State of World Population 2012 - Country Page List - UNFPA

through the wealthiest 20 per cent. Quintile
analyses of population-based surveys can help
identify inequalities and family planning needs
within countries, especially in combination with
data on urban-rural and other important dimensions
of access (Health Policy Initiative, Task
Order 1, 2010).
Because poverty takes on specific characteristics
within a given setting, some researchers
now advocate for separate quintile rankings for
urban and rural populations to paint a more
complete picture of inequalities between poverty
and wealth in both urban and rural areas.
This approach makes it possible to compare the
different experiences of poor women in urban
settings and relatively wealthy women in rural
communities. Research from a 16-country study
across Africa, Asia, and Latin America and the
Caribbean finds strong relationships between
family planning use, socioeconomic status,
and place of residence (Foreit, Karra and
Pandit-Rajani, 2010).
In countries such as Bangladesh, the prevalence
of modern contraceptive use is the same
across wealth quintiles in urban and rural settings:
there is a nominal difference between
contraceptive use among rich and poor in urban
communities, and between the wealthiest and
poorest within rural settings (Demographic
and Health Surveys, 2007). In Bangladesh, the
prevalence of contraceptive use is greater (by 6
per cent) in urban areas. Similar findings, which
support pro-rural strategies, have been found in
Peru, which would warrant pro-rural programming,
as would Bolivia, Ethiopia, Madagascar,
Tanzania and Zambia (Health Policy Initiative,
Task Order 1, 2010). In some countries, such as
Nigeria (DHS, 2008), modern contraceptive use
increases with increasing wealth for people who
live in urban and rural areas. The key difference
is the rate of change: wealthier people in rural
settings report higher use of contraceptives than
the urban poor. These results would support
policies that focus on reaching the urban poor,
especially if similar patterns of disparities exist
among indicators that measure adverse sexual
and reproductive health outcomes.
Educational achievement influences
desired family size, family planning use
and fertility
Level of schooling is associated with desired
family size, contraceptive use and fertility. An
analysis of 24 sub-Saharan African countries
showed that the adolescents most likely to
become mothers are poor, uneducated and live
in rural areas (Lloyd, 2009). Birth rates are
more than four times as high among uneducated
adolescent girls ages 15 to 19 as among
girls who have at least secondary schooling. A
similar gap exists based on wealth and residence.
And in these countries, the gaps are widening:
births among adolescent girls between the ages
of 15 and 19 with no education have increased
t
High school students
in Bucharest, Romania,
read a leaflet about
condoms.
©Panos/Peter Barker
THE STATE OF WORLD POPULATION 2012
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