title: The Oportunidades conditional cash transfer program: effects on pregnancy and contraceptive use among young rural women in Mexico.
abstract: BACKGROUND
  Oportunidades is a large conditional cash transfer program in Mexico. It is important to examine whether the program has any direct effect on pregnancy experience and contraceptive use among young rural women, apart from those through education.
  
  
  METHODS
  Data from the 1992, 2006 and 2009 waves of a nationally representative, population-based survey were used to describe trends in pregnancy experience, contraceptive use and education among rural adolescent (15-19) and young adult (20-24) women in Mexico. To examine differences in pregnancy experience and current modern contraceptive use among young women, multivariable logistic regression analyses were conducted between matched 2006 samples of women with and without exposure to Oportunidades, predicted probabilities were calculated and indirect effects were estimated.
  
  
  RESULTS
  Over the three survey waves, the proportion of adolescent and young adult women reporting ever being pregnant stayed flat (33-36%) and contraceptive use increased steadily (from 13% in 1992 to 19% in 2009). Educational attainment rose dramatically: The proportion of women with a secondary education increased from 28% in 1992 to 46% in 2009. In multivariable analyses, exposure to Oportunidades was not associated with pregnancy experience among adolescents. Educational attainment, marital status, pregnancy experience and access to health insurance--but not exposure to Oportunidades--were positively associated with current modern contraceptive use among adolescent and young adult women.
  
  
  CONCLUSIONS
  Through its effect on education, Oportunidades indirectly influences fertility among adolescents. It is important for Mexico to focus on strategies to increase contraceptive use among young rural nulliparous women, regardless of whether they are enrolled in Oportunidades.
authors.affiliation: Doctoral Student, Department of Health Services, School of Public Health, University of Washington, Seattle, USA, darneyb@ohsu.edu.
authors.forename: Blair G
authors.initials: BG
authors.lastname: Darney
authors.forename: Marcia R
authors.initials: MR
authors.lastname: Weaver
authors.forename: Sandra G
authors.initials: SG
authors.lastname: Sosa-Rubi
authors.forename: Dilys
authors.initials: D
authors.lastname: Walker
authors.forename: Edson
authors.initials: E
authors.lastname: Servan-Mori
authors.forename: Sarah
authors.initials: S
authors.lastname: Prager
authors.forename: Emmanuela
authors.initials: E
authors.lastname: Gakidou
mesh_terms: D000293:Adolescent; D003267:Contraception / Q000191:economics* / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female / Q000191:economics* / Q000627:therapeutic use; D005193:Family Planning Services / Q000191:economics*; D005260:Female; D005380:Financing, Government / Q000191:economics* / Q000706:statistics & numerical data; D006266:Health Education / Q000191:economics; D006297:Health Services Accessibility / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008429:Maternal Welfare / Q000191:economics; D008800:Mexico / Q000453:epidemiology; D010353:Patient Education as Topic / Q000191:economics; D011203:Poverty / Q000706:statistics & numerical data; D011247:Pregnancy; D019035:Rural Health Services / Q000191:economics; D012424:Rural Population / Q000706:statistics & numerical data*; D016387:Women's Health / Q000191:economics; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female