Department of International Health, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
Health Policy Plan. 2012 Mar;27(2):166-74. doi: 10.1093/heapol/czr022. Epub 2011 Mar 26.
To determine (a) whether the influence of the determinants of family planning use in Pakistan changed between 1990-91 and 2006-07, and (b) if these changes were associated with changes in the method mix.
Data from the Pakistan Demographic and Health Surveys (PDHS) of 1990-91 and 2006-07 were used in the analyses. Data on 5184 married, non-pregnant, fecund women in 1990-91 and 8041 married, non-pregnant, fecund women in 2006-07 were used. Logistic regression analysis was used to identify factors associated with the use of any contraceptive method and whether the influence of these factors changed between the survey years. Changes in the method mix were examined.
The effects of urban/rural residence, wealth and education on contraceptive use changed between 1990-91 and 2006-07. Differentials in contraceptive use by residence, wealth and education declined and were accompanied by changes in the method mix. In rural areas and among less-educated women, the contribution of traditional methods to the method mix increased. Among the poorest women, the method mix shifted towards traditional methods and condoms.
Less-educated, rural, Pakistani women increased the use of family planning at a faster rate than more-educated, urban, women by adopting the use of traditional family planning methods. Poor women also increased family planning use more quickly than non-poor women, by adopting condoms and traditional methods. The more rapid increase in the demand for family planning among poorer, less-educated, rural women is a positive trend. In order to convert this demand into the use of longer-term modern methods, however, access to high quality services must be improved in rural and low-income urban areas.
确定（a）在 1990-91 年和 2006-07 年期间，巴基斯坦计划生育使用的决定因素的影响是否发生变化，以及（b）如果这些变化与方法组合的变化有关。
本研究使用了 1990-91 年和 2006-07 年的巴基斯坦人口与健康调查（PDHS）的数据。在 1990-91 年，共分析了 5184 名已婚、未怀孕、生育能力正常的女性的数据；在 2006-07 年，共分析了 8041 名已婚、未怀孕、生育能力正常的女性的数据。使用逻辑回归分析来确定与任何避孕方法使用相关的因素，以及这些因素在调查年份之间的影响是否发生变化。还检查了方法组合的变化。
城乡居住、财富和教育对避孕使用的影响在 1990-91 年和 2006-07 年之间发生了变化。居住、财富和教育方面的避孕使用差异减少了，同时方法组合也发生了变化。在农村地区和受教育程度较低的妇女中，传统方法对方法组合的贡献增加了。在最贫穷的妇女中，方法组合转向了传统方法和避孕套。
与受教育程度较高、居住在城市的妇女相比，受教育程度较低、居住在农村的巴基斯坦妇女通过采用传统计划生育方法，更快地增加了计划生育的使用。与非贫困妇女相比，贫困妇女通过采用避孕套和传统方法，更快地增加了计划生育的使用。较贫穷、受教育程度较低、居住在农村的妇女对计划生育的需求更快增长是一个积极的趋势。然而，为了将这种需求转化为对长期现代方法的使用，必须改善农村和低收入城市地区获得高质量服务的机会。
