This paper blends quantitative with qualitative data in an investigation of community and contraceptive choice in Nang Rong, Thailand. Specifically, it develops an explanation of 1) method dominance within villages, coupled with 2) marked differences between villages in the popularity of particular methods. The quantitative analysis demonstrates the importance of village location and placement of family planning services for patterns of contraceptive choice. The qualitative data provide a complementary perspective, emphasizing the importance of social as well as physical space and giving particular attention to the structure of conversational networks.
With the objective of reducing maternal and neonatal mortality, the Safe Motherhood Program was implemented in Nepal in 1997. It was launched as a priority programme during the ninth five-year plan period, 1997-2002, with the aim of increasing women's access to health care and raising their status. This paper examines the association of access to health services and women's status with utilization of prenatal, delivery, and postnatal care during the plan period. The 1996 Nepal Family Health Survey and the 2001 Nepal Demographic and Health Survey data were pooled and the likelihood of women's using maternal health care was examined in 2001 in comparison with 1996. Multiple logistic regression analysis indicates that the utilization of maternal health services increased over the period. Programme interventions such as outreach worker's visits, radio programmes on maternal health, maternal health information disseminated through various mass media sources and raising women's status through education were able to explain the observed change in utilization. Health worker visits and educational status of women showed a large association, but radio programmes and other mass media information were only partially successful in increasing use of maternal health services. Socioeconomic and demographic variables such as household economic status, number of living children and place of residence showed stronger association with use of maternal health services then did intervention programmes.
BackgroundNepalese women lag behind men in many areas, such as educational attainment, participation in decision-making and health service utilization, all of which have an impact on reproductive health outcomes. This paper aims to examine the factors influencing infant mortality, specifically, whether women's autonomy has an impact on infant mortality in the Nepali context.MethodsData were drawn from the Nepal Demographic and Health Survey, 2006. The analysis is confined to 5,545 children who were born within the five years preceding the survey. Association between infant mortality and the explanatory variables was assessed using bivariate analysis. Variables were then re-examined in multivariate analysis to assess the net effect of women's autonomy on infant mortality after controlling for other variables.ResultsThe infant mortality rate (IMR) in the five years preceding the survey was 48 deaths per one thousand live births. Infant mortality rate was high among illiterate women (56 per 1000 live births) and among those not involved in decision making for health care (54 per 1000 live births). Furthermore, infant mortality was high among those women who had more children than their comparison group, who had birth intervals of less than two years, who had multiple births, who were from rural areas, who were poor, whose source of water was the river or unprotected sources, and who did not have a toilet facility in their household.Results from logistic regression show that women's autonomy plays a major role in infant mortality after controlling other variables, such as mother's sociodemographic characteristics, children's characteristics and other household characteristics. Children from literate women had a 32 percent lower chance (OR = 0.68) of experiencing infant mortality than did children from illiterate women. Furthermore, infants of women who were involved in decision-making regarding their own health care had a 25 percent lower (OR = 0.75) chance of dying than did infants whose mothers who were not involved in healthcare decisions.ConclusionInfant mortality is high in Nepal. In this context, mother's literacy and involvement in healthcare decision making appear to be the most powerful predictors for reducing infant mortality. Hence, in order to reduce infant mortality further, ongoing female education should be sustained and expanded to include all women so that the millennium development goals for the year 2015 can be attained. In addition, programs should focus on increasing women's autonomy so that infant mortality will decrease and the overall well being of the family can be maintained and enhanced.
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