Decision-Making Patterns and Contraceptive Use: Evidence from Uganda

DeRose, Laurie F.; Ezeh, Alex

doi:10.1007/s11113-009-9151-8

Cited by 60 publications

(63 citation statements)

References 41 publications

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“…The most basic approach is to collect data on proxy measures, such as spousal disparities in age, education, employment or asset sharing 30,31 characteristics thought to be associated with spousal inequity. More direct measures include scales for decisionmaking power, 4,[36][37][38] perceptions of gender equity 10,39,40 and self-efficacy.…”

Section: Introductionmentioning

confidence: 99%

The Influence of Intrafamilial Power on Maternal Health Care in Mali: Perspectives of Women, Men And Mothers-in-Law

White¹,

Dynes²,

Rubardt³

et al. 2013

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Despite decades of policies and programs aimed at improving reproductive health worldwide, high maternal morbidity and mortality persist in many resource-poor settings, particularly in Sub-Saharan Africa. [1][2][3] The predominant approach to mitigating this problem has been to target the knowledge, attitudes and practices of women of reproductive age and to strengthen health service provision. Although educating and designing services for women is undoubtedly important, this focus assumes that women have control over their maternal health care decisions. Evidence from diverse settings, however, indicates that women often have only partial, if any, autonomy over their reproductive and sexual health. [4][5][6][7][8] Not only do husbands have a significant influence on the behavior and actions of their wife, 7,9,10 but other household members, especially mothers-in-law, also exert control over younger women. 5,[11][12][13] Maternal morbidity and mortality are largely preventable through the provision of antenatal care, institutional delivery and timely postnatal care. 8,[14][15][16][17] 7,12,23 in some settings, substantial gaps in coverage remain even after adjustment for the availability of services. Accordingly, researchers and program planners have begun to appreciate the complexity of contextual influences on maternal health practices, and have adopted an approach that recognizes that individual attitudes and behaviors are products of their social and cultural environments. 24,25 Still, most studies have focused exclusively on women as the target population, and have aimed to understand and influence barriers and facilitators from their perspective. This narrow focus is incongruent with a sociocultural context in which women hold low status and are subject to the preferences and beliefs of their husband and elder relatives. 26-28Interpersonal power, however, has proven difficult to measure, such that power dynamics within a household and how they influence decisions on maternal health are not fully understood. 6,[29][30][31] To address this gap, we explored the link between household power dynamics and the maternal health behaviors of married women in rural Mali. Specifically, this article examines the relative influence of the preferences and beliefs of women, their hus- METHODS Data and SettingData for this analysis were drawn from the Projet Espoir Baseline Survey (PEBS), which was conducted between June and July 2011 in Bandiagara and Bankass, two rural districts of central Mali's Mopti region. This article contributes to the project's larger goal of identifying and addressing underlying social determinants of poor maternal health in rural Mali. Ethical approval was obtained from the institutional review boards at Emory University and the Malian Ministry of Health. The Mopti region is predominantly rural and agricultural, and has the lowest levels of education in the country. 51Although men and women in the region have roughly equal educational profiles overall, among younger cohorts, educational attainm...

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Section: Introductionmentioning

confidence: 99%

The Influence of Intrafamilial Power on Maternal Health Care in Mali: Perspectives of Women, Men And Mothers-in-Law

White¹,

Dynes²,

Rubardt³

et al. 2013

IPSRH

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“…The limited decision-making power of women in this setting often impedes their ability to achieve their fertility goals. [19][20][21][22][23][24][25][26] Moreover, in a patriarchal context, pronatal views tend to be stronger among men than among women, and husbands' real or perceived opposition to family planning may prevent wives who want to delay or stop childbearing from using contraceptives. 3,16,[27][28][29][30][31][32] The situation is no different in Nigeria, a patriarchal society where decision-making powers are traditionally vested in males.…”

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Is Age Difference Between Partners Associated with Contraceptive Use Among Married Couples in Nigeria?

