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Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
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OCR for page 69
SCARY OF RESULTS
Although the level of fertility is quite similar in
Colombia and Costa Rica, contraceptive prevalence in
greater and duration of use longer in Costa Rica, while
breastfeeding is more can and durations longer in
Colombia. Moreover, mortality is lower in Costa Rica
than in Colombia. In addition, the social and economic
climates of the two countries differ in Rome respects:
Colombia is somewhat more urbanized, but educational
attainment for both men and women is higher in Costa
Rica, while female labor force participation appears to
b e about the same in both counts in . The analys is
described in this paper has three stages: f irst, social
and economic character istics of the woman and her husband
are used to predict the propensity to breastfeed and the
propensity to contracept; second, dynamic models of the
duration of breastfeeding and the duration of contracep-
tive use, incorporating information about other experi-
ence~ in the birth interval, are estimated; finally,
conception rates are modeled using information about the
timing of breastfeeding, contraception, and child
mortality.
Although breastfeeding in nearly universal in Colombia,
and common but not universal in Costs Rica, in neither
country do the social and economic variables describing
education, place of residence, or experience in the labor
force serve as good predictors of whether or not a woman
will breastfeed . Such background character istics are
more successful in predicing the propensity to use
contraception. Although contraceptive prevalence is
considerably higher in Costa Rica than in Colombia, the
impact of soc ial and economic var tables is much grease r
in the latter country; this is consistent with the idea
that the success of the Costa Rican family planning
69
OCR for page 70
70
effort has not been confined to particular social or
economic strata. Nevertheless, in both countries,
better-educated and urban women are more likely to use
contraception.
The models of duration of breastfeeding and duration
of contraceptive use reveal important regularities as
well as behavioral differences between Colambia and Costa
Rica. As noted earlier, durations of breastfeeding are
longer and durations of contraceptive use shorter in
Colombia than in Costa Rica. Nevertheless, in both
countries, higher education of the woman or of her husband
and urban residence are associated with shorter durations
of breastfeeding. Child survival is associated with
longer durations of breastfeeding, but the impact of a
child death is much greater in Costa Rica, where durations
of breastfeeding are relatively short. As for contra-
ceptive use, not only are durations longer in Costa Rics,
but also the pattern of use is quite different, suggesting
differences in the decision-making process. There are
some similaritiess in both countries, for example,
better-educated and urban waken contracept longer. These
longer durations of use by urban women are particularly
marked in Colombia, which may be due to a greeter
concentration of family planning efforts in urban areas.
The differences became more apparent when method and
desire for an additional child are considered. In both
countries, women who use coitus-dependent methods and
those who desire an additional child have higher discon-
tinuation rates than other women. Among women using
cot/us-independent methods, in Colombia, discontinuation
rates are higher and concentrated in the first 3 to 5
months of use; in Costa Rica, these rates are much lower ,
and peak discontinuation is spread over the first year of
use. Similarly, in Colombia, women using coitus-dependent
methods show relatively high rates of discontinuation in
the first year and a half of use, whereas in Costa Rica,
discontinuation rates for these methods are higher for
short and for very long durations of use. In Costs Rica,
discontinuation rates for women who desire an additional
child do not diverge significantly from those of women
who do not until after 18 months of use; in Colombia,
discontinuation rates are shifted upward for women
desiring an additional child for all durations of use
greater than 3 months. This suggests that in Costa Rica,
women who desire additional children may use contracep-
tion for spacing purposes, whereas in Colombia, spacing
between births is obtained through near-universal
breastfeeding, although perhaps not intentionally.
OCR for page 71
71
In spite of these striking differences in breastfeeding
and contraceptive behavior, the y act of each of these
two variables on conception rates is remarkably similar
in the two countries, and generally agrees with expecta-
tions based on previous biometric research. Use of
contraception drastically shifts the conception rate
downward. The impact of brea~tfeeding on conception
rates is most marked at short durations and diminishes as
expected. In addition, background characteristics, with
the exception of urban residence, have little impact on
fertility except through contraceptive use. However,
although child mortality should inf luence fertility by
altering breastfeeding and contraceptive behavior, we
find that it continues to have a considerable impact on
conception rates, particularly at short interval lengths.
This suggests that infant mortality and short birth
intervals are mutually reinforcing in ways not captured
by the variables included in the model. Thus, the model
developed here is capable of revealing behavioral dif-
ferences in breastfeeding and contraception, as well as
describing biometric regularities in their impact on
fertility. It shows the details of how two quite
different countries have attained close to the same level
of fertility through quite different behavioral
mechanisms.
OCR for page 72
Representative terms from entire chapter:
discontinuation rates
