>g>in</str<strong>on</strong>g>g f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> Table 7 is that unmet need is similar<str<strong>on</strong>g>in</str<strong>on</strong>g> urban <str<strong>on</strong>g>and</str<strong>on</strong>g> rural areas with<str<strong>on</strong>g>in</str<strong>on</strong>g> countries. Although unmetneed is slightly higher <str<strong>on</strong>g>in</str<strong>on</strong>g> rural areas <str<strong>on</strong>g>in</str<strong>on</strong>g> four countries, <str<strong>on</strong>g>the</str<strong>on</strong>g>differences are small. In Kiribati <str<strong>on</strong>g>and</str<strong>on</strong>g> Tuvalu unmet need ishigher <str<strong>on</strong>g>in</str<strong>on</strong>g> urban than rural areas. The relati<strong>on</strong>ship betweeneducati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> unmet need is also quite different <str<strong>on</strong>g>in</str<strong>on</strong>g> eachcountry. The highest levels of unmet need are am<strong>on</strong>g88

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!