Spousal Separation and Interpretation of Contraceptive Use and Unmet Need in Rural Nepal

Ban, Bharat; Karki, Sujan; Shrestha, Ashoke; Hodgins, Stephen

doi:10.1363/3804312

Cited by 25 publications

(24 citation statements)

References 11 publications

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“…In Nepal, international migration and rural-to-urban migration within Nepal [migration may be seasonal, temporary, semipermanent, or permanent; its nature often depends on the reason for migration] are rapidly increasing [1]. A recent study in Nepal showed about a third of the households (30%) had at least one member of the family migrated.…”

Section: Introductionmentioning

confidence: 99%

“…Using NDHS 2016 data, this study examines spousal separation and its effect on contraceptive use in Nepal [4]. Previous work on this topic using 2011 NDHS data [5] and the data from 40 rural districts [1] showed a significantly higher unmet need and lower use of modern contraceptives among couples living separately compared with cohabiting couples. Spousal separation was shown to play a crucial role in the decline of total fertility in the absence of a corresponding rise in the contraceptive uptake in Nepal [5], which is also supported by a recent mixed method study [2] that identified recently married couples delaying to plan for a baby due to spousal separation, usually husband.…”

Section: Introductionmentioning

confidence: 99%

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Spousal Separation and Use of and Unmet Need for Contraception in Nepal: Results Based on a 2016 Survey

Mehata

Paudel

Dhungel

et al. 2020

The Scientific World Journal

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Nepal is facing a large-scale labour migration—both internal and international—driven by economic and employment opportunities. There is sparse literature available at the national level which examines the link between migration and contraceptive use. This study aimed at identifying contraceptive use and the unmet need for family planning (FP) and exploring its correlates among the married women of reproductive age (MWRA) by their husbands’ residence status, using data from Nepal Demographic Health Survey 2016–a nationally representative cross-sectional survey. A stratified two-stage cluster sampling in rural and a three-stage sampling in urban areas were used to select the sampling clusters, and data from 11,040 households were analyzed. Reported values were weighted by sample weights to provide national-level estimates. The adjusted odds ratio (aOR) was calculated using multiple logistic regressions using complex survey design, considering clusters, and stratification by ecological zones. All analyses were performed using Stata 15.0. Among the total MWRA, 53% were using a contraceptive method, whereas the proportion of contraceptive use among the cohabiting couple was 68%. The unmet need for contraceptive use was 10% among cohabiting couples and 50% among the noncohabiting couples. Contraceptive use was significantly low among the women reporting an induced abortion in the last five years and whose husbands were currently away. A strong negative association of spousal separation with contraceptive use was observed (aOR:0.14; p<0.001) after controlling other covariates, whereas a positive association was observed with the unmet need (aOR:8.00; p<0.001). Cohabiting couples had a significantly higher contraceptive use and lower unmet need compared with the couples living apart. Between 2006 and 2016, contraceptive use increased by 1% per year among cohabiting couples, although this increase is hugely attributable to the use of traditional methods, compared with modern methods. The labour migration being a significant and indispensable socioeconomic phenomenon for Nepal, it is necessary to monitor fertility patterns and contraceptive use by cohabitation status in order to ensure that the national family planning interventions are targeted to address the contraceptive and fertility needs of the migrant couples.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Spousal Separation and Use of and Unmet Need for Contraception in Nepal: Results Based on a 2016 Survey

Mehata

Paudel

Dhungel

et al. 2020

The Scientific World Journal

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“…More specifically, some have pointed out that ECP may be being used as a substitute for other contraceptive methods in Nepal. In recent years, this issue has been more poignant in dialogues and discussions, especially in light of the apparent stagnation of contraceptive prevalence in the country [6, 7]. The concern regarding the potential use of ECP as a substitute for contraceptive use also parallels concerns raised in response to the rising use of abortion in Nepal [8].…”

Section: Introductionmentioning

confidence: 99%

A new wave in the quiet revolution in contraceptive use in Nepal: the rise of emergency contraception

Thapa

2016

Reprod Health

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BackgroundIn Nepal, while the use of the emergency contraceptive pill (ECP) has been increasing rapidly in recent years, very little is known about the profile of ECP users. This study assesses the increasing role of ECP and the profile of ECP users in Nepal. Some policy and programmatic concerns are also addressed.MethodsSurvey interviews were undertaken involving 185 women who visited five metropolitan medical shops located in Pokhara seeking to purchase ECP for their own use. Descriptive statistics were calculated for data analysis.ResultsECP is popular among young (<25 years old) and educated women. Also, nearly 70 % of the ECP users described their most recent sexual relationship as infrequent/casual. The overwhelming majority of users are aware that ECP is for emergency use only. Most ECP users are also aware of other options like condoms, the oral pill, and injectable contraceptives; and a considerable proportion of women using ECP had also used these methods before.ConclusionECP is filling an important and unique role in reducing unplanned or unwanted pregnancy, especially among young, educated women, and those with infrequent sexual relationships.

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“…There is an overall need to increase the availability of long‐acting methods post‐abortion, both reversible and permanent, particularly for women desiring no more children. Additionally, women whose husbands travel for work and/or may not be living with them regularly are in particular need of effective post‐abortion contraception . Given that one in three Nepali men migrate per year, having a husband who is away is common, and these women could face unique sociocultural barriers to care and require particularly sensitive interventions.…”

Section: Discussionmentioning

confidence: 99%

Pharmacy access to medical abortion from trained providers and post‐abortion contraception in Nepal

Puri

Harper

Maharjan

et al. 2018

Intl J Gynecology & Obste

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Spousal Separation and Interpretation of Contraceptive Use and Unmet Need in Rural Nepal

Cited by 25 publications

References 11 publications

Spousal Separation and Use of and Unmet Need for Contraception in Nepal: Results Based on a 2016 Survey

Spousal Separation and Use of and Unmet Need for Contraception in Nepal: Results Based on a 2016 Survey

A new wave in the quiet revolution in contraceptive use in Nepal: the rise of emergency contraception

Pharmacy access to medical abortion from trained providers and post‐abortion contraception in Nepal

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