Accessibility of Family Planning Services and Contraceptive Use Dynamics among Limited Mobility Populations 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 status, and women tied closely to home by heavy natural resource related responsibilities. In this study multilevel discrete-time hazard models are employed to estimate the impact of family planning service accessibility on the probablity of 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 longitudinal contraceptive use, natural resource behaviors, healthcare service accessibility, family organization, and social participation. The study presents suggestions for family planning programs seeking to improve the accessibility of family planning services and the health outcomes of women with limited mobility.