Gonzalez Uribe, C.; (2012) Socioeconomic inequalities in use of contraception in Colombia: DHS 1986-2010. Doctoral thesis , UCL (University College London).

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Abstract

Background: In 2005 Colombia adopted the national Millennium Development Goal (MDG5) target of 75% modern contraceptive prevalence rate (CPR) by 2015. Important gains have been achieved with respect to living conditions, education and health indicators in recent decades but inequalities within the country remain to be addressed. Methods: The aim was to analyse socioeconomic inequalities in women’s ‘current non-use of contraception’ using the six Colombian Demographic and Health Surveys (DHS). A multidimensional approach to socioeconomic position was implemented. Absolute and relative socioeconomic inequalities were analysed using the Slope Index of Inequality (SII) and Relative Index of Inequality (RII). The interplay between level of education and Public capital with respect to contraceptive non-use was examined. Individual and contextual effects were investigated using a multilevel approach. Results: National prevalence in current non-use of contraception between 1986 and 2010 decreased from32.6% to 22.9%. Nationally, absolute inequalities narrowed but relative inequalities did not decline. Women with less than primary education had not met the CPR target in 2010 in urban (30.9%) and rural (41.4%) areas respectively. Absolute inequalities narrowed in urban areas but relative inequalities persisted in urban and rural areas. Gradients in contraceptive non-use with respect to household wealth were stronger among women in rural than in urban areas. The impact of level of education on contraceptive non-use was relatively weak among women in households and within communities with high Public capital compared to low Public capital. Municipality ethnic composition had an effect on women’s contraceptive non-use over and above individual and community characteristics. Conclusion: Colombia reached the national CPR target ahead of time. However, the persistent socioeconomic gradients in non-use of contraception by household wealth and education indicate the need to go beyond country averages and individual level determinants to monitor urban and rural socioeconomic inequalities and contextual effects on women’s contraceptive behaviour.

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