MEETING DIFFERENT NEEDS FOR CONTRACEPTION: A TREND ANALYSIS OF THE UNMET NEED AMONG DIFFERENT NEEDS AND DEMANDS GROUPS IN TÜRKİYE

Öz

Çok az ülke gebeliği önleyici modern yöntemlere erişimin önündeki zorlu engeller konusunda Aile Planlaması 2020 tarafından belirlenen hedeflere ulaşabilmiştir. Karşılanmamış aile planlaması ihtiyacının Türkiye’de 2013-2018 arasındaki 5 yıllık dönemde iki katına çıkmış olması konunun önemini bir kez daha gözler önüne sermiştir. Bu çalışmada, Türkiye’deki farklı ihtiyaç ve talep grupları arasındaki karşılanmamış gebeliği önleyici yöntem kullanımı ihtiyacı incelenmiştir. 2018 Nüfus ve Sağlık Araştırması (2018 TNSA) dayanan bu çalışma farklı paritelere sahip, farklı eğitim düzeylerinde, farklı refah gruplarındaki hanelerde yaşayan kadınlar arasında ve tüm yaş gruplarında karşılanmamış ihtiyacın boyutu artmış olduğunu göstermiştir. Eğitim düzeyi ve refah durumu ne olursa olsun, doğumlara ara vere ihtiyacı kadınlar arasında daha yaygındır. Yalnızca kontraseptif kullanmayanlar değil, aynı zamanda kullananların da karşılanmamış aile planlaması gereksinimleri olabilir. Başka bir yönteme geçme isteği, karşılanması gereken bir diğer talep olarak değerlendirilebilir.

Anahtar Kelimeler

• Karşılanmamış aile planlaması ihtiyacı
• gebeliği önleyici yöntem talebi
• Türkiye

DOĞUM KONTROLÜ İÇİN FARKLI İHTİYAÇLARIN KARŞILANMASI: TÜRKİYE’DEKİ FARKLI İHTİYAÇ VE TALEP GRUPLARI ARASINDA KARŞILANMAYAN İHTİYAÇLARIN TREND ANALİZİ

Öz

Very few countries were able to achieve the set targets of Family Planning 2020 on the challenging obstacles to access to modern contraceptive methods, The fact that the unmet need doubled in the 5-year period between 2013 and 2018 in Türkiye once again reveals the importance of the issue. In this study, the unmet need for contraceptive use among different needs and demand groups in Türkiye was examined. This study, based on the 2018 Demographic and Health Survey (2018 TDHS), has shown that the size of unmet need has increased among women living in households with different parities, different education levels, different wealth groups and in all age groups. Regardless of educational attainment and wealth status, limiting needs have become more common among women. Not only the non-user but also contraceptive users might also have unsatisfied family planning needs. The desire to switch to another method can be regarded as contraceptive demand that has to be fulfilled.

Anahtar Kelimeler

• Unmet need of family planning
• contraceptive demand
• Türkiye

Kaynakça

1. Ahinkorah, B. O., Ameyaw, E. K., & Seidu, A. A. (2020). Socio-economic and demographic predictors of unmet need for contraception among young women in sub-Saharan Africa: evidence from cross-sectional surveys. Reproductive Health, 17(1), 1–11. https://doi.org/10.1186/s12978-020-01018-2
2. Armand, F., Mitchell, S. (2014). Implementing total market approaches: family planning and beyond. Cases in Public Health Communication & Marketing, 8(1), 121-127.
3. Asif, M. F., & Pervaiz, Z. (2019). Socio-demographic determinants of unmet need for family planning among married women in Pakistan. BMC Public Health, 19(1), 1–8. https://doi.org/10.1186/s12889-019-7487-5
4. Aydoğdu, S. G. M. (2018). Amasya İl Merkezindeki Aile Sağlığı Merkezlerine Başvuran Kadınların Aile Planlaması Yöntem Kullanımı ve Etkileyen Faktörler. STED / Sürekli Tıp Eğitimi Dergisi, 27(6), 384–392. https://doi.org/10.17942/sted.513458
5. Barnes, J., Vail, J., & Crosby, D. (2012). Total Market Initiatives for Reproductive Health. Bethesda, MD: Strengthening Health Outcomes through the Private Sector Project, Abt Associates.
6. Bradley, S. E. K., Croft, T. N., & Fishel, J. D. (2012). Revising Unmet Need for Family Planning: DHS Analytical Studies No. 25. Calverton, Maryland, USA: ICF International.
7. Brady, C., Weeden, L., Hutchings, J.., Parks, J. (2016). Planning Guide for a Total Market Approach to Increase Access to Family Planning. Module 1: Landscape Assessment. Seattle, WA: PATH and Washington, DC: The Population Council, Evidence Project.
8. Brunner, B., Merida, M., Crosby, D., & Miles, L. (2014). Revisiting a total market approach to contraceptive security in Honduras. Cases in Public Health Communication & Marketing, 8(1), 64–85.

