Determinants of contraceptive continuation in rural Bangladesh.

A contraceptive study of rural Bangladeshi women indicated that the previous death of children, number of living children, desire for additional children and son preference were important determinants of contraceptive continuation. The importance of these factors varies to some extent with use of different contraceptive methods.     

Does sex of children matter? Implications for fertility in Pakistan

Preference for children of either sex is considered a constraint on fertility decline as it induces many couples to keep adding on surviving children in the hope of having a desired sex composition of children. However, preferences for children of a particular sex may differ in relation to demographic and socioeconomic characteristics of women, traditional values and cultural practices, such as propagating a family name, providing economic advantages, and obtaining a medium of social and economic security in times of illness, unemployment and old age. Utilizing the Pakistan Integrated Household Survey (2001-02), this paper aims at investigating the existence of sex preference and examines sex preference differentials by different attributes of women in Pakistan. The results reveal that there is a desire to have another child in the presence of all children of one sex, either sons or daughters. The desire to have a son with only or mostly daughters, however, is stronger than the desire to have a daughter with only or mostly sons. This behaviour will retard fertility decline unless there is a shift in the desire to have children of both sexes in Pakistan.     

Does son preference matter?

The demand for additional children is influenced by the presence of sons within a family. This study is based on cross-sectional data of 9416 currently married women under age 50 from a Pakistan national survey in 1979-80. The analysis suggests that having at least one son in the family influences the demand for additional children. Urban and rural comparisons indicated a higher preference for sons in urban areas. Unless the socioeconomic milieu changes, son preference is likely to remain strong in Pakistan.     

Son preference and intimate partner violence victimization in India: examining the role of actual and desired family composition

Son preference has been considered as a determinant of women's risk of intimate partner violence (IPV) experience in India, although quantitative evidence from large nationally representative studies testing this relationship is limited. This study examines the association between husband's son preference, sex composition of children and risk of physical and sexual IPV victimization among wives. Information was collected for 26,284 couples in the nationally representative 2005-2006 National Family Health Survey of India. The exposures were husband's son preference measured as husband's desire for one or more sons greater than the number of daughters and sex composition of the household: only sons, only daughters and mixed. Outcome included past year physical and/or sexual IPV. The results showed that husband's reported son preference (RR: 1.05; 95% CI: 0.98-1.13) and sex composition of children were not associated with risk for IPV victimization in the models adjusted for socio-demographic factors. The findings from this first population-based study of socio-cultural norms around son preference and married Indian women's risk for IPV victimization indicate that cultural preference for sons does not influence women's risk for IPV victimization.     

The effect of husbands' fertility preferences on couples' reproductive behaviour in rural Bangladesh

Bangladesh society is profoundly gender stratified, and yet male roles in reproductive health processes have not been rigorously investigated. This study examines the association between men's reproductive health knowledge, attitude and behaviour and their wives' subsequent reproductive behaviour using longitudinal data from the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B). A total of 4969 matched husband-and-wife data from a 1998 survey and women's contraceptive use history data following this survey are used. Results show a significant association between husbands' fertility preferences and current use of any family planning method. When wives' background characteristics, and husbands' background and socioeconomic characteristics are controlled for, the predicted probability of using a method of contraception among non-educated wives whose husbands want more children is 0.49 compared with 0.64 for those whose husbands do not want more children. However, the net effect of husbands' preference for additional children diminishes as wives' level of education increases. Among wives who had completed high school, the predicted probability of using a method of contraception is 0.70 for those whose husbands want more children compared with 0.69 for those whose husbands do not want more children.     

Relationships of desire for no more children and socioeconomic and demographic factors in Sri Lankan women.

Data from the 1982 Sri Lanka Contraceptive Prevalence Survey are used to identify women who wish to stop childbearing; they differ in socioeconomic status from their counterparts who want more children. Educated women are more likely to be motivated to cease childbearing than non-educated women; Christian or Sinhalese/Buddhist women are more willing to stop childbearing than Moor/Muslim or Tamil/Hindu women. The relationships between sex composition of existing children and women's fertility desires indicate that although moderate son preference exists it does not affect their contraceptive behaviour. Among those who want no more children, 15% are at risk of unwanted pregnancy because they do not practise contraception. Again better education and being Christian or Sinhalese/Buddhist reduced the risk of unwanted pregnancy. Women whose husbands disapproved of contraception had over four times higher risk of unwanted pregnancy than women whose husbands approved.     

