State of World Population 2012 - UNFPA Haiti

through the wealthiest 20 per cent. Quintileanalyses of population-based surveys can helpidentify inequalities and family planning needswithin countries, especially in combination withdata on urban-rural and other important dimensionsof access (Health Policy Initiative, TaskOrder 1, 2010).Because poverty takes on specific characteristicswithin a given setting, some researchersnow advocate for separate quintile rankings forurban and rural populations to paint a morecomplete picture of inequalities between povertyand wealth in both urban and rural areas.This approach makes it possible to compare thedifferent experiences of poor women in urbansettings and relatively wealthy women in ruralcommunities. Research from a 16-country studyacross Africa, Asia, and Latin America and theCaribbean finds strong relationships betweenfamily planning use, socioeconomic status,and place of residence (Foreit, Karra andPandit-Rajani, 2010).In countries such as Bangladesh, the prevalenceof modern contraceptive use is the sameacross wealth quintiles in urban and rural settings:there is a nominal difference betweencontraceptive use among rich and poor in urbancommunities, and between the wealthiest andpoorest within rural settings (Demographicand Health Surveys, 2007). In Bangladesh, theprevalence of contraceptive use is greater (by 6per cent) in urban areas. Similar findings, whichsupport pro-rural strategies, have been found inPeru, 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 asNigeria (DHS, 2008), modern contraceptive useincreases with increasing wealth for people wholive in urban and rural areas. The key differenceis the rate of change: wealthier people in ruralsettings report higher use of contraceptives thanthe urban poor. These results would supportpolicies that focus on reaching the urban poor,especially if similar patterns of disparities existamong indicators that measure adverse sexualand reproductive health outcomes.Educational achievement influencesdesired family size, family planning useand fertilityLevel of schooling is associated with desiredfamily size, contraceptive use and fertility. Ananalysis of 24 sub-Saharan African countriesshowed that the adolescents most likely tobecome mothers are poor, uneducated and livein rural areas (Lloyd, 2009). Birth rates aremore than four times as high among uneducatedadolescent girls ages 15 to 19 as amonggirls who have at least secondary schooling. Asimilar gap exists based on wealth and residence.And in these countries, the gaps are widening:births among adolescent girls between the agesof 15 and 19 with no education have increasedtHigh school studentsin Bucharest, Romania,read a leaflet aboutcondoms.©Panos/Peter BarkerTHE STATE OF WORLD POPULATION 201219