Contraceptive Practices in Honduras and Nicaragua: Age, Period and Cohort Differences over the Past 15 Years
Andreea A. Creanga, U.S. Centers for Disease Control and Prevention (CDC)
Paul Stupp, U.S. Centers for Disease Control and Prevention (CDC)
Daniel Williams, U.S. Centers for Disease Control and Prevention (CDC)
Carrie Shapiro-Mendoza, Centers for Disease Control and Prevention
This analysis examines age, period and cohort effects in contraceptive practices in Honduras and Nicaragua. We pooled data from four rounds of nationally-representative cross-sectional reproductive health surveys conducted in Honduras and Nicaragua from 1991 through 2006 and constructed synthetic birth-cohorts of reproductive-aged women(Honduras: n=27,214; Nicaragua: n=30,125). We adopted a hierarchical multi-level approach and specified separate logit cross-classified random-effects models for practice of any contraceptive method, modern methods and female sterilization adjusting for women’s residence, education and household wealth. Cohort effects have independently contributed to the increase in the use of all contraceptive methods, and disproportionally so to the increase in female sterilization practice in both countries (p<0.001). Period effects affected the use of all modern methods considered together more so than birth-cohort membership (Honduras: coef=0.276 vs. coef=0.187; Nicaragua: coef=0.432 vs. coef=0.203; all p-values<0.05). Strategies such as targeted contraceptive counseling and mass-media campaigns may increase women’s use of non-surgical modern contraception.