This study, conducted in 1997, explored the relationship between women's economic activities, fertility and contraceptive use in La Paz and El Alto, Bolivia by re-interviewing urban women from the 1994 Demographic and Health Survey (DHS), focusing on their participation in the work force.

Bolivia

Contraceptive use – particularly use of more effective modern methods – remains low among many Bolivian women, especially those in rural areas. In Bolivia, as families struggle to improve their standard of living, increasing numbers of women see a need to enter the labor market. Contraceptive use can reduce the amount of time women spend in childbearing and increase the amount of time they spend in the work force.

Research Findings

This study, conducted in 1997, explored the relationship between women's economic activities, fertility and contraceptive use in La Paz and El Alto, Bolivia. Researchers re-interviewed urban women from the 1994 Demographic and Health Survey (DHS), focusing on their participation in the work force. Results included:

• As women got older, their participation in the work force increased. Women who were widowed or separated, those who had more and older children, and those who had used a method of contraception during the study interval were likely to be working at the time of the interview in 1997. Age and education were positively associated with the probability that a woman working in 1994 would be working in 1997. Contraceptive use or having used reproductive health services during the study interval did not influence whether women working in 1994 were also working in 1997.

• Women who were single, separated or widowed were more likely than women in union to have entered the labor force during the interval between surveys. Having a child under the age of one decreased the likelihood that a woman would be working in 1997, but as the number of children a woman had increased, so did her chances of working in 1997.

• More than one-third of the women who had been in or were currently in a relationship reported domestic violence, defined as either physical or verbal abuse. Women whose partners were less educated were more likely to report violence. The more live births a woman had, the more likely she was to report a history of violence. Although being pregnant decreased the odds of violence, the use of contraception increased the likelihood of reporting violence by 42 percent. Interpreting this last finding is difficult, however, since information on when the violence occurred (in the past or on-going) was not obtained.

• More than half the women had heard, seen or read an article about reproductive health in the six months prior to the study. Almost half of the sample recognized the Ministry of Health's symbol for reproductive health and had heard of the social marketing condom product Pantera.

• Women seeking reproductive health services most often sought gynecological care. However, approximately one-third of the women said they had never visited a health care facility.

• Approximately one-third of the postmenopausal women expressed relief at no longer being at risk of pregnancy or having monthly periods. However, the same percentage expressed concerns about the physical and emotional effects of menopause. Half of all the women surveyed thought that women should have sex less frequently or not at all after menopause.

Recommendations

• As more women enter the labor force, employers could play an important role in promoting the use of preventive reproductive services, such as cancer screening, prenatal care, and contraceptive use. Nongovernmental organizations (NGOs) may be more effective in reaching women who work in the informal sector.

• The public and private sectors should explore ways to provide child care for low income women who need or want to work.

• Many Bolivian women experience domestic violence, and health care providers should be sensitive to the needs of this group. If providers themselves are unable to offer assistance, they must offer referrals for women seeking help.

• Health education programs should work to increase women and men's awareness of menopause, its effect on sexuality, and the physical changes women experience. Accurate knowledge of the symptoms that can accompany menopause as well as information to dispel myths could diminish women's apprehensions.

Study Details

This study was conducted by Lic. Teresa Polo Nájera and Lic. Mario Gutiérrez. Dr. Patricia Bailey of FHI served as technical monitor. The final report in Spanish will be posted on FHI's web site when available, as will a 10-page summary of the study in English (http://www.fhi.org). This study was supported by the Women's Studies Project at FHI, through a Cooperative Agreement funded by the U.S. Agency for International Development with field support from the USAID Mission in Bolivia.