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DOI: 10.1101/2023.05.21.23290311

Rural Residence, Motorcycle Access, and Contraception Use in South and Southeast Asia

J. A.Muir S. R. Sanders H. Hendricks M. R. Cope
Access to contraception is critical for limiting fertility. Yet, in South and Southeast Asia, access to these resources is often limited by spatial inequalities between ru- ral and urban areas. Access to a motorcycle may empower women living in rural areas to attenuate these spatial inequalities, increase their educational attainment and participation in labor markets, and thereby facilitate a shift in fertility pref- erences. Concomitantly, motorcycle access may increase access to contraception for geographically isolated women who desire to limit fertility. We employ logistic re- gression models to examine associations with contraception use and unmet need for contraception for women living in rural vs. urban areas and for women with vs. without access to a motorcycle. Roughly 40 percent of women reported cur- rent use of contraception while another 21 percent indicated an unmet need for contraception. After adjusting for other variables, women with a motorcycle were more likely to report current contraception use (AOR = 1.55, 95% CI [1.50, 1.61]), modern contraception use (AOR = 1.60, 95% CI [1.54, 1.66]), and traditional con- traception use (AOR = 1.49, 95% CI [1.41, 1.58]) compared to women who did not own a motorcycle. Women with a motorcycle were less likely to report an unmet need for contraception (AOR = 0.65, 95% CI [0.62, 0.68]) after adjusting for other variables. Our results are consistent with the premise that motorcycles facilitate contraception use among women living in resource-limited countries in South and Southeast Asia and thereby contribute to decreases in fertility. These relationships are contextualized by whether a woman lives in an urban or rural setting, and the number of children already present in their household; they are robust to control- ling for household-level wealth and other factors that may mediate associations with contraception use.