Understanding Changes in Socioeconomic Inequality of Unintended Pregnancy Among Iranian Married Women: A Blinder-Oaxaca Decomposition Analysis

Abstract

Background: Policymakers are interested in investigating effects of governments' policies on socioeconomic inequality in public health. Objectives: This study aimed to analyze levels of and changes in socioeconomic inequality of unintended pregnancy after the changes in family planning policies and to investigate determinants of its changes in Iran. Methods: Required data were extracted from Iran's Multiple Indicator Demographic and Health Surveys conducted in 2010 and 2015. We used data from 1123 and 900 married pregnant women aged 15 - 49 years in 2010 and 2015, respectively. Wagstaff normalized concentration index was used to measure unintended pregnancy inequality. The contribution of various factors to the measured inequality in 2010 and 2015 was investigated by decomposing concentration index. Changes in the unintended pregnancy inequality in 2010 - 2015 and its determinants were assessed using Blinder-Oaxaca decomposition method. Results: Pro-rich unintended pregnancy inequality declined by 120% from -0.145 to 0.030 in 2010 - 2015. However, the pro-poor unintended pregnancy inequality in 2015 was not statistically significant. Households’ economic status and women’s age at pregnancy were the two leading factors with positive contributions while contraceptive non-use before pregnancy and women’s education level had the most negative contributions to the reduced pro-rich inequality of unintended pregnancy in 2010 - 2015. Conclusions: Pro-rich unintended pregnancy inequality not only did not increase, but also declined to zero after the changes in family planning policies. Providing sustainable livelihood for disadvantaged households with women at reproductive ages can maintain this favorable condition in the future.