CONTRACEPTION, BREASTFEEDING, AND THE USE OF HEALTH CARE

根据最近人口与健康调查（DHS）的数据， 在多米尼加共和国、危地马拉、哥伦比亚、厄瓜多尔和 在秘鲁，拟议的研究将对以下方面进行比较评估： 避孕做法、母乳喂养的背景决定因素， 利用妇幼保健服务。 委员会还将审查 这三个决定因素之间的相互关系 生育率和儿童存活率，检验以下三个假设： 与医生和其他受过训练的医务人员接触和接触 与“高科技”避孕方法的实践有关 如宫内节育器和手术绝育; 2）在医院分娩， 接触医生与减少母乳喂养和早期 补充;和3）母乳喂养和 避孕做法并不纯粹是常见原因的结果 （包括使用产妇保健服务），但结果 同步，在孩子出生后的间隔中， 终止母乳喂养和开始母乳喂养的时间 使用避孕药具。 将采用各种方法来奋进科普 这种分析中固有的统计问题，并充分考虑到 所选DHS数据的不寻常和有利方面的优势 为这个项目。 后者包括社区电池 收集的关于卫生诊所和医院的资料，以及 收集五年母乳喂养和避孕行为日历 在秘鲁和多米尼加进行的实验性调查中， 共和国. 这项研究的结果将对一些人产生影响。 的决定因素和后果的争议 发展中国家的生育行为。

Using data from the Demographic and Health Surveys (DHS) recently conducted in the Dominican Republic, Guatemala, Colombia, Ecuador, and Peru, the proposed research will undertake a comparative assessment of the contextual determinants of contraceptive practice, breastfeeding, and use of maternal and child health (MCH) services. It will also examine the interrelations between these three proximate determinants of fertility and child survival, testing the following three hypotheses: 1) Contacts with and exposure to doctors and other trained medical personnel are associated with the practice of "high tech" contraceptive methods such as the IUD and surgical sterilization; 2) delivery in a hospital and exposure to doctors is associated with curtailed breastfeeding and early supplementation; and 3) the inverse association between breastfeeding and contraceptive practice is not purely the result of common causes (including the use of maternal health services), but results from synchronization, in the interval following the birth of a child, the timing of the termination of breastfeeding and the initiation of contraceptive use. A variety of methodologies will be employed in an endeavor to cope with the statistical problems inherent in such analyses, and to take full advantage of the unusual and propitious aspects of the DHS data selected for this project. The latter include the battery of community information collected on health clinics and hospitals, and the detailed five year calendars of breastfeeding and contraceptive behavior collected in the experimental surveys carried out in Peru and the Dominican Republic. The results of the study will have implications for a number of controversies concerning the determinants and consequences of reproductive behavior in developing countries.