Academic journal article International Family Planning Perspectives

Fertility-Limiting Behavior and Contraceptive Choice among Men in Nepal

Academic journal article International Family Planning Perspectives

Fertility-Limiting Behavior and Contraceptive Choice among Men in Nepal

Article excerpt

CONTEXT: Contraceptive choices among men who want no more children have been little explored in South Asia, particularly in Nepal, where fertility rates have remained high over the last few decades.

METHODS: Using the 2001 Nepal Demographic and Health Survey couple data set, multinomial logistic regression analyses were conducted for 1,041 married men aged 20 or older who had at least one living child and wanted no more children. Regression models examined relationships between selected characteristics and men's reported contraceptive use, and predicted probabilities were estimated to assess interactions between ecological zone, family composition and method choice. The primary goal was to determine whether the number and sex of living children influenced contraceptive use.

RESULTS: Twenty-four percent of men who wanted no more children were not using any contraceptive method at the time of the survey, 30% reported that their wives were sterilized, 12% had had a vasectomy, 7% were using condoms and 27% used other temporary methods. The probability of relying on permanent methods was highest among men who had at least two living sons and lowest among those who had only daughters, while the probability of using no method was highest among those who had only daughters.

CONCLUSION: In Nepal, men who report a desire to have no more children are likely to choose permanent methods only after they have two living sons.

International Family Planning Perspectives, 2008,34(1):6-14

It is widely acknowledged that men in developing countries make most of the decisions regarding family formation. (1-4) Despite women's increasing influence on house-hold decision making, their preferences regarding contraceptive choices and family size may not translate into practice unless they conform to their husband's wishes. (5), (6) Studies conducted in Africa and Latin America have shown that more than a quarter of men who want to limit or postpone their wives' childbearing do not use any method to prevent unwanted pregnancy. (7) Men's decision to use a method depends on a range of factors, (7-10), particularly the extent to which couples negotiate family planning matters and reach compromises with each other. (11-15)

Male involvement in family planning should be viewed in terms of not only the share of male method use, but also men's attitudes regarding method choices and family size preferences. (16) A better understanding of male involvement requires a systematic analysis of men's attitudes toward spacing and limiting behavior. (17), (18) This study examined contraceptive use among Nepalese men who wanted to limit their family size and the underlying factors that, in fluence their choice of a particular method.

This analysis focused on why men choose different methods and on the level of unmet need for contraception among men who want to limit family size. If these men are able to act effectively on their prelerences and are certain about their intentions, most of them would probably be using permanent methods. If they use a method that is not effective or if they do not use any method, their wives may be at risk of experiencing an unwanted birth or an abortion. Interesting empirical questions are: What proportion of these men are using permanent methods? Does this proportion vary according to the men's characteristies? If they use a permanent method, is it likely to be a male or a female method? And, for men who say they want to more children but who are not using permanent methods, do they lack access to such methods, do their wives object, do they themselves have objections to rendering themselves infertile or do they think they might change their minds later about wanting no more children? Unfortunately, the last question cannot be answered in this study because the 2001 Nepal Demographic and Health Survey (DHS), from which our data came, did not ask users about their reasons for choosing a particular method; instead, it probed for reasons only among men who were not using any method at the time of survey. …

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