Contraceptive use by Palestinian-refugee mothers of children aged 0–3 years attending the UN Relief and Works Agency for Palestine Refugees in the Near East's maternal and child health clinics in the occupied Palestinian territory (West Bank and Gaza Strip), Lebanon, Jordan, and Syria: a follow-up study

In 1994, the UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) introduced family planning services as an integral part of its expanded programme for maternal and child health. The main objective in this report of the 2005 follow-up was to assess contraceptive use 10 years after the baseline study in 1995 and at follow-up in 2000 to ascertain the progress in the achievement of the programme's objectives and to identify future needs of the mothers and improvements for the programme. METHODS: The total sample was 10 890 women who attended UNRWA's clinics for maternal and child health with their children (aged 0–3 years) whose births had been registered at the clinic. Trained senior staff nurses and senior nurses completed a standard questionnaire during interviews with the mothers. Data were analysed with EpiInfo (version 6.0). Informed verbal consent was obtained from the women. FINDINGS: The mean number of pregnancies per woman dropped from 4·39 in 1995 to 4·14 in 2000 and 3·90 in 2005. The mean number of children alive per mother fell from 3·85 in 1995 to 3·47 in 2000 and 3·26 in 2005. The mean birth interval rose from 29·8 months in 1995 to 34·3 months in 2000 and 37·9 months in 2005. Overall, 2581 (31%) of 8309 women in 1995, 2777 (50%) of 5565 in 2000, and 6033 (55%) of 10 890 in 2005 used modern contraceptives: an increase of 24·3% from 1995 to 2005. The rate of contraceptive use was highest in women with four to six children, whereas in the baseline study the highest rate was in women with more than ten children. The total fertility rate in the target population since the introduction of the family planning programme dropped from 4·7 in 1995 to 3·5 in 2000 and 3·2 in 2005. INTERPRETATION: The rate of contraceptive use has almost doubled during the 10 years since the baseline study. The steady increase in the use of modern contraceptives indicates a change in behaviour among Palestinian refugees to have smaller families. FUNDING: None.