Senior Manager, Research and Analysis, The DHS Program and Avenir Health, Rockville, MD, USA. Correspondence:
Director, Research and Survey, National Institute of Population Studies, Ministry of National Health Services, Regulations and Coordination, Islamabad, Pakistan.
Sex Reprod Health Matters. 2021;29(2):2020953. doi: 10.1080/26410397.2021.2020953.
This study examines the association of decision-making with contraceptive use along with other measures of women's empowerment and the gender context. We use data on currently married women from the Demographic and Health Survey conducted in Pakistan in 2017-2018. We contrast patterns in modern contraception with traditional contraception and examine specific modern methods. Husband's characteristics do not factor strongly in women's modern contraceptive use. Contraceptive decision-making is more pertinent to women's modern contraceptive use than household decision-making and is inhibited when husbands are the primary decision-makers of contraceptive decisions. In contrast, joint decision-making facilitates overall modern contraceptive use and the use of condoms in particular. Contraceptive use is reduced when the decision is made by someone other than the woman or her husband. Economic empowerment resources are weakly and inconsistently associated with modern contraceptive use. Furthermore, modern contraceptive use (particularly condoms and female sterilisation) is reduced when women live in an extended household. Region, education, and wealth remain important correlates of modern contraceptive use, even after controlling for other factors, as does the number of living children and, for female sterilisation and IUDs only, women's working status. This study finds support for expanding the range of available methods and combining service improvements with promoting women's empowerment, gender equity, and social behaviour change initiatives targeted to men and other family members.
本研究考察了决策与避孕措施的使用以及女性赋权和性别背景的其他措施之间的关联。我们使用了 2017-2018 年在巴基斯坦进行的人口与健康调查中关于目前已婚妇女的数据。我们将现代避孕方法与传统避孕方法进行了对比，并考察了具体的现代方法。丈夫的特征在女性使用现代避孕药具方面并没有起到重要作用。与家庭决策相比，避孕决策对女性使用现代避孕药具更为重要，当丈夫是避孕决策的主要决策者时，避孕决策会受到抑制。相比之下，共同决策有利于整体现代避孕药具的使用，特别是避孕套的使用。当决策不是由女性或其丈夫做出时，避孕措施的使用会减少。经济赋权资源与现代避孕药具的使用呈弱相关且不一致。此外，当女性居住在大家庭中时，现代避孕药具的使用（特别是避孕套和女性绝育）会减少。即使在控制了其他因素之后，地区、教育和财富仍然是现代避孕药具使用的重要相关因素，与女性绝育和宫内节育器一样，还有孩子的数量，而且仅对女性绝育和宫内节育器而言，女性的工作状况也是重要相关因素。本研究支持扩大现有方法的范围，并将服务改进与促进女性赋权、性别平等以及针对男性和其他家庭成员的社会行为改变倡议相结合。
