Department of Fertility and Social Demography, International Institute for Population Sciences (IIPS), Govandi Station Road, Deonar, Mumbai, Maharashtra, 400088, India.
BMC Womens Health. 2023 Aug 9;23(1):418. doi: 10.1186/s12905-023-02587-7.
Contraceptive use contributes to improved maternal and child health, education, empowerment of women, slow population growth, and economic development. The role of the family in influencing women's health and health-seeking behavior is undergoing significant changes, owing to higher education, media exposure, and numerous government initiatives, in addition to women's enhanced agency across South Asia. Against this backdrop, this study assesses the relationship between women's living arrangements and contraceptive methods used in selected south Asian countries (India, Pakistan, Nepal, and Bangladesh).
Data of currently married women aged 15-49 from the recent round of Demographic and Health Survey (DHS) of four South Asian countries, i.e., Nepal (2016), Pakistan (2017-18), Bangladesh (2017-18), and India (2019-21) had been used. Bivariate and multinomial logistic regression was performed using Stata with a 5% significance level.
Living arrangement of women had a significant association with contraceptive use in South Asia. The Mother-in-law (MIL) influenced the contraceptive method used by the Daughter-in-law (DIL), albeit a country-specific method choice. Modern limiting methods were significantly higher among women living with MIL in India. The use of the modern spacing method was considerably high among women co-residing with husband and/or unmarried child(ren) and MIL in Nepal and India. In Bangladesh, women living with husband and other family member including MIL were more likely to use modern spacing methods.. Women co-residing with the MIL had a higher likelihood of using any traditional contraceptive method in India.
The study suggests family planning program to cover MIL for enhancing their understanding on the benefits of contraceptive use and modifying norms around fertility. Strengthening the interaction between the grassroots level health workers and the MIL, enhancing social network of DIL may help informed choice and enhance the use of modern spacing methods. Women's family planning demands met with modern contraception, and informed contraceptive choices, must also be achieved to reach the 2030 Agenda for Sustainable Development.
避孕措施有助于改善母婴健康、教育、妇女赋权、减缓人口增长和经济发展。除了南亚妇女增强的代理权之外，由于高等教育、媒体曝光和众多政府倡议，家庭在影响妇女健康和寻求健康行为方面的作用正在发生重大变化。在此背景下，本研究评估了妇女生活安排与南亚部分国家（印度、巴基斯坦、尼泊尔和孟加拉国）所使用的避孕方法之间的关系。
本研究使用了来自南亚四个国家（尼泊尔、巴基斯坦、孟加拉国和印度）最近一轮人口与健康调查（DHS）的 15-49 岁已婚妇女的数据。使用 Stata 进行了双变量和多项逻辑回归分析，显著性水平为 5%。
妇女的生活安排与南亚的避孕方法使用有显著关联。岳母对儿媳使用的避孕方法有影响，尽管这是一种特定国家的方法选择。在印度，与岳母同住的妇女使用现代限制方法的比例明显更高。在尼泊尔和印度，与丈夫和/或未婚子女同住的妇女使用现代间隔方法的比例相当高。在孟加拉国，与丈夫和包括岳母在内的其他家庭成员同住的妇女更有可能使用现代间隔方法。与岳母同住的妇女使用任何传统避孕方法的可能性更高。
该研究表明，计划生育项目应涵盖岳母，以提高她们对避孕益处的理解，并改变围绕生育的规范。加强基层卫生工作者与岳母之间的互动，增强儿媳的社会网络，可能有助于做出知情选择，并增加现代间隔方法的使用。必须满足妇女对现代避孕的计划生育需求，并做出知情的避孕选择，以实现 2030 年可持续发展议程。
