Abstract
BackgroundUnmet need for contraception, the proportion of women who want to limit or delay childbirth but use no form of contraception, is the core indicator to evaluate the effectiveness of family planning programs. Understanding how migration influences unmet need is important to identify to whom and how to target sexual and reproductive health programs. We assessed how migration status in rural and urban settings is associated with having an unmet need for family planning.MethodsData on sexually active, fecund, reproductive-aged (15–49 years) women from the 2013–14 Zambia Demographic and Health Survey were analysed through univariate and multivariate logistic regression models.ResultsUnmet need for modern contraceptive methods was significantly higher among rural to rural migrant women (OR 1.30, 95%CI 1.00–1.70 p < 0.05) and rural non-migrant women (OR 1.41, 95%CI 1.06–1.85 p < 0.01) compared to urban non-migrant women after controlling for age, marital status, parity, religion, education and wealth.ConclusionWomen residing in, and migrating between, rural areas were significantly more likely to have an unmet need for contraception. Our findings highlight the importance of understanding migration and migrant streams to strengthen family planning programs. In Zambia, a focus on rural-rural migrants, rural non-migrants and the poorest could improve the health of the entire population.
Highlights
Unmet need for contraception, the proportion of women who want to limit or delay childbirth but use no form of contraception, is the core indicator to evaluate the effectiveness of family planning programs
This study aims to address this gap in research by assessing how different migration patterns affect the chances for women to have their reproductive needs unfulfilled
We found that ruralto-rural migrants were 30% more likely to have an unmet need and rural non-migrants were 40% more likely compared to urban non-migrants
Summary
Unmet need for contraception, the proportion of women who want to limit or delay childbirth but use no form of contraception, is the core indicator to evaluate the effectiveness of family planning programs. We assessed how migration status in rural and urban settings is associated with having an unmet need for family planning. There is limited evidence around how migrating affects women’s ability to plan their families by limiting or delaying future childbirth. Limited research is available on the effect of migration on unmet need. In Myanmar, Kenya and China, researchers found strong evidence of increased Modern Contraceptive Prevalence (MCP) in rural-to-urban migrants compared to non-migrants, whereas in Cambodia no difference was found [15,16,17,18]. In Zambia, access to modern contraception was significantly lower among rural women compared to those living in urban areas [19]
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