Son Preference, Parity Progression and Contraceptive Use in South Asia

Abstract

Background: The desire for sons has long been recognised as a significant determinant of childbearing decisions throughout most of South Asia. This paper provides an overview of the stated desire for sons and the manifestations of son-preferring behaviour in relation to parity progression and contraceptive use. Methods: This paper uses the most recently available Demographic and Health Survey (or equivalent) data from five South Asian countries: Afghanistan, Bangladesh, India, Nepal and Pakistan. The extent of son preference in these countries is compared in terms of reported latent son preference as well as in terms of revealed son preference in relation to differential stopping behaviour, and choices about contraceptive use and contraceptive method. Results: Parity progression is driven by son preference to some extent in all five countries studied. It is found that son preference is also a major factor in determining use of permanent contraceptive methods in every country apart from Afghanistan. The association is particularly strong in Nepal, India and Pakistan. Women with fewer than two sons are generally much less likely to use permanent contraceptive methods. On the other hand, son preference has little association with temporary or traditional contraceptive use in any country. Conclusion: The desire for sons has a significant impact on fertility and contraceptive choices across much of South Asia, even in places where high fertility persists. Family planning programmes in these areas need to change deeply embedded attitudes in order to be successful. In Pakistan and Afghanistan in particular, future reductions in fertility could be hindered by high levels of son preference.

Fertility Limiting Intention and Contraceptive Use among Currently Married Men in Nepal: Evidence from Nepal Demographic and Health Survey 2016

“…Men with three or more sons only were more likely to use sterilization methods than couples having less than two sons and at least one daughter. These findings also confirm that son preference is stronger in Nepal than Bangladesh as has been reported previously [18, 19]. Furthermore, the researchers showed an association between use of traditional methods and sex composition of children.…”

“…Previous studies have shown stronger association of son preference with contraceptive use pattern in Nepal compared to other South Asian countries [18, 19]. Furthermore, strong son preference was expressed through increased proportion of permanent method users after two or three sons compared to those having no son [19]. In addition, Leone et al showed that son preference was expressed through differential stopping of child bearing [6].…”

In the Pursuit of Sons: Additional Births or Sex‐Selective Abortion in Pakistan?

“…Stalling contraceptive prevalence rates and the consequent slowdown of fertility decline may indicate that women are having additional children in the pursuit of sons. Previous studies have also found that the number of living sons is associated with intentions to have additional children, intentions to use contraception, and subsequent fertility (Mahmood and Ringheim 1996; Sathar and Casterline 1998; Casterline, Sathar, Haque 2001; Hussain, Fikree, and Berendes 2000; Muhammad 2009; Channon 2015). …”

Influence of the preference for sons on contraceptive use in Bangladesh: A multivariate analysis

“…Women with fewer than two children are, by and large, considerably less to avail themselves of permanent contraception. On the other hand, the preference for sons has no real relationship with the choice in traditional and temporary contraceptive methods in this region ( Channon, 2015 ). In addition, women in rural areas with high infant mortality rates are less likely to use contraceptives than women in urban areas with low infant mortality rates ( Thang et al., 1992 ).…”