An Analysis of Contraceptive Method Choice among Married Women of Kanchanaburi Demographic Surveillance site in Thailand

Abstract

Introduction: The Fertility of Thailand declined to 1.6 in 2014 compared to 6.5 in the early sixties. This fertility revolution was accompanied by a concurrent revolution of contraceptive behavior among Thai people. This study examined the role of individual and geospatial factors to explain the variation in contraceptive method choice among married in two selected districts of Kanchanaburi Province, Thailand. Methods: The sample size in this study was 1468. The study population was currently married women of reproductive age (15-49 years) who were residing in two selected districts of Kanchanaburi province, Sai Yok and Muang districts, collected under the Kanchanaburi Demographic Surveillance Site (KDSS) project from 2004 to 2006. The study performed multinomial logistic regression for statistical analysis and Arc view GIS for spatial analysis to identify the factors associated with contraceptive method choice. Results: The women in the middle age group and urban women were more likely to use permanent methods over non use and temporary methods compared to young and rural women respectively. Women having higher than secondary education used both temporary and permanent contraceptive methods 2.5 times more than uneducated women (AOR 2.43; 95% CI 1.33– 4.46 for temporary versus none and AOR 2.54; 95% CI 1.29 – 5.01 for permanent versus none respectively). If women has no children, they were significantly less likely to use permanent method over non-use as well as over temporary methods. Geo-spatial analysis results showed transportation facilities determine the contraceptive choice. Conclusion: The better transportation network facilitated women to use a permanent contraceptive method rather than the temporary method. It is necessary to establish a better transportation system and education system in the areas, especially in the mountainous regions to improve accessibility and to realize reproductive health services. Further, investments in increasing women's access to various contraceptive options are urgently needed.