9. Bongaarts, J. (1991). The KAP-gap and the unmet need for contraception. Population and Development Review, 17(2), 293-315.
10. Cisek, C.R., Klein, K., Koseki, S., Wood, R. (2019). Strengthening family planning stewardship with a total market approach: Mali, Uganda, and Kenya experiences. Public Admin Dev, 39(1), 47– 56. https://doi.org/10.1002/pad.1840
11. Cook, R. J. (1995). Human rights and reproductive self-determination Conference on the Interventional Protection of Reproductive Rights: Keynote Speakers. The American University Law Review, 44(4), 975-1016.
12. Correa, S., & Petchesky, R. (1994). Reproductive and sexual rights. A feminist perspective. In G. Sen, A. Germain and L. C. Chen (eds.), Population Policies Reconsidered: Health, Empowerment, and Rights (pp. 107-123). Boston-New York: Harvard Center for Population and Development Studies and International Women’s Health Coalition.
13. Costa, A. M. (2000). On women’s right to experience their sexuality free from illness. In Latin American and Caribbean Women’s Health Network, Women’s Health Collection 5, Santiago, Chile: Latin American and Caribbean Women’s Health Network.
14. Çavlin, A. and Çağatay, P. (2020). The Unmet Need for Family Planning in Turkey. Global Goals Local Conditions. Policy Brief Hacettepe University Institute of Population Studies and UNFPA.
15. Dixon-Mueller, R., & Germain, A. (1993). Four Essays on Birth Control Needs and Risks. Reproductive Tracts: Issues and Innovations in Reproductive Health. New York: International Women’s Health Coalition.
16. Drake, J.K., Vail, J.G., Stewart, J.R. (2014). Best practices for fostering family planning total markets in Indonesia, Mexico, Romania, Thailand, and Turkey: a retrospective analysis. Cases in Public Health Communication & Marketing, 8(1), 19-41.
17. Ewerling, F., Victora, C. G., Raj, A., Coll, C. V. N., Hellwig, F., & Barros, A. J. D. (2018). Demand for family planning satisfied with modern methods among sexually active women in low- and middle-income countries: Who is lagging behind? Reproductive Health, 15(1), 1–10. https://doi.org/10.1186/s12978-018-0483-x
18. Getaneh, T., Negesse, A., Dessie, G., Desta, M., & Moltot, T. (2020). Predictors of unmet need for family planning in Ethiopia 2019: a systematic review and meta analysis. Archives of Public Health, 78(1), 1–11. https://doi.org/10.1186/s13690- 020-00483-2
19. Gunter, B., & Furnham, A. (1992). Consumer profiles: An introduction to psychographics. Routledge, London.
20. Hardee, K., Kumar, J., Newman, K., Bakamjian, L., Harris, S., Rodríguez, M., & Brown, W. (2014). Voluntary, Human Rights-Based Family Planning: A Conceptual Framework. Studies in Family Planning, 45(1), 1–18. http://www.jstor.org/stable/23654769
21. Hardee, K., and Jordan, S. (2019). Contributions of FP2020 in Advancing Rights- Based Family Planning: Upholding and Advancing the Promises of Cairo. FP2020–Technical Report.
22. Health Policy Plus Project. (2017). Applying a Total Market Approach to DMPA-SC. Washington, DC: Palladium, Health Policy Plus.
23. Htat, H. W., Longfield, K., Mundy, G., Win, Z., & Montagu, D. (2015). A total market approach for condoms in Myanmar: The need for the private, public, and socially marketed sectors to work together for a sustainable condom market for HIV prevention. Health Policy and Planning, 30(1), 14–22. https://doi.org/10.1093/ heapol/czu056
24. HUIPS (Hacettepe University Institute of Population Studies) (1994). Turkey Demographic and Health Survey 1993. Ankara: HUIPS, Hacettepe University Institute of Population Studies, Ministry of Health and Macro International Inc.
25. —— (1999). Turkey Demographic and Health Survey 1998. Ankara: HUIPS, Hacettepe University Institute of Population Studies, Ministry of Health General Directorate of Mother and Child Health and Macro International Inc.
26. —— (2004). Turkey Demographic and Health Survey 2003. Ankara: HUIPS, Hacettepe University Institute of Population Studies, Ministry of Health General Directorate of Mother and Child Health and Family Planning, State Planning Organization and European Union.
27. —— (2009). Turkey Demographic and Health Survey 2008. Ankara: HUIPS, Hacettepe University Institute of Population Studies, Ministry of Health General Directorate of Mother and Child Health and Family Planning, Turkish Republic Prime Ministry Undersecretary of the State Planning Organization, Turkish Scientific and Technological Research Council.
