Intentions to use contraceptives in Pakistan: implications for behavior change campaigns
Intentions to use contraceptives in Pakistan: implications for behavior change campaigns
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DOI：
10.1186/1471-2458-10-450
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发表时间：
2010-08-02
影响因子：
4.5
通讯作者：
Agha, Sohail
中科院分区：
文献类型：
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作者：
Agha, Sohail
背景：自1990-91年以来，巴基斯坦使用传统方法的速度比使用现代方法的速度更快。激素法或宫内节育器的重要性已经降低，而传统方法在方法组合中的重要性有所增加。有必要找出促使和阻止巴基斯坦已婚男女采用特定计划生育方法的因素。方法：除了受访者的社会和人口学特征外，一项具有代表性的家庭调查收集了1788名未怀孕妻子和1805名未怀孕妻子的丈夫的计划生育行为心理相关信息。男性和女性来自不同的家庭。主成分分析被用来确定对每个性别都很重要的潜在结构。结果：在女性中，亲家支持计划生育的观念是影响其避孕意愿的最重要的因素。一名妇女相信间隔生育的重要性，以及她认为可以选择有称职工作人员的方法和设施，这也是她打算使用避孕方法的强大动力。妇女形成使用避孕方法的意向的最大障碍是，她认为计划生育决定是由丈夫作出的，生育是由上帝的意志决定的。担心计划生育会损害妇女的子宫，降低了妇女使用需要手术的方法的意图，如宫内节育器和女性绝育。认为一个负责任、有爱心的丈夫利用计划生育来提高家庭生活水平和保护妻子健康的观念，是男人打算使用避孕套的最重要的决定因素。丈夫在能够与妻子讨论计划生育问题上缺乏自我效能感，这是使用戒烟意图的最大驱动力。一名男性担心避孕药会导致女性不孕并损害其子宫，这降低了他使用现代避孕方法的意愿。结论：这些发现突显了在巴基斯坦实施的计划生育行为改变运动中，婆婆和丈夫等次要目标受众的重要性。强调儿童间隔的重要性的运动可能会产生影响。在巴基斯坦，客户对护理质量的看法是使用避孕方法意向的重要决定因素。客户担心宫内节育器和绝育程序可能会损害妇女的子宫并导致不孕，应该得到解决。调查结果表明，有必要对巴基斯坦的实际服务质量进行评估。
Background: Since 1990-91, traditional method use has increased at a faster rate in Pakistan than modern method use. The importance of hormonal methods or the IUD has diminished and that of traditional methods has increased in the method mix. There is a need to identify factors motivating and deterring the adoption of specific family planning methods among married men and women in Pakistan.Methods: In addition to social and demographic characteristics of respondents, a representative household survey collected information on psychological correlates of family planning behavior from 1,788 non-pregnant wives and 1,805 husbands with not-pregnant wives. Males and females were from separate households. Principal components analysis was conducted to identify the underlying constructs that were important for each gender. Multinomial logistic regression analysis was conducted to determine the correlates of male and female intentions to use contraceptive methods.Results: Amongst women, the perception that her in-laws support family planning use was the strongest determinant of her intentions to use contraceptive methods. A woman's belief in the importance of spacing children and her perception that a choice of methods and facilities with competent staff were available were also powerful drivers of her intentions to use contraceptive methods. The strongest obstacle to a woman's forming an intention to use contraceptive methods was her belief that family planning decisions were made by the husband and fertility was determined by God's will. Fears that family planning would harm a woman's womb lowered a woman's intentions to use methods requiring procedures, such as the IUD and female sterilization. The perception that a responsible, caring, husband uses family planning to improve the standard of living of his family and to protect his wife's health was the most important determinant of a man's intention to use condoms. A husband's lack of self-efficacy in being able to discuss family planning with his wife was the strongest driver of the intention to use withdrawal. A man's fear that contraceptives would make a woman sterile and harm her womb lowered his intention to use modern contraceptive methods.Conclusions: These findings highlight the importance of having secondary target audiences such as mothers-in-law and husbands in family planning behavior change campaigns implemented in Pakistan. Campaigns that stress the importance of child spacing are likely to have an impact. Client perceptions of the quality of care are important determinants of intentions to use contraceptive methods in Pakistan. Client concerns that the IUD and sterilization procedures might harm a woman's womb and cause sterility should be addressed. The findings suggest that there is a need to assess the actual quality of service delivery in Pakistan.