Fertility Rate Decreases Despite Low Method Use Among Women in Ecuador

Abstract

A Family Planning and Child Survival Survey was conducted from July to October 1989 by the Centro de Estudios de Poblacion y Paternidad Responsable and the Ecuador Ministry of Health with assistance from the US Centers for Disease Control. A self-weighting national sampling plan was used in 6 regions of Ecuador: Quito; the urban and rural areas of the mountainous region; Guayaquil; and the urban and rural areas of the coastal region. Trained female interviewers with 7961 women aged 15-49 using 2 pretested questionnaires. A special analysis investigated the sexual and contraceptive behavior of women aged 15-24. The total fertility rate (TFR) has declined from 4.3 lifetime births/woman in 1987 to 3.8 in 1989; however in rural areas the TFR was 5.0. Most of the decline occurred in the coastal region: from 3.2 to 2.6 births/woman in Guayaquil from 4.1 to 3.2 in other urban areas and from 5.4 to 4.7 in rural areas. The TFR remained higher in the sierra (4.2) than in the coastal areas (3.5). 53% of married women were current users while approximately 1 in 4 married women were at risk of an unplanned pregnancy. 89% of women knew of at least one modern contraceptive method but only one-third of all women aged 15-49 were using a contraceptive method. The methods most frequently used were female sterilization (12%) the IUD (8%) periodic abstinence (6%) and the pill (5%). The estimated infant mortality rate was 53 deaths/1000 live births in 1987. A direct estimate based on the reports of all women was 37 deaths/1000 live births for the period 1984-1989. 76% of married women aged 15-49 had had a prenatal examination during their most recent pregnancy up form 70% in 1987. Almost 99% of women with postsecondary education had had prenatal care compared with only 40% of women with no education.