28. —— (2014). 2013 Turkey Demographic and Health Survey. Ankara: HUIPS, Hacettepe University Institute of Population Studies, T.R Ministry of Development, T.R. Ministry of Health, Turkish Scientific and Technological Research Council.
29. —— (2019). 2018 Turkey Demographic and Health Survey. Hacettepe University Institute of Population Studies, T.R Ministry of Development, T.R. Presidency of Turkey Directorate of Strategy and Budget, and Turkish Scientific and Technological Research Council.
30. Jabeen, S., Rathor, A., Riaz, M., Zakar, R., & Fischer, F. (2020). Demand- and supply- side factors associated with the use of contraceptive methods in Pakistan: a comparative study of demographic and health surveys, 1990-2018. BMC women’s health, 20(1), 265. https://doi.org/10.1186/s12905-020-01112-4
31. Kotler, P., & Armstrong, G. (2001). Principles of marketing. 9th edition. New Jersey: Prentice Hall Inc., 785 p.
32. Kotler, P. & Keller, K. L. (2009) Marketing Management Pearson Education International, 13th Edition. Pearson.
33. Mason, K. O. (1994). Do population programs violate women’s rights? Asia Pacific Issues, 15, 1-8.
34. Mozumdar, A., Acharya, R., Mondal, S. K., Shah, A. A., & Saggurti, N. (2019). India’s family planning market and opportunities for the private sector: An analysis using the total market approach. The International journal of health planning and management, 34(4), 1078–1096. https://doi.org/10.1002/hpm.2753
35. Ozdemir, R., Cevik, C., Ciceklioglu, M. (2019). Unmet needs for family planning among married women aged 15–49 years living in two settlements with different socioeconomic and cultural characteristics: a cross-sectional study from Karabuk Province in Turkey. Rural and Remote Health, 19(5125), 1-9. https://doi.org/10.22605/RRH5125
36. Population Foundation of India, 2020. Meeting the Unmet Need A Choice-Based Approach to Family Planning. Retrieved from https://www.familyplanning2020.org/sites/default/files/resources/2020/Choice-Based-FP-White-Paper.pdf
37. Riley, T., Sully, E., Ahmed, Z., & Biddlecom, A. (2020). Estimates of the Potential Impact of the COVID-19 Pandemic on Sexual and Reproductive Health In Low-and Middle-Income Countries. International perspectives on sexual and reproductive health, 46, 73–76. https://doi.org/10.1363/46e9020
38. Sinding, S. W. (1993). Getting to Replacement: Bridging the Gap between Individual Rights and Demographic Goals. Demography India, 22(1), 1-10.
39. Taruberekera, N., Chatora, K., Leuschner, S., Munjoma, M., Sithole, H., Balasubramanian, S Park, F. J., Rego, R., Rowan, A., & Longfield, K. (2019). Strategic donor investments for strengthening condom markets: The case of Zimbabwe. PLoS ONE 14(9): e0221581.
40. United Nations Department of Economic and Social Affairs, Population Division (2020). World Family Planning 2020 Highlights: Accelerating action to ensure universal access to family planning (ST/ESA/SER.A/450).
41. UNFPA and PATH(2008). Reducing unmet need for family planning: evidence-based strategies and approaches. Outlook, 25(1), 1-8. http://www.unfpa.org/webdav/site/global/shared/documents/publications/2008/EOL_nov08.pdf
42. U.S. Agency for International Development (n.d.). Total market approach. Retrieved October 15, 2021. Retrieved from https://www.fpfinancingroadmap.org/learning/specific-topics/total-market-approach
43. USAID | DELIVER PROJECT, Task Order 4. 2014. A Participatory Approach: Using Evidence to Support a Total Market Approach to Family Planning. Arlington, Va.: USAID | DELIVER PROJECT, Task Order 4.
44. Westoff, C.F. (1978). The unmet need for birth control in five Asian countries. International Family Planning Perspectives, 10(3), 173-181.
45. Westoff, C.F. and Bankole, A. (1995), Unmet Need: 1990-1994, Demographic and Health Surveys Comparative Studies. No.6. Macro International, Calverton, Maryland.
46. World Health Organization. (‎2017)‎. Family planning evidence brief: accelerating uptake of voluntary, rights-based family planning in developing countries. World Health Organization. https://apps.who.int/iris/handle/10665/255859. License: CC BY-NC-SA 3.0 IGO
47. Yücel, U., Çiçeklioğlu, M., Öcek, Z. A., & Varol, Z. S. (2020). Access to primary health care family planning services and contraceptive use in disadvantaged women: a qualitative study. European Journal of Contraception and Reproductive Health Care, 25(5), 327–333. https://doi.org/10.1080/13625187.2020.1795119