[Knowledge and practice of contraception in Haiti: a factor in fertility decline over the last two decades?]. / La connaissance et la pratique de la contraception en Haiti: facteur de la baisse de la fecondite depuis deux decennies?

PIP: Information on contraceptive knowledge and practice in Haiti is available from four national surveys taken over 20 years: the 1977 Haiti Fertility Survey, the 1983 Contraceptive Prevalence Survey, the 1989 National Survey of Contraception, and the 1994-95 Survey of Mortality, Morbidity, and Use of Services. The proportion of Haitian women in union declaring knowledge of at least one contraceptive method increased from 83% in 1977 to 99% in 1994-95. The influence of educational level and rural or urban residence on knowledge declined over time and was virtually nil by 1995. The surveys indicated that, among women in union, 18% used a contraceptive method in 1977, 7% in 1983, 10% in 1989, and 17% in 1995. Educated and urban women had higher rates of contraceptive usage. The use of traditional methods has declined since 1977, while the proportion of women using modern methods increased from 5% in 1977 to 13% in 1995. Combining the survey results reporting contraceptive practice with analyses of the proximate determinants indicates that contraceptive usage only partially explains the decline in Haiti's total fertility rate from 6 in 1982-83 to 4.8 in 1995. Assuming that the natural fertility rate has remained constant at 17.7 children/woman over the past 2 decades, it was estimated, using the Bongaarts method, that in 1994-95 7.4 births were avoided due to marriage patterns, 3.6 due to breast-feeding and postpartum infecundity, 1.3 due to contraception, and 0.6 due to abortion. It is very likely that the impact of duration of union will decline in the future, as premarital sexual activity increasingly becomes the norm.^ieng