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Number of Downlaods: 23

Published Date: Jun 1, 2004

Factors Associated with Failure of Family Planning Methods in Pakistan: Burhan Village Case Study(W-91)

Aneela Sultana and Ali Abbas Qazilbash

2004

In Pakistan, the highest unmet need for knowledge
and use of contraceptives is among the rural women and is not only associated
with level of education of women, but also with the socio-cultural restraints,
that deprive a women over the control of her body. Poverty, lack of
opportunities and poor management of the available facilities, further burden
the society, which seeks refuge by having a large family. The aim of this study
is to validate the hypothesis, that cultural and psychological factors,
particularly the spousal communication, behavior and attitude influence the
women’s decision on issues regarding fertility regulation. To identify these
factors, previous empirical was researched and exploratory qualitative
interviews were conducted during a six-month field visit of Burhan, district
Attock, tehsil Hassan Abdal, with a population of about 8,000. A socio-economic
survey was conducted from 80 households only and the total population of the
selected households was 616 persons comprising 56 per cent males and 64 per
cent females. The survey yielded a sample population of 43 married females in
their reproductive age for detailed interviews.

The findings show that 77 per cent of the women
interviewed were below 20 years of age when they got married and 17 per cent
were below 15 years at the time of their marriage. The spousal age gap was
found to be high as 42 per cent women were 7-9 years younger than their
husbands, while 21 per cent were 10-12 years younger. The literacy level among
the women was poor as well, as 28 per cent of these women had no schooling,
while 33 per cent had five years of schooling and 26 per cent had 8 years of
schooling. This study, did however, also reveal that even an educated women had
no say in the decision making process with regards to the family size and
fertility rate, because of the social constraints and culturally, traditionally
defined norms. Decision making was solely the responsibility of the husband in
88 per cent cases, while only 5 per cent of the families involved both the wife
and husband and in a further 5 per cent, the husband and mother-in-law were
involved in the decision making process. There was only one case, where the
wife alone was involved in the decision-making process for fertility
regulation. With regards to the spousal communication, this study revealed that
in 28 per cent spacing between children was discussed between the husband and
wife, whereas only 19 per cent actually discussed the number of children that
they would have and 16 per cent discussed maternal health. The most intriguing
aspect of this study was revealed when women were asked about the degree of
freedom granted to them by their husbands. Of these 43 women, 14 per cent said
that their husbands gave them permission to leave their homes alone, 9 per cent
could go the hospital alone, 58 per cent were allowed to talk to other women
about matter related to family affairs and 49 per cent were allowed to talk to
family health workers (LHVs, LHWs etc). The interesting part of this finding
was the fact that not a single woman said that she would argue with her
husband.

The culture of a given community determines the
reproductive behavior of a person including family planning, family size,
desire for a male child etc. This study re-enforces this hypothesis, with the
added fact that the role of males is essential to curtail the menace of
increasing population. At the same time, female education and empowerment of
women go hand in hand with social justice and development. There is no doubt
that in our society, be it rural or urban, education and empowerment of women
is not considered a high priority. Women marry at a young age to men who are
often 7- 12 years older then them. As a result, they are dominated by their
spouses and the prevailing conservative traditions; hence have little to say
with regards to their own reproductive health.
Therefore, in order to effectively promote the use of contraceptives and
make family planning a success, new indicators need to be identified and
captured. The role of men must be addressed adamantly and couple’s joint
decision-making should be promoted as a strategy for increasing family planning
use.