Population Services International, 1120 19th Street, NW, Suite 600, Washington, DC 20036, USA.
BMC Public Health. 2010 Aug 2;10:450. doi: 10.1186/1471-2458-10-450.
Since 1990-91, traditional method use has increased at a faster rate in Pakistan than modern method use. The importance of hormonal methods or the IUD has diminished and that of traditional methods has increased in the method mix. There is a need to identify factors motivating and deterring the adoption of specific family planning methods among married men and women in Pakistan.
In addition to social and demographic characteristics of respondents, a representative household survey collected information on psychological correlates of family planning behavior from 1,788 non-pregnant wives and 1,805 husbands with not-pregnant wives. Males and females were from separate households. Principal components analysis was conducted to identify the underlying constructs that were important for each gender. Multinomial logistic regression analysis was conducted to determine the correlates of male and female intentions to use contraceptive methods.
Amongst women, the perception that her in-laws support family planning use was the strongest determinant of her intentions to use contraceptive methods. A woman's belief in the importance of spacing children and her perception that a choice of methods and facilities with competent staff were available were also powerful drivers of her intentions to use contraceptive methods. The strongest obstacle to a woman's forming an intention to use contraceptive methods was her belief that family planning decisions were made by the husband and fertility was determined by God's will. Fears that family planning would harm a woman's womb lowered a woman's intentions to use methods requiring procedures, such as the IUD and female sterilization.The perception that a responsible, caring, husband uses family planning to improve the standard of living of his family and to protect his wife's health was the most important determinant of a man's intention to use condoms. A husband's lack of self-efficacy in being able to discuss family planning with his wife was the strongest driver of the intention to use withdrawal. A man's fear that contraceptives would make a woman sterile and harm her womb lowered his intention to use modern contraceptive methods.
These findings highlight the importance of having secondary target audiences such as mothers-in-law and husbands in family planning behavior change campaigns implemented in Pakistan. Campaigns that stress the importance of child spacing are likely to have an impact. Client perceptions of the quality of care are important determinants of intentions to use contraceptive methods in Pakistan. Client concerns that the IUD and sterilization procedures might harm a woman's womb and cause sterility should be addressed. The findings suggest that there is a need to assess the actual quality of service delivery in Pakistan.
自 1990-91 年以来，巴基斯坦传统方法的使用率增长速度快于现代方法。激素方法或宫内节育器的重要性降低，而传统方法在方法组合中的重要性增加。有必要确定激励和阻止已婚男女采用特定计划生育方法的因素。
除了受访者的社会和人口特征外，一项代表性的家庭调查还从 1788 名未怀孕的妻子和 1805 名与未怀孕妻子同住的丈夫那里收集了计划生育行为的心理相关信息。男性和女性来自不同的家庭。进行主成分分析以确定对每个性别重要的潜在结构。进行多项逻辑回归分析以确定男性和女性使用避孕方法的意图的相关性。
在女性中，公婆支持计划生育使用的看法是决定其使用避孕方法意图的最强决定因素。女性对孩子间隔重要性的信念以及她认为方法的选择和有能力的工作人员的设施可用的看法也是她使用避孕方法意图的强大驱动力。女性形成使用避孕方法意图的最大障碍是她认为计划生育决策由丈夫做出，生育由上帝的旨意决定。担心计划生育会损害女性的子宫，降低了女性使用需要手术的方法（如宫内节育器和女性绝育）的意愿。丈夫有责任，关心，使用计划生育来提高家庭的生活水平并保护妻子的健康，这是决定丈夫使用避孕套的意图的最重要决定因素。丈夫缺乏与妻子讨论计划生育的自我效能感是使用撤回的最强驱动力。男性担心避孕药会使女性不育并损害她的子宫，从而降低了他使用现代避孕方法的意愿。
这些发现强调了在巴基斯坦实施计划生育行为改变运动时，将次要目标受众（如婆婆和丈夫）作为次要目标受众的重要性。强调孩子间隔重要性的运动可能会产生影响。客户对护理质量的看法是决定在巴基斯坦使用避孕方法意图的重要决定因素。客户担心宫内节育器和绝育手术可能会损害女性的子宫并导致不育，应该解决这些问题。调查结果表明，有必要评估巴基斯坦实际的服务提供质量。
