A Needs Assessment of Family Planning Within a Ngöbe–Buglé Patient Population in Bocas Del Toro, Panama

Abstract

BACKGROUND: The World Bank has characterized poverty among Panama’s largest indigenous population, the Ngöbe–Buglé, as “abysmal.” In addition, family size is significantly above and age of first conception significantly below the average for Panama. We conducted a Needs Assessment of Family Planning to better understand the preferences, barriers to access, and interplay with local culture and socioeconomic status within this population. METHODS: We conducted a mixed methods study among the indigenous patient population of a local NGO, Floating Doctors. 70 patients were interviewed using a quantitative survey based upon the DHS Individual Questionnaire. Data was analyzed for two primary outcomes: preferences for family planning and unmet need. In addition, 41 key informant interviews were conducted, with data organized around barriers to access, cultural preferences, and issues of human rights. RESULTS: Fifty three percent (33/62) of subjects met the DHS criteria for unmet need. Lack of money and access were identified as the most significant barriers to obtaining family planning. Key informant interviews suggested that young motherhood and large family size were significantly impacting issues of local health, education and socioeconomic status. CONCLUSION: This study reveals a profound unmet need for family planning resources. It also highlights the impact of this need on local education, socioeconomics, and public health. Finally, the data suggests that these disparities may be increasing due in part to complex economic shifts. Family planning may mark a clear starting point by which to empower Ngöbe–Buglé families to reclaim health, cultural, and economic stability.