Couple’s reports of household decision-making, unmet need for contraception, and unintended pregnancy in Bangladesh

Uddin, Jalal and Pulok, Mohammad Habibullah and Sabah, Md. Nasim-Us (2015): Couple’s reports of household decision-making, unmet need for contraception, and unintended pregnancy in Bangladesh.

Abstract

Introduction: Previous researches emphasize the role of wife’s sole contribution in household decision-makings as predictor of family planning and reproductive health behaviors in many developing countries. These studies tend to overlook how couple’s joint decision-making may promote better reproductive health outcomes than any partner’s sole decision-makings which lack input or agreement from other partner in a marital relationship. Using married couple’s matched responses in decision-making questions; this study examines the association between couples’ concordant and discordant decision-makings, and wife’s unmet need for contraception and unintended pregnancy in Bangladesh.

Methods: This study used couple’s dataset (n= 3336) of Bangladesh Demographic and Health Survey of 2007. Multivariate logistic regression was used to examine the likelihood of unmet need for contraception, and unintended pregnancy among married women of reproductive age.

Findings: Study findings reveal that there are substantial levels of both concordance and discordance in responses to household decision-making items. Results from logistic regression analyses suggest that compared to couple’s joint decision making, husband-only or wife-only decision-making is associated with higher risk for women in having both unmet need for contraception and unintended pregnancy. Regression results also indicate that unmet need for contraception and unintended pregnancy are lower among women with lower parity, women from relatively richer households, and women heard family planning messages on television.

Conclusion: As couple’s joint decision-making is significantly associated with better reproductive outcomes, policy makers may promote community based outreach programs, and communication campaigns for family planning focusing on egalitarian gender role approach.

• Item Type: MPRA Paper
• Language: English
• Keywords: Contraception, pregnancy, women’s power, decision-making.
• Subjects: I - Health, Education, and Welfare > I1 - Health; I - Health, Education, and Welfare > I1 - Health > I12 - Health Behavior

References

1.Sedgh G, Singh S, Hussain R. Intended and unintended pregnancies worldwide in 2012 and recent trends. Stud Fam Plann 2014;45:301–14.

2.Darroch JE, Singh S. Trends in contraceptive need and use in developing countries in 2003, 2008, and 2012: an analysis of national surveys. Lancet 2013;381:1756–62.

3.Klima CS. Unintended pregnancy. Consequences and solutions for a worldwide problem. J Nurse Midwifery 1998;43:483–91.

4.Gipson JD, Koenig MA, Hindin MJ. The effects of unintended pregnancy on infant, child, and parental health: a review of the literature. Stud Fam Plann 2008;39:18–38.

5.Marston C, Cleland J. Do unintended pregnancies carried to term lead to adverse outcomes for mother and child? An assessment in five developing countries. Popul Stud (NY) 2003;57:77–93.

6.Hardee K, Eggleston E, Wong EL, et al. Unintended pregnancy and women’s psychological well-being in Indonesia. J Biosoc Sci 2004;36:617–26.

7.Eggleston E. Unintended pregnancy and women’s use of prenatal care in Ecuador. Soc Sci Med 2000;51:1011–8.

8.Joyce TJ, Kaestner R, Korenman S. The effect of pregnancy intention on child development. Demography 2000;37:83–94.

9.Story WT, Burgard SA. Couples’ reports of household decision-making and the utilization of maternal health services in Bangladesh. Soc Sci Med 2012;75:2403–11.

10.Becker S, Fonseca-Becker F, Schenck-Yglesias C. Husbands’ and wives' reports of women's decision-making power in Western Guatemala and their effects on preventive health behaviors. Soc Sci Med 2006;62:2313–26.

11.Jejeebhoy SJ. Convergence and Divergence in Spouses’ Perspectives on Women's Autonomy in Rural India. Stud Fam Plann 2002;33:299–308.

12.Islam M., Rashid M. Determinants of unintended pregnancy among ever-married women in Bangladesh. J Fam Welf 2004;50:40–7.

13.Barkat-e-khuda, Roy NC, Rahman DM. Unmet contraceptive need in Bangladesh: evidence from the 1993/94 and 1996/97 Demographic and Health Surveys. Asia-Pacific Popul J 1999;14:37–50.

14.Kamal M, Islam A. Prevalence and socioeconomic correlates of unintented pregnancy among women in rural Bangladesh. Salud Publica Mex 2011;53:108–15.

15.Khatun M, Rahman M, Khan ABMNI. Men and women’s unmet need for family planning in Bangladesh: An empirical study. J Asiat Soc Bangladesh 2007;52:143–65.

16.Rahman MM, Mostofa MG, Hoque MA. Women’s household decision-making autonomy and contraceptive behavior among Bangladeshi women. Sex Reprod Healthc 2014;5:9–15.

17.Rahman M. Women’s Autonomy and Unintended Pregnancy Among Currently Pregnant Women in Bangladesh. Matern Child Health J 2011;16:1206–14.

18.National Institute of Population Research and Training (NIPORT), Mitra Associates, ICF International. Bangladesh Demographic and Health Survey 2007. 2009.

19.Bradley SEK, Croft TN, Fishel JD, et al. Revising Unmet Need for Family Planning. DHS Analytical Studies No. 25. Calverton, Maryland, USA: 2012.

20.Carter M. Husbands and maternal health matters in rural Guatemala: wives’ reports on their spouses' involvement in pregnancy and birth. Soc Sci Med 2002;55:437–50.

21.Mullany BC, Hindin MJ, Becker S. Can women’s autonomy impede male involvement in pregnancy health in Katmandu, Nepal? Soc Sci Med 2005;61:1993–2006.

22.Chakraborty N, Islam MA, Chowdhury RI, et al. Determinants of the use of maternal health services in rural Bangladesh. Health Promot Int 2003;18:327–37.

23.Collin SM, Anwar I, Ronsmans C. A decade of inequality in maternity care: antenatal care, professional attendance at delivery, and caesarean section in Bangladesh (1991-2004). Int J Equity Health 2007;6:9.

24.Amin R, Becker S, Bayes a. NGO-promoted microcredit programs and women’s empowerment in rural Bangladesh: quantitative and qualitative evidence. J Dev Areas 1998;32:221–36.

25.Parkhurst JO, Rahman SA, Ssengooba F. Overcoming access barriers for facility-based delivery in low-income settings: insights from Bangladesh and Uganda. J Health Popul Nutr 2006;24:438–45.

26.Allendorf K. The quality of family relationships and use of maternal health-care services in India. Stud Fam Plann 2010;41:263–76.

27.Kabeer N. Conflicts Over Credit: Re-Evaluating the Empowerment Potential of Loans to Women in Rural Bangladesh. World Dev 2001;29:63–84.

28.Mumtaz Z, Salway S. Understanding gendered influences on women’s reproductive health in Pakistan: Moving beyond the autonomy paradigm. Soc Sci Med 2009;68:1349–56.