Trends, patterns and correlates of contraceptive use among Kuwaitis, 1984 - 1999

To document the changes in trends and patterns of contraceptive use from 1984 to 1999 and analyze the sociodemographic correlates of contraceptive use. A nationally representative household survey of Kuwaiti women of reproductive age was conducted in 1999 and compared with published data from three earlier national surveys. About 52% of Kuwaiti women were currently using some form of contraception and 79% had used it at some time in their life [ever-use]. Three fourths were using a modern method of contraception at the time of the survey. Oral contraceptive pills were the leading method, followed by IUCDs. Oral contraceptive use declined from 79 to 45% in the period 1984-1999. Use of withdrawal increased from 2% in 1987 to 11% in 1999. Multivariate analysis indicated that a higher age and parity, a higher level of education of both spouses, urban residence, and a lower desired fertility were associated with higher contraceptive use. Contraception is generally used for spacing children, with the wife being the main user. There is a continuing need to provide services and accurate information about the various methods of contraception

Prevalence and social correlates of consanguinity in Kuwait

Kuwait has one of the highest consanguinity rates in the world. Our objectives in this study were to assess the frequency and trend in consanguineous marriages, and to identify factors associated with inbreeding. Patients and A representative sample of 482 households from the most developed [the Capital], and the least developed [Jahra], of the five governorates in Kuwait was selected. The study involved only Kuwaiti nationals. A structured questionnaire was administered by previously trained team members through a household face-to-face interview. Data were obtained for 959 current or previous marriages. Frequency of total [first and second cousin] consanguinity was much higher in Jahra governorate [42.1%] than the Capital [22.6%]. Over the last decade, the inbreeding has decreased in the Capital but not in Jahra. Bivariate analysis indicated that several socioeconomic and demographic variables were significantly associated with consanguinity. The control of confounding factors by logistic regression showed, however, that Bedouin origin and year of marriage were the only variables significantly related to consanguinity. There is a widening gap between Bedouins and non-Bedouins in the practice of consanguinity in Kuwait

On the reliability of assessing consanguinity in a highly fertile population: a Kuwaiti example

Kuwait is considered to have the highest prevalence of consanguinity in the world. Since findings of consecutive surveys were not consistent, our objective was to explain the differences in assessing the extent of blood relationship among the Kuwaiti couples. A representative sample of 482 households from the most developed [the Capital] and the least developed [Jahra] of the five governorates in Kuwait was selected. Previously trained team members administered a structured questionnaire through a household face-to-face interview. The procedure was repeated after a year. There were 1407 ever married individuals who provided data on their parental blood relationship and their own marital consanguinity. Inter-observer variation was fairly satisfactory up to the level of second cousins, but appeared very poor when third cousins were taken into account. The large differences between the authors who assessed the prevalence of blood relationship in Kuwait were due to the methodological approach [operational definition of consanguinity, data collection, time frame, etc.] but the main reason appeared to be the recall bias resulting from a huge number of relatives. Consanguinity data obtained by interview are too 'soft' for studying a highly fertile population, like that of Kuwait. Meticulous data collection may provide reliable information up to the level of second cousins, but not beyond

Quality of birth and death notifications in Kuwait

It is generally agreed that the coverage of the vital events of births and deaths is fairly complete in Kuwait where 99% of all births and 65% of all deaths occur in a hospital. However some items of the notifications have a very large number of missing data. On the birth notification, the items that are most often poorly recorded are medical complications, prenatal visits and length of gestation. On the death notification, information on sociodemographic features of the deceased's parents is missing in approximately 90% of the cases, although the cause of death is completely reported. A majority of the items on the fetal death notification have more than 20% of the information missing. A comparison of notification items with matching information obtained from a survey of mothers indicates a relatively high level of reliability for several items. The need for improvement in data quality is highlighted, and suggestions to reduce the level of missing data are offered