|
| ||||||
MEDIA CENTER In Pakistan, Husbands as Obstacles to Contraceptive Use NEW YORK (27 June 2001) — In tackling the question of unmet need for contraception in Pakistan, an article in the Population Council's June issue of Studies in Family Planning measures the costs of contraception and explores why women of reproductive age who say they want to limit childbearing do not necessarily use contraception. The research reveals that access to services is by no means the only obstacle to contraceptive use. In Pakistan various social costs present imposing barriers, say researchers John B. Casterline, Zeba A. Sathar, and Minhaj ul Haque. In 1996 the authors conducted focus-group discussions and in-depth interviews with men and women in eight different locales in north, central, and southern Punjab. Later that year they conducted a survey throughout the province. The authors assessed six major obstacles to contraceptive use: the strength of motivation to avoid pregnancy, awareness and knowledge of contraception, the social and cultural acceptability of contraception, perceptions of the husband's attitudes and preferences, health concerns, and perceived access to services. Unlike earlier studies on the subject, the analysis by Casterline and colleagues assigns explicit weights to each obstacle. According to their findings, women's perceptions of their husbands' attitudes and preferences emerge as a dominant obstacle. Contraceptive prevalence in Pakistan began to increase in the 1990s, rising from 12 percent in 1990-91 to 24 percent in 1996-97. Nevertheless, unmet need for family planning remains at relatively high levels by international standards. The country's fertility rates are also high in relation to those of other South Asian nations and in relation to conventional measures of socioeconomic development, such as income and urbanization. "What emerges most clearly from the qualitative interviews with women is the extent to which users and nonusers are polarized in their fear of side effects and in their perceptions of husbands' disapproval of contraception," say the authors. "Men, in contrast, invoke a more diverse set of reasons for nonuse, ranging from religious concerns to fear of social ostracism to concern about financial costs and fear of side effects." Statistical analysis of the survey data leads to similar conclusions: the principal obstacles to women's use of contraception are a perception that their husbands are opposed and a feeling that contraceptive practice is unacceptable on social and religious grounds. Lack of appropriate knowledge about contraception is a further obstacle of some importance. The authors argue that family planning services in Pakistan can be more successful if they are designed so as to weaken these obstacles to the adoption and continued use of contraception. John B. Casterline is Senior Associate, Policy Research Division, Population Council, New York. E-mail: jcasterline@popcouncil.org. Zeba A. Sathar is Deputy Representative and Program Associate and Minhaj ul Haque is Senior Program Officer, Population Council, Islamabad, Pakistan. Other articles, reports, data and book reviews, Vol. 32, No. 2, June 2001 Articles Husbands' and Wives' Reports of Contraceptive Use, by Stan Becker and Elizabeth Costenbader Bargaining Power Within Couples and Use of Prenatal and Delivery Care in Indonesia, by Kathleen Beegle, Elizabeth Frankenberg, and Duncan Thomas Reports Adolescent Pregnancy and Parenthood in South Africa, by Carol E. Kaufman, Thea de Wet, and Jonathan Stadler · Husband-Wife Survey Responses in Malawi, by Kate Miller, Eliya Msiyaphazi Zulu, and Susan Cotts Watkins Data Lebanon: 1996 Maternal and Child Health Survey Madagascar: 1997 Demographic and Health Survey Book Review Barbara Ibrahim on The Female Circumcision Controversy: An Anthropological Perspective by Ellen Gruenbaum For subscription information on Studies in Family Planning, call 212-339-0514, fax 212-755-6052, or email publications@popcouncil.org.
|
