Abstract
The freedom to make informed decisions about one’s fertility is essential to securing the autonomy and well-being of women and girls while promoting the health and development of families and communities. Modern contraceptive use is significantly correlated with decreases in unintended pregnancy, maternal and newborn mortality, and unsafe abortion. It is also positively correlated with gains in individual- and population-level education and economic prosperity. Over the last few decades, policies and programs committed to increasing voluntary contraceptive use have made great strides across most of Latin America; however, to date, no country has been able to bridge the contraceptive use gap between the region’s indigenous and nonindigenous populations. As program planners and policy-makers look for ways to reduce these disparities, we assert that: (1) the most effective and efficient interventions will be those that address gender norms and inequalities that are significantly correlated with poor family planning outcomes; and (2) addressing these norms and inequalities among indigenous populations will require integrated, crosscutting approaches at all levels of program and policy planning, implementation, and evaluation. To make our argument, we highlight the pathways through which social constructs of gender roles and expectations serve as strong predictors for family planning outcomes. Then, through an analysis of gender norms among various indigenous populations across the region, we identify areas that can be best leveraged to see positive family planning results. We conclude by making recommendations on how to integrate gender into current and future initiatives and highlight the role that inter-sectorial action and systems-informed evaluation may play in such processes.
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- 1.
Contraceptive prevalence rate (CPR) is the percentage of women who are currently using, or whose sexual partner is currently using, at least one method of contraception at a particular point in time, regardless of the method used. Unless stated otherwise, it is usually measured among married or in-union women aged 15 to 49.
- 2.
Unmet need is a useful measurement for identifying and targeting women at high risk of unwanted pregnancy. It can be defined as the contraceptive needs of fecund women who want to delay or limit childbearing, yet who are still sexually active and not using contraception. Unmet need for modern contraception usually refers to the need for permanent methods (male and female sterilization), short-acting hormonal methods (pills, injectables, and vaginal ring), long-acting reversible contraception (implants and IUDs), barrier methods (male and female condoms, diaphragm, sponge), and/or emergency contraception.
- 3.
For example, though lack of decision-making power and control over resources are two overarching issues that come up in the literature, in Mexico there are a few matriarchal societies, such as the indigenous Zapotec community of Juchitan in Oaxaca, where women dominate trading and decision-making (DevTech Systems, Inc. 2012).
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Levy, J.K., Goold, A., Houston, A., Rios-Zertuche, D., Munar, W. (2018). Gender and Family Planning Among Indigenous Women in Mexico and Central America: A Call to Action. In: Schwartz, D. (eds) Maternal Death and Pregnancy-Related Morbidity Among Indigenous Women of Mexico and Central America. Global Maternal and Child Health. Springer, Cham. https://doi.org/10.1007/978-3-319-71538-4_6
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