Fertility preferences, contraceptive behaviors and unmet needs:: a gap between urban and suburban parts of a city

Objectives To explore the differences in unwanted fertility in different parts of a city. Methods Data were obtained from the 9999 Manisa Demographic and Health Survey (MDHS) in Turkey. We collected information from a representative sample of 1728 evermarried women aged 15-49 years on fertility, fertility preferences, unmet need for family planning, contraceptive discontinuation, and abortion. Data were analyzed using SPSS 10.0 for Windows's. Results Of the persons studied, 1238 (71.6%) were living in urban settlements and 490 (28.4%) in suburban (gecekondu) settlements. The total fertility rate is higher among gecekondu women (2.42) than among urban women (2.14) although gecekondu women have a lower wanted fertility rate (1.54) than urban women (1.77). Married women in the urban area were currently using a contraceptive method more frequently (75.6%) than those living in the gecekondu area (61.7%) (OR 2.5; 95% CI 1.9-3.2; p < 0.001). The unmet need percentage in gecekondu women (17.7%) is higher than in urban women (8.3%; p < 0.001). The induced abortion rate is higher in urban women (14.8 per 1000 pregnancies) than in gecekondu women (7.1 per 1000 pregnancies; OR 2.1; 95% Cl 1.4-3.1; p < 0.001). Conclusions There are inequalities in the achievement of fertility preferences and in accessibility to family planning services between urban and suburban parts of the city.