Callata-Cardenas Sandra, Peña-Cerna Fátima Milagros Del Rosario, Hernández-Vásquez Akram, Azañedo Diego
Faculty of Health Sciences, Universidad Científica del Sur, Lima 15067, Peru.
Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima 15046, Peru.
Healthcare (Basel). 2023 Aug 14;11(16):2293. doi: 10.3390/healthcare11162293.
The objective of this study was to determine the socioeconomic inequalities and factors associated with the use of modern contraceptive methods (MCM) in the population of sexually active women of childbearing age in Ecuador. This was an analytical observational study, based on a secondary data analysis of the 2018 National Health and Nutrition Survey (ENSANUT). Information on 19,106 sexually active, married, or cohabiting women between the ages of 15 and 49 were included. Concentration curves (CC) and Erreygers concentration indices (ECI) were calculated, taking into account the use of MCM as the dependent variable and the wealth index as the independent variable. Crude and adjusted prevalence ratios with 95% confidence intervals were calculated using generalized linear models of the Poisson family. We found that 92.8% of the women surveyed used some type of MCM in the last month. A higher educational level presented a significant pro-rich concentration in the use of MCM (EIC: 0.05; = 0.004). On the other hand, women belonging to the age group of 20 to 29 years (ECI: -0.027; = 0.027), women with no job (ECI: -0.025; = 0.004), and non-indigenous women (EIC: -0.031; < 0.001), presented a pro-poor concentration. Factors significantly associated with MCM use were age, marital status, occupation, parity, ethnicity, area of residence, and living on the coast. In Ecuador, there are socioeconomic inequalities at different levels of population subgroups in women of childbearing age. Measures to promote the use of MCM are required, focusing on groups that present inequality, taking into account the factors associated with their use.
本研究的目的是确定厄瓜多尔育龄性活跃女性群体中与现代避孕方法（MCM）使用相关的社会经济不平等及因素。这是一项分析性观察研究，基于对2018年全国健康与营养调查（ENSANUT）的二次数据分析。纳入了19106名年龄在15至49岁之间的性活跃、已婚或同居女性的信息。以MCM的使用作为因变量，财富指数作为自变量，计算了浓度曲线（CC）和埃雷格斯浓度指数（ECI）。使用泊松族广义线性模型计算了95%置信区间的粗患病率和调整患病率比值。我们发现，92.8%的受访女性在上个月使用了某种类型的MCM。在MCM的使用方面，较高的教育水平呈现出显著的有利于富人的集中趋势（EIC：0.05；P = 0.004）。另一方面，年龄在20至29岁的女性（ECI：-0.027；P = 0.027）、无工作的女性（ECI：-0.025；P = 0.004）以及非土著女性（EIC：-0.031；P < 0.001）呈现出有利于穷人的集中趋势。与MCM使用显著相关的因素包括年龄、婚姻状况、职业、生育次数、种族、居住地区以及居住在沿海地区。在厄瓜多尔，育龄女性在不同人口亚组层面存在社会经济不平等。需要采取措施促进MCM的使用，重点关注存在不平等的群体，并考虑与其使用相关的因素。
