Quality of family planning services and contraceptive use dynamics among populations with limited mobility in the western Chitwan Valley of Nepal

Elizabeth G. Sutherland, University of North Carolina at Chapel Hill

Limited mobility populations are of special concern because they are vulnerable groups whose health outcomes are often highly dependent upon local services due to a constrained ability to travel to seek care. Limited mobility populations considered in this analysis are poor women, women with low participation in nonfamily activities, and women tied closely to home by heavy natural resource related responsibilities. In this study we employ multilevel discrete-time hazard models to estimate the impact of family planning service quality on the adoption and discontinuation of contraception among limited mobility populations. The Chitwan Valley Family Study presents a unique opportunity to examine these relationships because of extensive data collection on contraceptive use dynamics, natural resource behaviors, local healthcare service quality, family organization, and social participation. The study presents suggestions for family planning programs seeking to improve the health outcomes of women with limited mobility through improvements in local quality of care.