TY - JOUR
T1 - Emergency Contraception in Mexico
T2 - Trends in Knowledge and Ever-Use 2006–2014
AU - Han, Leo
AU - Saavedra-Avendano, Biani
AU - Lambert, William
AU - Fu, Rongwei
AU - Rodriguez, Maria I.
AU - Edelman, Alison
AU - Darney, Blair
N1 - Funding Information:
We conducted a retrospective repeated cross-sectional study using the three most recent waves (2006, 2009, 2014) of the ENADID (Encuesta Nacional de la Dinámica Demográfica), a publically-available demographic survey (National Survey of Demographic Dynamics [ENADID] n.d.). ENADID is a 2-stage stratified probability sample from all 31 Mexican states and Mexico City; the sample is representative both at the state level and by rural urban stratum and permits population-level estimation. It is administered in a standardized interview format—in person through direct household visits (Instituto Nacional de Salud Publica [INEGI] 2006, 2009). 2006 is the first year EC use was included as a response option in the survey. This study was approved by the National Institute of Public Health and the Mexico ethics review committee, and deemed exempt by the Oregon Health & Science University institutional review board.
Funding Information:
B.D. and B.S. are partially supported by a Society of Family Planning Junior Investigator Award (SFPRF9-JI2). M.R. is a Women?s Reproductive Health Research fellow; Grant 1K12HD085809.
Funding Information:
Acknowledgements B.D. and B.S. are partially supported by a Society of Family Planning Junior Investigator Award (SFPRF9-JI2). M.R. is a Women’s Reproductive Health Research fellow; Grant 1K12HD085809.
Publisher Copyright:
© 2017, Springer Science+Business Media, LLC.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Objectives A package of interventions to introduce emergency contraception (EC) to Mexico was implemented, resulting in the addition of EC to the national family planning guidelines in 2004. We describe EC knowledge and use among women in Mexico over time. Methods We used the 2006, 2009, and 2014 of waves of a nationally representative demographic survey (ENADID). We assessed EC knowledge and usage in women ages 15–29 who are not using permanent methods and tested whether EC knowledge and use is changing over time after controlling for socio-demographic characteristics using logistic regression. Results Our sample included n = 99,223 (population N = 40,234,355) women ages 15–29. Overall, knowledge of EC increased over time: 62% in 2006 to 79% in 2009 to 83% in 2014 (p < 0.001). Among young women who have used contraception (n = 42,883; N = 16,816,701), the proportion that reported EC use increased from 3 to 11% to 29% (p < 0.001). Compared to non-users, women who had ever used EC were more likely to be using no method of contraception (44 vs. 35%) or barrier method (22 vs. 17%). Demographic factors including lower wealth, lower education, indigenous status and rural living are significantly associated with less EC knowledge and use. Stratified multivariate analysis found that demographic disadvantages magnify lower EC use among rural residents compared to non-rural residents. Conclusions for Practice Knowledge and use of EC are growing rapidly in Mexico, but disparities persist in demographically disadvantaged women, particularly those living in rural areas. Women who use EC appear to be at higher risk of unintended pregnancy based on current contraceptive use.
AB - Objectives A package of interventions to introduce emergency contraception (EC) to Mexico was implemented, resulting in the addition of EC to the national family planning guidelines in 2004. We describe EC knowledge and use among women in Mexico over time. Methods We used the 2006, 2009, and 2014 of waves of a nationally representative demographic survey (ENADID). We assessed EC knowledge and usage in women ages 15–29 who are not using permanent methods and tested whether EC knowledge and use is changing over time after controlling for socio-demographic characteristics using logistic regression. Results Our sample included n = 99,223 (population N = 40,234,355) women ages 15–29. Overall, knowledge of EC increased over time: 62% in 2006 to 79% in 2009 to 83% in 2014 (p < 0.001). Among young women who have used contraception (n = 42,883; N = 16,816,701), the proportion that reported EC use increased from 3 to 11% to 29% (p < 0.001). Compared to non-users, women who had ever used EC were more likely to be using no method of contraception (44 vs. 35%) or barrier method (22 vs. 17%). Demographic factors including lower wealth, lower education, indigenous status and rural living are significantly associated with less EC knowledge and use. Stratified multivariate analysis found that demographic disadvantages magnify lower EC use among rural residents compared to non-rural residents. Conclusions for Practice Knowledge and use of EC are growing rapidly in Mexico, but disparities persist in demographically disadvantaged women, particularly those living in rural areas. Women who use EC appear to be at higher risk of unintended pregnancy based on current contraceptive use.
KW - Contraception
KW - ENADID
KW - Emergency contraception
KW - Mexico
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U2 - 10.1007/s10995-017-2328-6
DO - 10.1007/s10995-017-2328-6
M3 - Article
C2 - 28699094
AN - SCOPUS:85023204421
VL - 21
SP - 2132
EP - 2139
JO - Maternal and Child Health Journal
JF - Maternal and Child Health Journal
SN - 1092-7875
IS - 11
ER -