Constrained contraceptive choice: IUD prevalence in Uzbekistan.

CONTEXT Because individuals' and couples' needs vary, the availability of a variety of contraceptive choices is a key component of successful family planning programs. Most women in Uzbekistan rely on a single contraceptive method (the IUD), but it is unclear whether this reflects constraints on choice or simply a widespread preference. METHODS Nationally representative data from the 1996 Uzbekistan Demographic and Health Survey and the 2002 Uzbekistan Health Examination Survey were used to evaluate the relationship between demographic characteristics and knowledge and use of contraceptives among sexually active women. Separate multivariate regression analyses were performed for 1996 and 2002. RESULTS Nearly all sexually active women knew about contraceptives, and in 2002 most reported that they had ever used the IUD (71%) or any modern method (77%). In both surveys, women with higher levels of wealth (odds ratios, 2.2-3.1) and education (1.9-2.5) were more likely than other women to know about contraceptive methods other than the IUD. Higher levels of wealth and education, as well as urban residence and non-Uzbek ethnicity, were also associated with the use of contraceptives other than the IUD, although these relationships were generally weaker in 2002 than in 1996. CONCLUSION Despite the high prevalence of contraceptive use in Uzbekistan, the country's reproductive health program may be constraining method choice. Expanded programmatic efforts emphasizing choice from a range of methods are needed, especially among subgroups of women who have little knowledge or experience with methods other than the IUD.