Analysis of motivation to contraceptive use applying the weighting procedure

This paper presents a technique for scaling contraceptive use motivation for the sample population of the Family Planning Health Services Project in Matlab. The project, which began in 1977, is conducted by the International Centre for Diarrhoeal Disease Research, Bangladesh. The hypothesis of the research is that through the use of a scaling algorithm the power of demographic characteristics, attitudes, and intentions for predicting contraceptive use can be enhanced. The analysis shows that two factors explain use motivation. Scale 1 is weighted for demographic variables and desire for additional children, while Scale 2 is comprised of education and intentions of contraceptive use. Both scales have a pronounced independent predictive power. We conclude that scaling has improved upon the predictive power of indicators of reproductive motivations.     

Sociodemographic attributes of Iranian wives who reported unwanted pregnancies

In a 1989 Family Planning Study in Iran, 40 percent of the married women of reproductive age reported that their last or current pregnancies were unwanted and unintended. This finding is consistent with the results obtained from a number of studies undertaken in the countries of North Africa and the Middle East. Although the phenomenon of unwanted pregnancy is a significant topic in the population studies, it has received very little attention. This paper shows the differences between two groups: group A, those married women who reported that their last or current pregnancies were wanted, and group B, those married women who reported that their last or current pregnancies were unwanted. The findings of this study clearly show significant differences between these two groups in regard to some key sociodemographic attributes: wife/husband's education, actual and desired fertility, wife's current age, past and present practice of contraceptive methods, and extent of satisfaction with family planning services are among the attributes differentiating these two groups. Our examination of these variables suggests that group B had higher parity, fertility, less desire for more children, less use of contraceptive techniques, and less satisfaction with the efficiency of the contraceptive techniques than group A. The relationship between education and wanted/unwanted pregnancies is mixed. The urban women who wanted pregnancies and were 25 years old or older were more educated than those who did not want pregnancies. On the contrary, the rural women whose pregnancies were not wanted were more educated than those who wanted pregnancies regardless of age, parity, and locality differences. Furthermore, the urban/rural women with different levels of parities who did not want to be pregnant were more educated than the urban/rural women who wanted pregnancies. Finally, the standardized regression coefficients, obtained in logistic regression, reveal that among urban women the desire for more children and parity are the first and second most significant independent variables differentiating between group A and group B. Among rural women, living children and the desire for more children were the first and second most important variables differentiating between group A and group B.     

Use of periodic abstinence in Bangladesh: do they really understand?

Data from a nationally representative study in Bangladesh (BDHS 1996-97) were analysed to identify significant predictors of use of periodic abstinence, in comparison with other modern contraceptive methods. The study found that women in Bangladesh mostly use modern methods during their peak reproductive years, after which some of them switch to periodic abstinence. These women tend to be more from educated and from higher socioeconomic backgrounds and with at least one living son. Another set of data from the Matlab DSS was analysed and the results were in the same direction. Focus group discussions found that women were using the periodic abstinence method incorrectly, abstaining for more days than is necessary. For Bangladeshi contraceptive users to reach a higher degree of use-effectiveness for period abstinence, more IEC materials need to be developed.     

Sociodemographic attributes of Iranian wives who reported unwanted pregnancies

Abstract

In a 1989 Family Planning Study in Iran, 40 percent of the married women of reproductive age reported that their last or current pregnancies were unwanted and unintended. This finding is consistent with the results obtained from a number of studies undertaken in the countries of North Africa and the Middle East. Although the phenomenon of unwanted pregnancy is a significant topic in the population studies, it has received very little attention. This paper shows the differences between two groups: group A, those married women who reported that their last or current pregnancies were wanted, and group B, those married women who reported that their last or current pregnancies were unwanted. The findings of this study clearly show significant differences between these two groups in regard to some key sociodemographic attributes: wife/husband's education, actual and desired fertility, wife's current age, past and present practice of contraceptive methods, and extent of satisfaction with family planning services are among the attributes differentiating these two groups. Our examination of these variables suggests that group B had higher parity, fertility, less desire for more children, less use of contraceptive techniques, and less satisfaction with the efficiency of the contraceptive techniques than group A. The relationship between education and wanted/unwanted pregnancies is mixed. The urban women who wanted‐pregnancies and were 25 years old or older were more educated than those who did not want pregnancies. On the contrary, the rural women whose pregnancies were not wanted were more educated than those who wanted pregnancies regardless of age, parity, and locality differences. Furthermore, the urban/rural women with different levels of parities who did not want to be pregnant were more educated than the urban/rural women who wanted pregnancies. Finally, the standardized regression coefficients, obtained in logistic regression, reveal that among urban women the desire for more children and parity are the first and second most significant independent variables differentiating between group A and group B. Among rural women, living children and the desire for more children were the first and second most important variables differentiating between group A and group B.     

