Senior lecturer, Department of Applied Statistics, College of Business and Economics, University of Rwanda, Huye,
Lecturer, Department of Economics, College of Business and Economics, University of Rwanda, Kigali.
Int Perspect Sex Reprod Health. 2019 Oct 4;45:13-23. doi: 10.1363/45e7519.
Evidence suggests that as Rwanda has strengthened its family planning program, disparities in contraceptive use by socioeconomic status have narrowed. However, the changes in these gaps, and the mechanisms that underlie them, are not well understood.
Data from the 2005, 2010 and 2015 Rwanda Demographic and Health Surveys on 19,028 in-union women aged 15-49 were analyzed to examine trends in socioeconomic disparities in contraceptive use. Descriptive statistics and multivariate regression with interaction terms were used to identify changes in these disparities, as well as to describe trends in desired fertility, and in types and sources of contraceptives used.
Between 2005 and 2015, the prevalence of modern contraceptive use rose from 11% to 48%. In the regression analysis, interaction terms indicated that prevalence increased to a lesser extent among women who were wealthy, had a least a secondary education or lived in urban areas than among those who were poor, were uneducated or lived in rural areas (odds ratios, 0.5-0.7). In parallel, declines in desired fertility were greater among women with no education than among those with at least a secondary education (by 0.7 vs. 0.5 children); among the poorest than the richest women (by 1.0 vs. 0.5 children); and among rural than urban residents (by 0.9 vs. 0.4 children).
The shrinking of gaps in contraceptive use by socioeconomic status coincided with narrowing of disparities in demand for children and with improvements in family planning services, suggesting that disadvantaged populations may have especially benefited from public programs to increase contraceptive access.
有证据表明，随着卢旺达加强计划生育项目，按社会经济地位划分的避孕方法使用率差距已经缩小。然而，这些差距的变化及其背后的机制仍未得到充分理解。
分析了 2005 年、2010 年和 2015 年卢旺达人口与健康调查中关于 19028 名 15-49 岁已婚妇女的数据，以检查避孕方法使用方面社会经济地位差距的变化趋势。采用描述性统计和带有交互项的多元回归来确定这些差距的变化，以及描述期望生育数量、使用的避孕方法类型和来源的趋势。
2005 年至 2015 年间，现代避孕方法的使用率从 11%上升到 48%。在回归分析中，交互项表明，富裕、受过至少中等教育或居住在城市地区的妇女的使用率增加幅度较小，而贫穷、未受教育或居住在农村地区的妇女的使用率增加幅度较大（比值比为 0.5-0.7）。同时，没有受过教育的妇女的期望生育数量下降幅度大于受过至少中等教育的妇女（减少 0.7 比 0.5 个孩子）；最贫穷的妇女比最富有的妇女下降幅度更大（减少 1.0 比 0.5 个孩子）；农村居民比城市居民下降幅度更大（减少 0.9 比 0.4 个孩子）。
避孕方法使用率的社会经济地位差距缩小与儿童需求差距缩小以及计划生育服务的改善同时发生，这表明弱势群体可能特别受益于增加避孕方法获取的公共项目。
