The correlates of natural method use in Moldova; are natural methods associated with poverty and isolation?

The Republic of Moldova demonstrates the highest reliance on natural contraceptive methods in Europe, and natural methods account for an increasing proportion of contraceptive mix since 1997. This study investigates method use correlates in Moldova in order to explain this high reliance on natural methods.The study tests hypotheses that current natural method use is associated with economic disadvantage and spatial isolation. The impact of national Family Planning (FP) is also examined by testing the significance of FP media exposure. The study controls for the effect of fertility preferences and coital activity on odds of natural method use. Data are drawn from the MDHS 2005- the first ever European DHS. The study population consists of 5860 women who had first sex, and were not pregnant. The effect of correlates is assessed using a multilevel, multinomial logistic regression model, accounting for cluster level effects.Findings support the hypothesis that economic disadvantage is associated with natural method use. Region and rural residence increase the probability of natural contraceptive use- although FP clinic access has no direct effect. Exposure to FP media decreases the odds of no method use, but the effect declines with age and there is no significant effect on natural method use. Women unaware of how to avoid AIDS are significantly more likely to be non-users.This study recommends that FP effort should be directed toward the poorest women by ensuring contraception is affordable and appropriate, and enhancing existing FP media to focus on women unaware of AIDS transmission routes.