title: [Social determinants of contraceptive use in Tunisia].
abstract: BACKGROUND
  In Tunisia, the "Revolution" of January 2011 highlighted significant regional disparities and social inequalities in access to health care, including reproductive health services. The purpose of this study was to analyze the social determinants of the use of contraception in Tunisia.
  
  
  METHODS
  A cross-sectional national study conducted in 2012; on a sample of 15 to 49-year married women (n=4374) drawn by a two levels random sampling. Prevalence of contraception and its association factors were assessed. Logistic regression was used to evaluate the variation of contraception prevalence with area of residence, age, level of education, number of children and household income.
  
  
  RESULTS
  The prevalence of contraception was 66.4 %. Eighty-two percent of women used a modern contraceptive method. The use of contraceptive methods was significantly dependent on the age (P<0.001), area of residence (P=0.008), education (P<0.001). The prevalence of contraception was higher in North West (OR=1.1 [0.81-1.5]; P<0.001), among multiparous women (OR=4.49 [3.57-5.66]; P<0.001), among the youngest women (OR=1.4 [0.9-2,19]; P<0.001) and among those with higher levels of education (OR=1.62 [1.19-2.21]; P=0.008).
  
  
  CONCLUSIONS
  Tunisia, precursor Arab country in family planning, is recording a slowdown in the use of contraception in comparison with other countries of North Africa. Social determinants, such as, age, living conditions, area of residence and level of education are indicators to consider when targeting interventions.
authors.affiliation: Faculté de médecine de Tunis, université Tunis El Manar, résidence les printemps 2, Cité Taieb El Mihiri, 2045 Tunis, Tunisie. Electronic address: kaouther.dimassi@gmail.com.
authors.forename: K
authors.initials: K
authors.lastname: Dimassi
authors.affiliation: Faculté de médecine de Tunis, université Tunis El Manar, résidence les printemps 2, Cité Taieb El Mihiri, 2045 Tunis, Tunisie.
authors.forename: F
authors.initials: F
authors.lastname: Douik
authors.affiliation: Faculté de médecine de Tunis, université Tunis El Manar, résidence les printemps 2, Cité Taieb El Mihiri, 2045 Tunis, Tunisie.
authors.forename: M A
authors.initials: MA
authors.lastname: Douzi
authors.affiliation: Faculté de médecine de Tunis, université Tunis El Manar, résidence les printemps 2, Cité Taieb El Mihiri, 2045 Tunis, Tunisie.
authors.forename: O
authors.initials: O
authors.lastname: Saidi
authors.affiliation: Faculté de médecine de Tunis, université Tunis El Manar, résidence les printemps 2, Cité Taieb El Mihiri, 2045 Tunis, Tunisie.
authors.forename: H
authors.initials: H
authors.lastname: Ben Romdhane
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000379:methods* / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005193:Family Planning Services / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D012959:Socioeconomic Factors; D014416:Tunisia / Q000453:epidemiology; D055815:Young Adult
keywords: Contraception; Déterminants sociaux; Inequality; Inégalité; Reproductive health; Santé reproductive; Social determinants