1. Contraceptive Trends Among Women at Reproductive Age
in Cambodia, from 2007 to 2009
Authors: K Sotheary, A Beyer, G Mundy, D Rosen
Population Services International
BACKGROUND
The modern contraceptive prevalence rate (CPR) among married women in Cambodia increased from 19% in 2000 to 27% in 2005 (CDHS, 2005). Nonetheless, it falls significantly short of the government’s Millennium Development Goal of 60% by 2015, and roughly a quarter of all Cambodian women report an unmet need for family planning (FP). Low levels of FP are contributing to a high maternal mortality of 472 deaths per 100,000 live births in recent years.
DESCRIPTION
PSI/Cambodia’s existing reproductive health programs are increasing demand for, and access to, high quality affordable reproductive health services and products to low-income women of reproductive age (WRA). This includes the sales, distribution and provision of services for oral contraceptive pills, DMPA injections, IUDs and implants. To monitor the impact of PSI‘s programs, two cross-sectional surveys were conducted in 2007 and 2009.
METHODOLOGY
Baseline survey in 2007 (n= 704) and follow-up survey (n= 859) in Kampot and Kampong Thom provinces, Cambodia.
Stratified multiple-stage design, with systematic random sampling
RESULTS
The CPR has remained static over the reporting period % in 2007 and 39.7% in 2009 (this difference is not statistically significant);
There was an increase in the proportion of women who have ever used a modern birth spacing method. However, the rate of discontinuation has also increased significantly;
There was an increase in the rate of discontinuation of modern BS methods.
Reported discontinuation because of side effects increased by nearly double.
Reported discontinuation because of a desire to have more children fell significantly.
 As myths and misconceptions persist, women associate them as real and perceived ‘side effects.’ It is likely that a portion of those who reported discontinuation as a result of ‘side effects’ stopped because of misconceptions;
Both rounds found that husbands and health care workers remain by far, the most significant positive influences in women’s decisions to use.
2007
2009
Currently use a modern
contraception
Ever used a modern
Ever discontinued
using a modern
42.7%
39.7%
n.s.
60.8%
65.9%
***
54.5%
65.4%
*** Significantly different at p < 0.001
sig.
Ever discontinued
using a modern
contraception because
of side effects
26.2%
44.9%
Ever discontinued
using a modern
contraception because
wanted more children
52.2%
31.1%
***
CONCLUSIONS
These data indicate that more women are being encouraged to try modern contraception but that a higher proportion are also giving up on use. Greater programmatic focus on reducing discontinuity rates is needed.
Programs should address the real and perceived side effects and ensure opportunities to switch methods- particularly from hormonal methods to non-hormonal methods such as IUDs.
This research was supported by Kreditanstalt fuer Wiederaufbau (KfW) and conducted by PSI/Cambodia Strategic Information Department, PSI/Cambodia. Contact: Khim Sotheary
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