Trends of contraceptive use in Colombia from 1990 to 2005

Since the 1990's the Colombian health system provides universal access to family-planning services. Hence, the importance of evaluating trend changes in contraceptive use.Objectives: To evaluate the trends in unmet needs, failure and contraceptive use, by socio-demographic and geographic characteristics from 1990-2005. Methods: A probabilistic-multistage sample from the National Demographic and Health Survey representing the five regions of Colombia conducted in the years 1990, 1995, 2000 and 2005 was used. The sample included 35,309 females 15- 49 years old who reported having or having had any sexual partner. Statistical analysis was conducted accounting for weighting and sample design. Results: A significant increasing trend from 1990-2005 was observed in the prevalence of use of any contraceptive method (66.1%-78.2%). Adolescents presented the lowest prevalence in contraceptive use and were more likely to report unmet needs and contraceptive failure. However, the population of adolescents had the highest increase in the prevalence of contraceptive use (1990:36.9 to 2005:57.2). Regarding geographic area and socioeconomic-status (SES), we found a disparity in contraceptive use indicating that females in urban areas or higher SES were more likely to report contraceptive use. This disparity decreased from the 1990xs to 2000 ([1990: urban 69.1% vs. rural 59.1%; 2005:78.8% vs. 76.7%]; [1995:high-SES 77.0% vs. low 58.4%, .; 2005:80.7%.vs. 73.0%]). Conclusion: The lower prevalence of contraceptive use among adolescents and the higher prevalence of unmet needs suggest the need to target programs to this population. The decrease in disparity by area and SES could be the result of the implementation of family planning programs.