Two sons and a daughter: sex composition and women's reproductive behaviour in madhya pradesh, India

Summary This article examines how the sex composition of women's current children at the start of a pregnancy interval influences both fertility desires and the full range of reproductive actions women may take to realize them, including temporary contraception, abortion and sterilization, in Madhya Pradesh, India, where popular notions of ideal family size and sex composition are dominated by son preference. The analysis is conducted using a dataset of 9127 individual pregnancy intervals from a 2002 statewide representative survey of 2444 women aged 15-39 with at least one child. The results indicate that women's preferences go beyond a singular preference for male children, with the preferred composition of children being two boys and one girl. Women with this composition are 90% less likely to report having wanted another pregnancy (OR 0.097, p<0.01) relative to those with two girls. These preferences have significant implications for reproductive actions. While sex composition has no statistically significant effect on the use of temporary contraception, those with the preferred sex composition are twice as likely to attempt abortion (OR 2.436, p<0.01) and twelve times more likely to be sterilized (OR 12.297, p<0.01) relative to those with two girls only.     

Mass media exposure and its impact on family planning in Bangladesh

This paper analyses mass media exposure and its effect on family planning in Bangladesh using data from the Bangladesh Demographic and Health Survey (BDHS) 1993-94. The findings indicate that radio and television are two important mass media for disseminating family planning information in Bangladesh. However, access to them and exposure to family planning through them are still limited. Slightly more than 40% (42.1%) of respondents reported that they had heard family planning messages via radio, while 17.2% said television, 8.4% said poster and 5.4% said billboard. Respondent's place of residence, education, economic status, geographical region and number of living children appeared to be the most important variable determining mass media exposure to family planning. Multivariate analysis shows that both radio and TV exposure to family planning messages and ownership of a radio and TV have a significant effect on current use of family planning methods. These factors remain significant determinants of contraceptive use, even after controlling socioeconomic and demographic factors. The study reveals that both socioeconomic development policies and family planning programmes with a special emphasis on mass media, especially radio, may have a significant effect on contraceptive use in Bangladesh. The principal policy challenge is to design communications strategies that will reach the less privileged, rural and illiterate people who are by far the majority in Bangladesh.     

Effect of child survival on contraceptive use in Bangladesh.

A study in Bangladesh showed that couples who lost a child often stopped practising contraception in order to have another child. Logistic regression analysis revealed that contraceptive continuation was related to maternal age, parity, husband's education and the sex of the last child.     

Factors affecting the choice of nonpermanent contraceptive methods among married women

Data from the 1976 US National Survey of Family Growth were used to examine the effect of sociodemographic factors on choice of nonpermanent contraceptive methods among white, fecund, married women aged 15-44 who intend no additional births. A multivariate analysis revealed that age of the respondent had a strong negative relationship to the effectiveness of contraceptive chosen. Being Catholic had a negative effect on the effectiveness of contraceptive chosen, but significant interaction occurred between age and parity and between age and education. 1 explanation may be that increased age may result in reduced perception of risk that an unwanted birth will occur. Another explanation is that concerns about health risks associated with the pill or IUD use may lead to use of other methods among older women. The most probable explanation of the observed relationship is a cohort effect. Older women who began marital contraception at an earlier point in time have continued to use the same methods as were initially available early in their marriage. The lack of a significant association between parity and the effectiveness of contraceptive method chosen based on multivariate analysis is most likely due to the high correlation between parity and age. The lack of a significant effect of education on choice of method may be explained by the nearly universal access to all methods of contraception for married women. Further research on the same lines is strongly urged to shed light on current behavior patterns.     

Determinants of birth intervals in Sudan

Using individual birth history data from the Sudan Fertility Survey, 1979, parity-related differences in fertility are demonstrated, as well as differences between socioeconomic groups. Rural women, women with no education and those married to uneducated husbands show rapid parity progression and its cumulative effects on fertility which are consistent over all birth intervals. Urban women, women with some education and those married to educated husbands, however, go rapidly through their second and third birth intervals and then more slowly at higher parities. A limitation of the study was the inability to control fully for the effects of breast-feeding and contraception. There is evidence for a reduction in high parity births, starting in the 1970s.     

