Contraception and culture: the use of yuyos in Paraguay.

The use of herbs (yuyos) as contraception is common practice in Paraguay. This report analyzes data from the 1995-1996 Paraguayan Reproductive Health Survey. The analysis reveals that women are more familiar with yuyos (88%) than any other method of family planning. Modeling the determinants of ever having relied on yuyos as contraception demonstrates that older women (OR = 1.043) and women with more children (OR = 2.283) are significantly more likely to have used yuyos, but an interaction between older women with more children shows they are less likely to have used this method (OR = .982). Women living in rural areas (OR = .664) and those with more education (OR = .883) are less likely to have used the method. These findings show widespread acceptance and use of yuyos for contraception in Paraguay. More research into the chemical properties of yuyos is needed to determine their contraceptive efficacy and to prevent harmful effects from their misuse.

PIP: According to the 1995-96 Paraguayan Reproductive Health Survey of 6465 reproductive-age females, women are more familiar with herbs (yuyos) than any other method of contraception. These herbs are prepared most frequently as teas and drunk every day. 88% of respondents were aware of yuyos. Bivariate analysis indicated that current yuyo users were geographically isolated, older, less educated, poorer, and more likely to speak Guarani in the home than non-users. In the multivariate analysis, ever-use of yuyos was significantly associated with older age (odds ratio (OR), 1.043) and more children (OR, 2.283), while high education (OR, 0.883) and urban residence (0.664) were inversely related to ever-use. Since no protocol exists for yuyo use for contraception, indigenous women rely on word-of-mouth advice and may be at risk of toxic side effects from improper use. Needed, to reduce this risk, are research studies on the use of herbs in other countries for contraceptive purposes and more rigorous testing of the chemical agents found in plants used for fertility control. If efficacy is discovered, additional research is recommended to identify the conditions under which and for how long yuyos should be taken for contraception or menstrual regulation. Any program that builds on yuyo use to promote use of modern contraceptive methods must proceed in a culturally sensitive way.

Contraceptive use and fertility in Paraguay, 1987.

In 1987, 38 percent of married Paraguayan women aged 15-44 were practicing contraception, with oral contraceptives being the most prevalent method. Fertility rates for the population were at corresponding levels, with an overall fertility rate of 5.4 births per woman. Fertility has not changed substantially for the nation as a whole since 1979, and contraceptive use has increased by only 6 percentage points. Findings from the present study are consistent with the lack of a public sector family planning program in the country. Pharmacies are the principal source of contraceptives in the country. Twenty-two percent of all women and one-third of married women are at risk of having an unplanned pregnancy. The greatest impact on contraceptive use can be made if new and continued program efforts focus n the interior of the Oriental region of the country.

PIP: In 1987, staff from the International Planned Parenthood Federation affiliate in Paraguay (CEPEP) with technical assistance from the US Centers for Disease Control (CDC) selected 1500 households in metropolitan Asuncion and the interior of the Oriental region (the Interior) to study contraceptive behavior and fertility. Eligible respondents to the survey consisted of women 15 to 44 years old, regardless of marital status. Researchers interviewed only 1 woman per household and completed 2224 interviews. The 1987 overall fertility rate of 5.4 births per woman did not change much since 1979 (4.9), and contraceptive use only increased from 32.1% to 37.6%. Metropolitan Asuncion reported the highest prevalence (more than 50%). In terms of methods to control family size, oral contraceptive (OC) led the list of contraceptive use at 13.5%, followed by native herbs called yuyos at 7.2% and intrauterine devices (IUDS) at 5.1%. After the Paraguayan MOH stopped providing family planning services through MOH facilities in 1979, pharmacies became the primary source of contraceptives (51%). Prior to 1979, the MOH supplied 45% of all contraceptives. Findings in the survey indicated that 22% of all women and 33% of married women are at risk of having an unplanned pregnancy. Also the women exhibited a strong interest in spacing or limiting family size, but because the public sector does not provide contraceptives women cannot do so.