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  • Title: [Sociodemographic determinants of women's health].
    Author: Ordonez Gomez M.
    Journal: Profamilia; 1991 Jun; 7(17):47-54. PubMed ID: 12284196.
    Abstract:
    This work correlates a series of variables influencing fertility, maternal-child health, and infant mortality from Colombia's 1990 Contraceptive Prevalence, Demography, and Health Survey for 13 regions of Colombia. Causes of death among women aged 15-49 years for 1989 are then examined, and an integrated health program developed by the Association for Family Welfare (PROFAMILIA) for lower income rural and semirural women is described as an example of a successful primary health care program. Colombia's total fertility rate declined from 7.0 in 1965 to 2.9 in 1990. The marital total fertility rate among some subgroups, however, still exceeds 5.0. Fertility is often higher in rural zones, among less educated women, and among those not employed outside the home. The major fertility determinants are family planning, nuptiality, and socioeconomic status, as well as infertility due to lactation and abortion. Family size ideals also play a role. The highest fertility in Colombia today is in the departments of the Atlantic region, in Choco and the Pacific Coast, and in the subregion of the departments of Tolima-Huila and Caqueta. According to the 1990 survey, 66% of women currently in union used a contraceptive method. 62.3% of women in Cali and 61.8% in Bogota used modern methods, compared to only 41% in Tolima-Huila-Caqueta and 43% in Guajira-Magdalena. About 52% of fertile-aged women in Colombia are currently in union. The region of highest fertility have the lowest ages at 1st sexual relations, 1st union, and birth of 1st child. The 1st birth occurred at an average age of 24 years in Antioquia compared to 20 years in the Atlantic Coast. The regions of highest fertility are also those with the greatest proportion of women in union: 60% in the Atlantic region and in Tolima-Huila-Caqueta but only 46% in Antioquia. Socioeconomic status is a major fertility determinant, working through education and accessibility of family planning services. The correlation between illiteracy and fertility in positive and significant. The 1990 survey indicated that there has been progress since 1986 in the proportion of women obtaining prenatal care and professionally attended at delivery, and that the prevalence of acute respiratory infections and diarrheal diseases among children under 5 has declined. Infant mortality rates have declined as well, but are higher among the youngest and oldest mothers and for higher birth order children and those born in rapid succession. Infant mortality was also highly correlated with accessibility of health care and with socioeconomic status. Abortion and obstetrical causes were the 6th major cause of death among fertile-aged women, accounting for 5.4% of deaths overall. Mortality rates from these causes were much higher in less developed departments, accounting for 9.3% of deaths to the age group in Tolima-Huila-Caqueta, 8.6% in Choco-Cauca-Narino, and 7.1% in Boyaca-Cundinamarca-Meta, compared to 3.3% in the Valle region and 2.8% in Antigua Caldas.
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