European Population Conference 2012
"Will contraceptive use go up if Pakistani couples keep talking?"
Syeda Saman Naz and Batool Zaidi
Pakistan's latest Demographic and Health Survey shows a slowdown in the rate of fertility decline and a stagnant contraceptive prevalence rate. At the same time, the proportion of ever users of contraception is accelerating, which is translated by high discontinuation rates among contraceptive users. All the major reproductive health surveys show an increasing proportion of women reporting "husband disapproval" as the primary reason for not using any contraception, largely ignoring husbands' response on fertility desires. This paper uses a nationally representative survey from 5,208 couples and 2,345 contraceptive episodes contributed by these couples in four years prior to the survey. Using multiple logistic regressions and multinomial discrete-time hazard regression models, it will analyze the influence of interspousal communication on couples' perceptions and fertility preferences and how these factors in turn influence adoption of contraception and then persistent contraceptive use. The analysis includes the influence of these factors on contraceptive discontinuation, failure, and switching. Preliminary results show that wife's perception of husband's fertility is the strongest predictor of contraceptive use. Therefore the obstacle is not so much men's disapproval but the lack of communication on fertility preferences and attitudes between the couple that lead to inaccurate perceptions.
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