Preferences for sex of children: a multivariate analysis

Data from the 1973-74 Growth of Alberta Family Study were used to determine whether women who express a preference for sons versus daughters differ from each other in terms of selected characteristics. 67% of the 599 women surveyed indicated a preference for at least 1 child of each sex. However, the majority of those who wanted 3 children desired 2 sons and 1 daughter, indicating a slight son preference. Discriminant function analysis indicated the pull toward son preference was greater the higher the woman's education, the more sisters the wife has, and the higher the current family size and number of additional children expected. While the number of wife's sisters makes the greatest contribution to daughter preference among adolescent mothers, birth place (Canada) was most important among older women. Finally, it was shown that acceptance of traditional female roles was a significant discriminator among women with a strong sex preference and those with no sex preference at all. These findings suggest that sex preference may become an important factor in fertility decisions as family size continues to decrease. If sex predetermination were to become possible, an imbalance in the sex ratio is a likely result.     

Determinants of contraceptive use and method choice in Turkey

In this study, the determinants of contraceptive use and method choice are examined based on various variables, classified as individual, cultural, fertility and contextual. The data used came from the 1993 Turkish Demographic and Health Survey. The main finding is that there exists a positive association between the educational level of both spouses and the use of contraceptive methods in Turkey. After all individual, cultural, fertility and contextual variables are controlled, a woman's education is a stronger predictor of method use and method choice than that of her husband. Increasing the educational level of women may be the most effective means of advancing family planning acceptance and increasing the demand for contraceptive services in Turkey. The study also shows that, to a great extent, contraceptive use and choice of modern method depend on the sex of a couple's living children, implying some preference for sons, although generally women prefer to have children of both sexes.     

The effects of sex preselection on the sex ratio of families

Advances in the potential for couples to predetermine the sex of their children will have significant consequences for many aspects of society. Among the likely demographic impacts are changes in both population size and the sex ratio. The aim of this article is to assess the effects of sex preselection on the sex ratio of families. The expected family sex ratio is derived and characterized for couples with particular preferences for the sex composition of their families. When couples desire k children of one sex and none of the other, the proportion of children in the completed family that are of the desired sex falls with increasing k. Constraints on total family size further reduce this proportion. When couples have a desire for a balanced composition of one boy and one girl, and when they have a preference for, say, a boy to be born first, they can expect a proportion of boys in the family that at first rises, and then falls, as sex preselection methods improve.     

Parental preference for sons and daughters in a Western industrial setting: evidence and implications

This paper considers whether sex composition of existing children in Australian families is an important factor in parity progression. Using census data from 1981, 1986, 1991, 1996 and 2001, women are linked with their co-resident children, allowing investigation of family sex composition and its changing impact over time on the propensity to have another child. The study finds that parents are much more likely to have a third and fourth birth if existing children are all of the same sex, indicating a strong preference for children of both sexes. This increased propensity has added around three per cent to the fertility of recent cohorts. The paper concludes with a discussion of the potential impact of sex-selection technologies on fertility. The authors argue that future widespread use of reliable sex-selection technologies might act to increase fertility in the short term, but would lead to a long-term reduction in fertility.     

The relation of son preference and religion to induced abortion: the case of South Korea

This paper explores the factors that influence the practice of induced abortion in a very low fertility society, with particular emphasis on son preference and three distinct religions: Confucianism, Buddhism and Christianity. Using multivariate logistic regression models fitted by the generalized estimating equation (GEE) method, this paper analysed the data collected by the 2000 Korea National Fertility and Family Health Survey of 6348 married women aged 15-49 years with a total of 1217 pregnancy outcomes. The results showed that the likelihood of induced abortions in women with two or more children, compared with those with one child, was significantly influenced by the sex composition of the previous children: odds ratio (OR)=12.71 (95% CI=5.49, 29.42) for women with only son(s), and OR=3.91 (95% CI=1.67, 9.14) for women with only daughter(s). At parity two, women with two sons were much more likely to have induced abortions than women with two daughters (OR=5.88, 95% CI=2.70, 12.85). Although Buddhist women were not significantly different from Confucian women in induced abortion practice, Christian women were much less likely than Confucian women to have an induced abortion (OR=0.39, 95% CI=0.18, 0.88 for women with only sons and OR=0.44, 95% CI=0.24, 0.81 for women with two children). This suggests that even in this very low fertility society, son preference and religious affiliation are significant predictors of women's practice of induced abortion.