Using data from the Pakistan Demographic and Health Survey of 1990-91, this study examines the effect of selected socio-cultural and supply factors on contraceptive use as reported by married women of reproductive ages. In addition to the expected positive relationship of woman’s age, number of living children, education, and place of residence with contraceptive use, it is theorised that there are five factors potentially affecting fertility regulation in the socio-structural context of Pakistan. These include the extend of communication between husbands and wives, religious beliefs, female autonomy, son preference, and the family planning service and supply variables. Using logistic regression analysis, the results of the study indicate that the explanatory power of these five factors is significant in affecting the use of contraception in both urban and rural areas. While knowledge of a source for family planning is the strongest predictor of contraceptive use, husband-wife communication and religious attitudes are also significant. The fact that the inclusion of the theoretical variables dampens the predictive effect of the primary and secondary education for women leads to the speculation that while the extremely low levels of literacy among women must be addressed through government commitment to universal education, scarce family planning programme resources can be focused more effectively on promoting spousal communication, about family size and contraceptive use, and on soliciting the support of religious leaders to counteract the misperceptions about Islamic teachings on family planning and reliance on fate. With high quality and accessible services, these measures could go a long way towards providing couples with the means to meet their reproductive goals.

Globally, men have not shared equally with women the responsibility for fertility regulation. While family planning efforts have been directed almost exclusively toward women, the lack of male involvement may also reflect the limited options available to men. Current methods for men are either coitus-dependent, such as the condom or withdrawal, or permanent, such as vasectomy. The 20-year history of social science research on male contraceptive methods is examined here in terms of the human and method factors related to the acceptability of hypothetical methods and the prevalence of use of existing methods. New male methods, particularly if reversible, may alter men's willingness to accept or share responsibility for the control of fertility. Research opportunities in the areas of gender, decision-making, communication, health education, and service delivery will be enhanced when methods for women and men are comparable.

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