Sri Lanka.

Abstract

According to a survey of 5865 ever-married women 15-49 years in Sri Lanka, the island nation has relatively good immunization coverage, increasing contraceptive use, and declining fertility. In the 1960s and 1970s, the total fertility rate dropped from over 6.0 to 3.4. A "marriage boom" in the late 1970s contributed to a temporary fertility increase to a 3.7 child average. The 1987 Contraceptive Prevalence Survey showed that Sri Lankan fertility resumed its decline in the 1980s, recording an average total fertility rate of 2.8 children between 1982-86. Contraceptive prevalence also increased. An estimated 62% of married women 15-49 were currently using contraception in 1987 compared to 55% in 1982 and only 32% in 1974. 21% of the married women used rhythm, withdrawal, or prolonged abstinence as their methods, but 30% were protected by sterilization. Relatively small percentages chose oral contraception, condoms, or the IUD and injection. The women were less likely to use methods which necessitated repeat clinic or pharmacy visits. This preference most likely reflects the type of family planning services available. Nearly 80% of the married women indicated they did not want any more children; 69% in this age group were contracepting. Nearly all Sri Lankan pregnant mothers received prenatal care, and 87% of births during the 1982-86 period were assisted by medically trained personnel.