Abstract
Background
According to the recent 2007 Jordan Population and Family Health Survey (JPFHS), Jordan has been successful in increasing the use of modern family planning (FP) methods among married women ages 15–49. Since 2002, the country has made strides in expanding the availability of high-quality FP services and products through two Reproductive Health Action Plans (RHAP-I and RHAP-II). However, population growth, high unmet need for FP methods, and marked disparities in FP indicators for certain populations create near-term challenges for the government of Jordan to fully meet the FP needs of its population. This paper presents the findings of a market segmentation analysis to help inform policy and program implementation for family planning in Jordan.
Objectives
The purpose of this study was to conduct a desk-based analysis of the JPFHS 2007 to better understand and define the roles of the public, commercial, and nongovernmental organization (NGO) sectors in serving current and potential FP users. Specifically, the Health Policy Initiative analyzed socioeconomic and demographic characteristics across the five standard of living (SLI) quintiles and compared method use and provider sources by wealth quintiles to determine the extent to which FP use and provider choice behavior differed. Where data were available, 2007 results were compared to 2002 and 1997 JPFHS data to understand trends over time.
Results
Fifty-seven percent of currently married women are currently using some method of contraception, ranging from 48 percent of the poorest quintile to 62 percent of the wealthiest quintile. The methods of contraception used also vary by quintile; 26 percent of the wealthiest women use intrauterine devices (IUDs), compared with only 16 percent of the poorest women. Marked disparities in contraceptive use also exist between urban and rural residence for all methods. In particular, modern method use is five to 10 times higher in urban areas versus rural areas, depending on the method. Modern contraceptive use in rural areas is 31 percent among the poorest quintile, compared with 45 percent among the wealthiest quintile. A similar pattern between wealth quintiles was also observed for urban areas.
Use of the public sector is highest among the poorest quintile, while use of the commercial sector is highest among the wealthiest quintile. Of the 42 percent of users who obtain family planning from the public sector, 54 percent are in the poorest quintile and 25 percent are in the wealthiest quintile. Trends over the last 10 years indicate that the poorest women are shifting from the NGO and commercial sectors to the public sector. From 2002 to 2007, women’s use of contraceptives obtained through NGOs decreased from 33 percent to 24 percent in the poorest quintile and 20 percent to 14 percent in the wealthiest quintile. During this same period, use of contraceptives from the commercial sector increased from 15 to 19 percent in the poorest quintile and decreased from 62 to 60 percent in the wealthiest quintile.
In 2007, among the 7 percent of women ages 15–49 who were currently pregnant, 26 percent of their pregnancies, as well as their births in the last five years, were unintended—they were either mistimed (14.7%) or unplanned (11.3%). These figures represent a significant decline from 2002, when one-third of all births where mistimed (17.2%) or unplanned (15.9%). When broken down by quintile, unmet need for spacing and limiting vary greatly.
