Aim: The aim of the study was to investigate levels and related factors of the unmet needs for family planning (FP) among married women aged 15–49 living in two settlements (rural and urban) having different economic, social and cultural structures in Karabuk, a province in the northwest of Turkey.
Methods: This cross-sectional study was conducted in the rural Cumayan%u0131 village and the urban Emek neighbourhood between October 2016 and June 2017. The sample size was determined to be 289 married women aged 15-49 from each settlement according to the effect size of 0.3, alpha error probabilityof 0.05 and power of 0.95. In the study, 594 currently married women (298 from Cumayan%u0131 and 296 from Emek) were contacted. The dependent variable was the level of unmet need for FP. The independent variables included the sociodemographic and reproductive characteristics of the women. The data were collected through face-to-face interviews. The characteristics of the two settlements were compared using the chi-square test. Bivariate and multivariate logistic regression analyses were carried out to examine the factors associated with the dependent variable.
Results: The comparison of the participants demonstrated that the education, employment, and income levels of the rural women were lower than those of the urban women (p<0.001). The rural women had more pregnancies, miscarriages and stillbirths, and the mortality among their children was higher compared to the urban women (p<0.001). The percentage of unmet needs for FPin Cumayan%u0131 village was about two times higher than in Emek neighbourhood (9.7% vs 5.4%). The multivariate analysis was conducted separately for each settlement and marrying by way of only a religious ceremony increased the unmet needs for FP by 4.61 times (95% CI 1.3–16.1) (p= 0.016) in Cumayan%u0131. The multivariate analysis of all the women participating in the study revealed that marriage by way of only a religious ceremony increased the unmet needs by 4.96 times (95% CI 1.4–17.1) (p= 0.011).
Conclusion: The study showed the effects of socioeconomic and cultural factors on women’s fertility behaviours and unmet needs for FP to favour urban women. Not being married by civil marriage was a significant predictor of unmet need. These findings highlight a need for intervention, particularly for the empowerment of rural women, in order to improve reproductive health outcomes.