Ethnicity and the use of health services in Belize

Data from the 1991 Belize Family Health Survey show differentials in the use of maternal and child health services between ethnic groups (Creole, Mestizo, Maya/Ketchi and Garifuna). Multivariate analysis is used to explore whether such differentials can truly be attributed to ethnicity or to other characteristics that distinguish the ethnic groups. Health services considered are: family planning, place of delivery (hospital/other), postpartum and newborn check-ups after a birth, and immunisations for children. The language usually spoken in the household is found to be important for interpreting ethnic differentials. Mayan-speaking Maya/Ketchis are significantly less likely to use family planning services or to give birth in a hospital. Spanish-speakers (Mestizos and Maya/Ketchis) are less likely to use newborn and postpartum differentials check-ups, after controlling for other characteristics. There are no ethnic differentials for immunisations. Programmatic implications of these results are discussed(Summary)

Determinants of contraceptive use in Belize

Drawing from perspectives of wealth flows and opportunity structures, a path model comprised of socioeconomic status, education age, labor force participation, and family size is formulated. It is hypothesized that these variables are positive predictors of contraceptive use directly; and indirectly through woman's attitude regarding power in reproductive decision making. Residence (urban versus rural) and breastfeeding are used as control variables. These hypotheses are tested with data on currently married/in union women of reproductive age from the 1991 Belize Family Health Survey. Ordinary least squares regression and logistic regression are used to estimate each relationship in the model, first including a variable measuring current family size relative to a desired or ideal family size. The attitude that women should have power in reproductive decision making is a significant determinant of contraceptive use when current family size is included in the model but loses significance when current family size relative to an ideal is used. This model is then run separately for the two largest ethnic groups, Mestizos and Creoles, as identified by the language spoken in the household. The attitude that women should have power in reproductive decision making is a significant determinant of contraceptive use for women who speak Spanish whereas education and labor force participation are not. For the Creole, however, labor force participation and education are significant predictors of contraceptive use but attitude toward decision making is not. These relationships hold when current family size and current relative to ideal family size are not used in the models. The analysis demonstrates that groups of women, i.e., the Mestizo, with overall less education and lower labor force participation rates are more dependent upon their own attitudes to control their fertility. On the other hand, the higher status associated with more educated women who have higher labor force participation rates, i.e., the Creole, assumes and absorbs any effect of attitude in controlling fertility. It is speculated that attitudes are significant for Mestizos because they are part of a more traditional culture in which women have less opportunity for education and employment. In contrast, the creole women are so autonomous, as evidenced by their labor force participation and educational attainment, that attitude becomes irrelevant. (AU)