Community effects on pregnancy intention among cohabiting women in the Philippines: implications for maternal and child health.

Unintended pregnancy impacts both maternal and child health. International studies continue to emphasize the importance of reproductive health in the context of community. Only a few researchers have explored the impact of community factors on pregnancy intention using population-based surveys. This issue is of particular importance for women of low socioeconomic status in developing countries, where unintended fertility rates remain relatively high. Using the 1998 (n = 6,849) and 2003 (n = 6,773) Demographic and Health Surveys in the Philippines, we employed multilevel logistic models to explore whether community factors are associated with pregnancy intention among these women. The results showed community social capital, comprised of community-related variables, significantly predicted women's pregnancy intention, even after controlling for women's socioeconomic status, individual background factors, and spousal characteristics. The relationship between pregnancy intention and selected variables associated with community social capital, however, was not consistent across the two surveys. Community context, in general, has a significant influence on women's pregnancy intention. Specific components of the community context vary in their associations with pregnancy intention over time. In addition, differences in pregnancy intention may explain individual-level social disparities between communities. These findings suggest population health policies designed to promote maternal and child health must be context-specific.