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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
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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.
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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.
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