Internal Migration and Contraceptive Knowledge and Use in Guatemala

Published in International Family Planning Perspectives (Vol. 32, No. 3, pps. 146-153), this report was motivated by the observation that levels of modern contraceptive knowledge and use among people living in rural areas of Guatemala differ substantially from those of people living in urban areas. The premise of the research being shared here is that understanding the pace and extent of rural-to-urban migrants' adoption of urban contraceptive practices is important in determining if there is a strong need for migrant-focused reproductive health programmes.

Specifically, the study used survey data from the 1999 Guatemalan Migration and Reproductive Health Survey, which was part of a 4-nation comparative study on internal migration designed to identify the impact of rural-to-urban migration experience on change in women's reproductive behaviour and health status. The authors' goal was to examine the pace at which and extent to which individuals who migrate from rural to urban areas of Guatemala attain urban levels of modern contraceptive knowledge and use, as well as to explore whether the relationship between migration experience and contraceptive knowledge and use differs between Mayans and Ladinos.

As explained here, bivariate and multivariate analyses of data on 971 married men and women indicate that migrants' contraceptive knowledge was positively associated with the number of years they had lived in an urban area. In addition, the authors learned that Mayan migrants in Guatemala City did not accumulate contraceptive knowledge at the same rate as non-Mayan migrants, perhaps due to cultural and linguistic barriers to obtaining knowledge of and access to contraceptives. They found that rural-to-urban migrants eventually achieve a level of modern contraceptive use slightly below that of urban nonmigrants, with the level of contraceptive knowledge being an important factor associated with use of modern methods.

The authors conclude that lack of knowledge and familiarity with modern contraceptive methods remains a major barrier to modern contraceptive use in Guatemala, particularly in the indigenous population. In addition, the ability of migrants to adopt urban contraceptive practices seems to be impeded by their limited contraceptive knowledge and, therefore, may be closely linked to the pace at which they learn about modern contraceptive methods in their new environment. Thus, they say, programmes designed to raise contraceptive awareness and use in Guatemala should address recent migrants (particularly indigenous Mayans) in urban areas. Such efforts will have "multiple payoffs"; for example, migrants may be inspired through increased awareness to not only change their own behaviour, but also to carry information/messages about contraception back to relatives and friends in their rural home communities - a strategy with a multiplier effect.

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