Changes in contraceptive use and fertility: Panama, 1976 to 1984.

PIP: From 1976 to 1984 important demographic changes occurred in Panama. The total fertility rate declined from 4.5 to 3.7, and contraceptive use among married women 20-44 years of age increased from 55% to 63%. However, using data from 3 national level reproductive health surveys which were conducted in Panama in 1976, 1979, and 1984, we found that most of the changes took place between 1976 and 1979. Since 1979, overall contraceptive use and fertility have remained virtually unchanged, although there has been an important method-mix shift toward an increase in the use of contraceptive sterilization and IUD's, with an accompanying decline in the use of oral contraceptives. Although the singulate mean age at marriage remained relatively constant, the average duration of breastfeeding rose 23% during the period. Further gains in contraceptive prevalence and reduction in unplanned fertility in Panama will largely depend on enhanced program efforts 1st begun in the early 1970's by the Panama Ministry of Health. Future program efforts especially should be directed toward encouraging young couples to space their children more effectively by using temporary methods of contraception. The surveys used for this analysis were the 1976 Panama National Fertility Survey of the World Fertility Survey program, the 1979 Panama Contraceptive Prevalence Survey (Westinghouse), and the 1984 Panama Maternal-Child Health/Family Planning Survey.^ieng