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Correlates of unmet need for contraception in Bangladesh: Does couples’ concordance in household decision-making matter?
Authors: Mohammad Habibullah Pulok, Jalal Uddin, and Mohammad N. Sabah
Source: Contraception, pii: S0010-7824(16)00072-X. doi: 10.1016/j.contraception.2016.02.026
Topic(s): Contraception
Household decision-making
Unmet need
Country: Asia
Published: FEB 2016
Abstract: Introduction: A large body of literature has highlighted that women's household decision-making power is associated with better reproductive health outcomes while most of the studies tend to measure such power from only women's point of view. Using both husband's and wife's matched responses to decision-making questions, this study examined the association between couples' concordant and discordant decision-makings, and wife's unmet need for contraception in Bangladesh. Methods: This study used couple's dataset (n= 3336) from Bangladesh Demographic and Health Survey of 2007. Multivariate logistic regression was used to examine the likelihood of unmet need for contraception among married women of reproductive age. Findings: Study results suggested that couples who support the equalitarian power structure seemed to be more powerful in meeting the unmet demand for contraception. Logistic regression analysis revealed that compared to couple's concordant joint decision-making, concordance in husband-only or other's involvement in decision-making was associated with higher odds of unmet need for contraception. Wives exposed to family planning information, discussed family planning more often with husbands and those from richest households were less likely to have unmet need for contraception. Conclusion: Couple's concordant joint decision-making, reflecting the concept of equalitarian power structure, appeared to be a significant analytic category. Policy makers in the field of family planning may promote community-based outreach programs and communication campaigns for family planning focusing on egalitarian gender roles in the household.