The Contraceptive Method Mix: An Overview

Abstract

This book presents an investigation of the factors underlying contraceptive method choice. The process of contraceptive choice may be described as a funnel with the spectrum of possible choices at the top progressively narrowed down by the factors of available technology and cost what manufacturers and family planning agencies currently make available what is socioculturally acceptable and at the bottom the method mix from which the method that meets personal preference is selected. Since the choices made by individuals influence what is manufactured and distributed the funnel may be thought of as a 2-way sieve. In Part I of the book chapters 2-5 describe the perception of alternatives from the point of view of consumers and physicians access considerations and economic perspectives. Part II of the book in chapters 6-11 considers contraceptive choice in 6 Asian countries. Chapters 12 and 13 describe the situation in the United States considering sterilization separately from other methods. Chapter 14 summarizes factors in contraceptive choice and breaks down choice behavior in terms of contraceptive goals (birth spacing or family size limitation) contraceptive competence contraceptive evaluation and contraceptive access. Chapter 15 describes the application of multinomial logit analysis to contraceptive choice. Contraceptive prevalence in the major countries of East Asia (China Hong Kong Korea Taiwan and Japan) is about 70%. In Southeast Asia prevalence is less consistent -- 74% and 65% for Singapore and Thailand respectively but 50% or less in Malaysia Indonesia and the Philippines. South Asia has the lowest prevalence rates in Asia -- 33% for India 25% for Bangladesh and 5% for Pakistan. The high prevalence rates in East Asia have all been achieved in a relatively short period of time. Great diversity characterizes the methods used in Asia with different methods prevalent in various time periods. Female sterilization is currently prevalent in Bangladesh Hong Kong India Korea the Philippines Singapore Sri Lanka and Thailand. The pill is most popular in Hong Kong Indonesia Malaysia and Pakistan. Male sterilization has the highest number of users in Nepal. IUDs are favored in China and Taiwan and condoms in Japan.