Ranjan Mukesh, Mozumdar Arupendra, Acharya Rajib, Mondal Subrato Kumar, Saggurti Niranjan
Pachhunga University College, Mizoram University, Aizawl, Mizoram, India.
Population Council, New Delhi, India.
SSM Popul Health. 2020 May 22;11:100603. doi: 10.1016/j.ssmph.2020.100603. eCollection 2020 Aug.
India, where more than one married woman of reproductive age often live in the same household, provides an ideal setting to promote family planning through intrahousehold influence.
This study examined the association between use of modern contraceptives by young married women, and other married women live in the same household.
We included 31,361 currently married women of 15-24 years from women data of the National Family Health Survey 2015-16. Each of these women was living with another married woman within the same household, who was also interviewed. From each household, we labeled the woman with the shortest marital duration as the Index Woman. The second woman in each household was either labeled as Peer or Other or Elderly (had married within 5 years or 5-19 years after or 20 or more years after the marriage of Index women, respectively). The association between use of modern contraceptives by Index Women and the second woman in household was examined using logistic regressions-controlled for the background characteristics of Index Women.
Index Women had 2.9 times adjusted odds (95%CI 2.5-3.3) of using modern contraceptives if living with Peers, who were also using modern contraceptives. Similarly, when the second women using modern contraceptives, an Index Woman had 1.7 times adjusted odds for using modern contraceptives (95%CI 1.5-1.9) if living with Elderly, and about 2.5 times adjusted odds if living with Other women (95%CI 2.1-2.8). The association between contraceptive use by an Index Woman and the second woman in the household remained significant even after controlling for background characteristics, showing the independent effect of intrahousehold influence on contraceptive use.
The conclusive evidence of positive intrahousehold influence on contraceptive use of Index Women will encourage program managers to promote intrahousehold communication to increase use of family planning.
在印度，往往有多名育龄已婚女性生活在同一家庭中，这为通过家庭内部影响来推广计划生育提供了理想环境。
本研究调查了年轻已婚女性使用现代避孕方法与同住在一个家庭中的其他已婚女性之间的关联。
我们从《2015 - 2016年全国家庭健康调查》的女性数据中纳入了31361名年龄在15 - 24岁的已婚女性。这些女性中的每一位都与同住在一个家庭中的另一位已婚女性共同生活，且后者也接受了访谈。我们将每个家庭中婚姻持续时间最短的女性标记为索引女性。每个家庭中的第二位女性则分别标记为同龄人、其他女性或年长女性（分别在索引女性结婚后5年内、5 - 19年或20年及以后结婚）。我们使用逻辑回归分析，在控制索引女性背景特征的情况下，研究索引女性与家庭中第二位女性使用现代避孕方法之间的关联。
如果索引女性与同样使用现代避孕方法的同龄人同住，其使用现代避孕方法的调整后优势比为2.9倍（95%置信区间2.5 - 3.3）。同样，当第二位女性使用现代避孕方法时，如果索引女性与年长女性同住，其使用现代避孕方法的调整后优势比为1.7倍（95%置信区间1.5 - 1.9），如果与其他女性同住则约为2.5倍（95%置信区间2.1 - 2.8）。即使在控制了背景特征之后，索引女性与家庭中第二位女性的避孕使用之间的关联仍然显著，这表明家庭内部影响对避孕使用具有独立作用。
家庭内部对索引女性避孕使用产生积极影响的确凿证据，将鼓励项目管理者促进家庭内部沟通，以增加计划生育的使用。
