 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. The principal aim of this study is to assess the strength in Pakistan of a set of hypothesized obstacles to practicing contraception. Survey data are analyzed that were collected in Punjab province in 1996 and that contain unusually detailed measurement of various perceived costs of practicing contraception, as well as focused measurement of fertility motivation. The framework guiding the research specifies 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 preferences and attitudes, health concerns, and perceived access to services. Net effects of each obstacle are estimated through structural equation modeling of the intention to practice contraception in the near future, in which the six obstacles are treated as latent variables. The estimates indicate that the two principal obstacles to using a contraceptive are the woman’s perception that such behavior would conflict with her husband’s fertility preferences and his attitudes toward family planning and her perception of the social or cultural unacceptability of contraception. The results confirm the value of taking contraceptive costs seriously, and, in particular, of attempting to measure these costs in empirical research on family planning. (Studies in Family Planning 2001; 32[2]: 95–110)
Stan Becker is Professor, and Elizabeth Costenbader is a doctoral candidate, School of Hygiene and Public Health, Department of Population and Family Health Sciences, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 20205–2179. E-mail: sbecker@jhsph.edu Many Demographic and Health Surveys (DHS) in the past decade have queried husbands and wives about their current contraceptive use. In this study, couples’ concurrence on use and method used is compared by means of data from 23 countries, mostly in sub-Saharan Africa. Husbands report higher levels of use than do their wives in every country studied, with ranges from 2 percent higher (Brazil) to 150 percent higher (Mali). Many of the discrepancies are the result of husbands’ sole reports of periodic abstinence and condom use. Couples with polygynous husbands show less concurrence than do monogamous couples, although the majority of these differences could result from a data-collection problem. Monogamous couples in which one or both spouses reported having extramarital sex partners show less concurrence than do monogamous couples reporting no other partners. Problems of validity of both husbands’ and wives’ reports are discerned, and in the few instances where a direct comparison is possible, wives’ reports are shown to have greater validity. Logistic regression results show that spousal discussion about family planning and greater female education are consistent predictors of concurrence. (Studies in Family Planning 2001; 32[2]: 111–129)
Kathleen Beegle is Associate Economist and Elizabeth Frankenberg is Social Scientist, RAND, 1700 Main Street, P.O. Box 2138, Santa Monica, CA 90407–2138. E-mail: efrankenberg@rand.org. Duncan Thomas is Senior Economist at RAND and Professor of Economics at the University of California, Los Angeles. Indonesian women’s power relative to that of their husbands is examined to determine how it affects use of prenatal and delivery care. Holding household resources constant, a woman's control over economic resources affects the couple’s decisionmaking. Compared with a woman with no assets that she perceives as being her own, a woman with some share of household assets influences reproductive health decisions. Evidence suggests that her influence on service use also varies if a woman is better educated than her husband, comes from a background of higher social status than her husband's, or if her father is better educated than her father-in-law. Therefore, both economic and social dimensions of the distribution of power between spouses influence use of services, and conceptualizing power as multidimensional is useful for understanding couples' behavior. (Studies in Family Planning 2001 32[2]: 130–146)
ReportsCarol E. Kaufman is Healthy Ways Project Director, University of Colorado Health Sciences Center, University North Pavilion, 4455 East Twelfth Avenue, AO11–13, Denver, CO 80220. E-mail: carol.kaufman@uchsc.edu. Thea de Wet is Associate Professor, Rand Afrikaans University, Johannesburg, South Africa. Jonathan Stadler is Project Coordinator, LoveLife, Reproductive Health Research Unit, Baragwanath Hospital, Johannesburg, South Africa, and was Research Coordinator, Adolescent Health Program, Health Systems Development Unit during this project. South Africa's total fertility rate is estimated to be one of the lowest in sub-Saharan Africa, fewer than three births per woman nationally and declining. At the same time, adolescent childbearing levels remain high: More than 30 percent of 19-year-old girls are reported to have given birth at least once. Evidence from focus-group discussions conducted in urban and rural areas in South Africa with young black women and men, and with the parents of teenage mothers, is used to consider the experience of early parenthood, including the role of paternity, education, work opportunities, and subsequent fertility. In South Africa, in contrast to many other settings, teenage mothers may return to school once they have given birth, and this opportunity is strongly related to a long delay before the birth of a second child. Educated girls also tend to bring more bridewealth, which may encourage parents to support their daughters' schooling, and perhaps their return to school following childbirth. The support of the child, however, is often subject to paternal recognition and commitment, even though boys are unwilling to admit paternity because it jeopardizes their educational and employment opportunities. (Studies in Family Planning 2001; 32[2]: 147–160)
Kate Miller is a doctoral candidate and Susan Cotts Watkins is Professor, Department of Sociology, Population Studies Center, University of Pennsylvania, 3718 Locust Walk, Philadelphia, PA 19104. E-mail: millerka@ssc.upenn.edu. Eliya Msiyaphazi Zulu is Research Fellow, the African Population and Health Research Centre, Population Council, Nairobi. Previous efforts by demographers to describe and explain spousal differences in reporting about family planning behavior have focused on individual attributes that are assumed to be related to the practice of contraception. This study extends that research by documenting spousal disagreement on a range of issues—household items, livestock, children, and spousal communication about fertility, family planning, and AIDS. Using data from a 1998 study of 585 monogamous couples in rural Malawi, the analysis identifies a systematic gender component to reporting: For many of the survey questions considered, when spouses disagree, husbands are more likely to say "yes" and wives "no." The findings are interpreted in terms of gendered strategies in the interview process. (Studies in Family Planning 2001; 32[2]: 161–174)
Data
|
