Oral contraceptive use

Type Working Paper - Health and population studies based on the 1987 Thailand Demographic and Health Survey: Demographic and Health Surveys further analysis series number 1
Title Oral contraceptive use
Author(s)
Publication (Day/Month/Year) 1989
Page numbers 123
Abstract
The study of oral contraceptive use in Thailand utilizing data collected from the Thai Demographic and Heath Survey (TDHS) has investigated four topics related to oral contraceptive use: (1) differentials in use among married women of different demographic and socio-economic backgrounds; (2) the source of supply in relation to the cost of the most recent cycle and the background characteristics of users; (3) the patterns of switching to or from use of oral contraceptives (4) and the extent to which users forget to take a pill daily.

The principal findings on oral contraceptive use are:

1. There are substantial differences in prevalence of use among according demographic and socio-economic background characteristics. The percentage of women in the oldest age group who have ever used pills is relatively low reflecting the low availability of oral contraceptives on a national level in the contraceptive market prior to widespread distribution through the National Family Planning Program. The prevalence of current oral contraceptive use also reveals differences in the purpose for which contraceptive is practiced. Among all temporary methods used, pills dominate slightly more among urban than rural women. The highest prevalence is found in the North followed by Bangkok, the remainder of central, the Northeast and the South respectively. Women of 4-6 years of education are more likely to practice pills in higher proportions than women of other educational levels. The oral contraceptive prevalence rate of Buddhists is twice that of Moslems.

2. The local government health center is the most prevalent source of oral contraceptives in rural areas. In urban areas, the private sector, particularly the pharmacy, is the predominant urban source. Rural women arc more likely to receive pills free from government sources. For those who have to pay for pills, the clients of government outlets pay less than the clients of private sectors. The decision as to whether or not a client of a government source must pay for pills appears to be based primarily on factors other than the economic and social circumstances of the clients.

3. The majority of women who initially use pills switch to injection and female sterilization. More than one in three of women who started using some other temporary method rather than the pill shifted to the pill at sometime. The relationship between the pill and injection is prominent when the relationship between current use and use of previous methods is examined. An association with use of "ineffective" methods such as periodic abstinence or withdrawal is also detected in this study. The shift of use from
condom, periodic abstinence and withdrawal to other methods reflect the inefficiency of these methods.

4. One-fourth of current pill users reported forgetting to take the pills at least once during the previous month. Women in Bangkok were most likely to forget to take pills followed by provincial urban and rural women respectively. Older women forgot to take pills more times in a month than younger women. Women with less schooling are less likely to forget a pill than women with higher education. Women who do not want more children and presumably hae stronger contraceptive motivation than women who still want more children tend to forget to take the pill less. Women of highest economic status and women who work in agriculture are less likely to forget to take pills than women of lower economic status and women who work outside agriculture. Women who obtained pills from government sources and obtained them free take pills more currectly than women who purchased pills from private sectors. The extent of oral contraceptive compliance may depend on the interaction between pill acceptors and pill providers. The availability and accessibility of pills are not the main factors that have a significant impact on fertility control. The performance of thc providers has to be taken into consideration for the effective use of pills as a means to control fertility.

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