Contraceptive Availability and Use in Five Developing Countries

Abstract

Recent innovative approaches to research on contraceptive availability and use such as use of perceived travel time use of motivational and attitudinal data and studying the importance of perceived accessibility in relation to a range of availability settings are overviewed. Proposed analytic refinements designed to isolate more carefully the availability-use relationship include: 1) focusing analysis on current users and "potential users" (nonusers at risk of unwanted pregnancy who intend to use family planning); and 2) disaggregating the analysis of the contraceptive accessibility and use relationship by high medium or low level of availability urban/rural residence and clinical or supply method type. The paper then applies multiple classification analysis to test these analytic refinements using recent contraceptive prevalence survey data for Costa Rica Thailand Colombia Honduras and Nepal. Findings suggest that after controlling for several sociodemographic variables (age eduation work status number of children desire for children) contraceptive accessibility has its strongest impact on current use in medium and low availability countries in rural areas and among users/potential users of supply methods. Implications for future research are the need for study of the proportion of users to various distances; introduction of intention to use indices in surveys; study of which methods are preferred; and studying influence of attitude biases on travel effort estimates.