Ejercicio de derechos a la salud sexual y reproductiva entre mujeres de 20-29 años en Panamá y factores asociados.[Sexual and reproductive health rights exercise among women aged 20-29 in Panama and associated factors.]

Abstract

Introduccion: Los derechos a la salud sexual y reproductiva (DSSR) son basicos, y la capacidad de las mujeres para ejercerlos influye en lograr objetivos de desarrollo. Objetivos: Estimar indicadores de DSSR en mujeres de 20-29 anos identificando factores asociados. Metodos: Con datos de la Encuesta Nacional de Salud Sexual y Reproductiva 2014-2015 se analizaron 1206 casadas/unidas (982 con demanda de planificacion familiar, 1082 con hijos, y 978 usuarias de anticonceptivos), midiendose la violencia conyugal en el ultimo ano, conocimiento sobre prevencion del VIH, demanda satisfecha con anticonceptivos modernos, atencion profesional al parto y autonomia. Se utilizo la regresion logistica multivariada para probar asociaciones. Resultados: Padecio violencia conyugal 13.0%, tenia conocimiento sobre prevencion del VIH 38.8%, satisfacia su demanda de planificacion familiar con metodos modernos 62.0%; recibio atencion profesional al parto 81.1%; y mostro autonomia 10.3%. Las oportunidades relativas ajustadas (ORa) de violencia conyugal eran mayores en mujeres que la justificaban ORa=1.92;IC95%:1.09-3.39); el conocimiento sobre prevencion del VIH aumentaba con la escolaridad (ORa=1.13;IC95%:1.04-1.22); la satisfaccion de la demanda con metodos modernos era menor si justificaban la violencia conyugal (ORa=0.42; IC95%:0.20-0.85) y mayor en aquellas con una mayor percepcion de empoderamiento (ORa=2.33;IC95%:1.15-5.00). Las ORa de atencion profesional en el ultimo parto disminuyen cuando aumentaba la edad (ORa=0.72;IC95%:0.62-0.84), y era menor si experimentaron matrimonio infantil (ORa=0.43;IC95%:0.19-0.95). Las ORa de mayor autonomia resultaron menores en casadas (ORa=0.22;IC95%:0.10-0.47) y amas de casa (ORa=0.53;IC95%:0.28-0.98). Conclusiones: El ejercicio de DSSR y sus factores asociados constituyen desafios al diseno de politicas publicas. Abstract Introduction: Sexual and reproductive health rights (SRHR) are basic, and women capacity to exert them influence achieving development goals. Objectives: Estimate indicators of SRHR in women aged 20-29 years, identifying associated factors. Methods: A total of 1206 married/cohabitant women (908 with need for family planning, 1082 with children and 978 contraceptive users) were analyzed with data from National Sexual and Reproductive Health Survey 2014-2015. It was obtained the proportion of conjugal violence victims in the last year, with knowledge about VIH prevention, family planning needs satisfied by modern contraceptive methods, with professional care at delivery and with autonomy. Multivariate logistic regression was used to test associations. Results: The 13.0% of women suffered conjugal violence, 38.8% had knowledge about HIV prevention, 62.0% used modern contraceptives for satisfying family planning needs, 81.1% received professional care at delivery, and 30.7% made informed decisions about SRH. Adjusted odds ratio (AOR) for conjugal violence were greater when women justified violence (AOR=1.92;95%CI:1.09-3.39); knowledge about HIV prevention increases with schooling (AOR=1.13;95%CI:1.04-1.22); family planning met with modern contraceptives methods was lower, if they justified violence (AOR=0.42;95%CI 0.20-0.85) and higher in women with a higher empowerment perception (AOR=2.33;95%CI:1.15-5.00). The AOR for professional care at last delivery decrease with increasing age (AOR=0.72;95%CI:0.62-0.84) and was lower if they experienced child marriage (AOR=0.43;95%CI:0.19-0.95). The AOR for autonomy was lower in married women (AOR=0.22;95%CI:0.10-0.47) and housewives (AOR=0.53;95%CI:0.28-0.98). Conclusions: The exert of SRHR and its associated factors challenge public policies design.