Ibisomi¹

2014

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An age difference between sexual partners is a social norm in most societies; typically, the man is older than the woman. The acceptability of unions in which the husband is considerably older than his wife is more variable, although relatively large age differences are found in patriarchal societies. Large age gaps are often accompanied by differences in maturity, life experiences, social position and financial resources, which may make relationships inherently unequal and a source of risk for women's health.1-5 For instance, asymmetries in age, education and economic circumstances compromise women's ability to negotiate safer sexual behavior. [1][2][3][6][7][8] The studies that have examined associations between partners' age differences and contraceptive behavior have concentrated on adolescent females' nonmarital relationships and on whether protection was used against STIs (especially HIV). [1][2][3][4][7][8][9][10][11][12][13][14][15][16][17] The emphasis on adolescents and on nonmarital relationships may divert attention from more common age asymmetries and from the risks that may exist in such relationships. For instance, age differences in marital relationships are usually of little public interest, unlike situations involving unmarried adolescents. Furthermore, there is the need to examine the role that contraceptive use may play in preventing unintended pregnancy in age-asymmetric relationships, given that contraception has been found to be an effective means of fertility control for various health, economic and social reasons. 18Examination of age differences between marital partners is of particular importance in Sub-Saharan Africa, where, as a result of gender imbalances and cultural influences, males are frequently in charge of what happens (or does not happen) within relationships, including sexual interactions and decisions regarding family size and contraceptive use. The limited decision-making power of women in this setting often impedes their ability to achieve their fertility goals. [19][20][21][22][23][24][25][26] Moreover, in a patriarchal context, pronatal views tend to be stronger among men than among women, and husbands' real or perceived opposition to family planning may prevent wives who want to delay or stop childbearing from using contraceptives.

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“…Si bien la toma de decisiones reproductivas dentro de una sociedad puede ser vista como el resultado de un proceso de interacción, diversos estudios han documentado la desventaja de la mujer en la toma de decisiones reproductivas (Casterline et al, 1997;Beegle et al, 2001;Jejeebhoy, 2002;DeRose y Ezeh, 2010). En cambio, algunas investigaciones acerca del acuerdo conyugal respecto al comportamiento reproductivo sugieren que las parejas discuten y negocian el uso de anticonceptivos, así como el momento idóneo para tener hijos (Mitchell, 1972;Ezeh, 1993;Lasee y Becker, 1997;Ramirez et al, 2005;Gipson y Hindin, 2009;Kulczycky, 2011;Testa et al, 2014).…”

Section: Estudiosunclassified

El deseo individual de (más) hijos y su concordancia en el interior de los núcleos conyugales en México

García

Castillo

2018

EDU

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En esta investigación analizamos si el deseo de (más) hijos de uno de los miembros del núcleo conyugal predice el deseo del otro; investigamos las variables sociodemográficas y contextuales que interfieren con la concordancia en el interior de los núcleos conyugales; y analizamos si el sexo de los hijos nacidos vivos (HNV) está vinculado al deseo individual de (más) hijos, y a la concordancia o discrepancia entre los deseos de los miembros del núcleo conyugal. El análisis de los datos obtenidos de la Encuesta Nacional sobre Niveles de Vida de los Hogares (ENNViH) mostró una asociación significativa entre la composición por sexo de los HNV, el deseo de los cónyuges de tener hijos adicionales, y el acuerdo en pareja respecto a los planes futuros de reproducción.

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Decision-Making Patterns and Contraceptive Use: Evidence from Uganda

Abstract: Decision-making, Contraception, Gender, Uganda, Multi-level, Community,

Cited by 60 publications

References 41 publications

The Influence of Intrafamilial Power on Maternal Health Care in Mali: Perspectives of Women, Men And Mothers-in-Law

The Influence of Intrafamilial Power on Maternal Health Care in Mali: Perspectives of Women, Men And Mothers-in-Law

Is Age Difference Between Partners Associated with Contraceptive Use Among Married Couples in Nigeria?

El deseo individual de (más) hijos y su concordancia en el interior de los núcleos conyugales en México

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