The Impact of Multi-level Factors on Family Planning Use among Mayan-Quiché Couples in the Rural Highlands of Guatemala
Authors: Kathryn L. Schmidt, Carol J. Hogue and Karen L. Andes
Abstract: Guatemala has the highest number of maternal deaths in Central America, and indigenous women living in rural regions face even higher risk. Because family planning (FP) can improve maternal health, research was conducted in Totonicapán, a remote, indigenous village in the Highlands, to understand the factors that drive the use or non-use of FP and the possible unmet FP need to space and limit births. The objective was to gain contextual information on factors influencing communication and decision-making in FP issues (CDFP) and to assess the extent to which factors influence the use of FP methods among Totonicapán couples. Focus-group discussions and in-depth interviews were conducted in Totonicapán followed by a secondary data analysis of the Guatemala Reproductive Health Survey. Cultural and social factors such as gender roles, religion, FP knowledge, pregnancy intentionality, and negotiation are influential components to the CDFP. Partner negotiation/communication and FP knowledge were significant positive predictors of ever using a FP method. To improve maternal health, interventions such as community forums and collaborating with valued community members (midwifes) should be implemented to dispel inaccurate perceptions about family planning and to encourage couple involvement in FP.