Doctoral Dissertation Research: Women's Choice of Contraceptives: Who Decides?

本研究将探讨居住在尼泊尔加德满都谷地的妇女的避孕选择。加德满都谷地拥有良好的保健、计划生育和社会服务，为妇女提供各种避孕替代方法。考虑到临时避孕方法的可用性，有些令人惊讶的是，绝育和注射被广泛使用。我们的研究集中在政府降低农村地区生育率的运动是否在城市地区造成了对绝育和注射的偏好，即使在城市地区，实际上有更广泛的选择，或者妇女地位和父权家庭结构的问题在决定避孕选择方面更重要？在这项研究中，我们建议研究妇女对使用特定方法的偏好如何受到社会经济和人口因素以及妇女赋权的影响。同样，我们将审查政府和非政府部门对计划生育政策和媒体对计划生育信息的间接影响。最后，我们将审查妇女选择生殖健康方法的更广泛影响，以及这种选择如何反映对生殖健康的了解。本研究将采用定量和定性相结合的方法。定量研究的数据将来自2001年尼泊尔人口与健康调查。实地采用的定性方法包括在加德满都谷地的三个市区与大约150名已婚妇女和男子进行焦点小组讨论。对非政府组织工作人员、计划生育工作人员和决策者的关键资料提供者的访谈以及对政府/非政府组织政策和文件的内容分析也将是定性部分采用的其他方法。本研究的更广泛影响包括以下几点。对了解妇女如何决定使用特定方法感兴趣的研究人员、学生和政策制定者将发现这项研究对改善生殖健康很重要。在发展中国家，特别是在城市地区，增加避孕药具的使用，对妇女如何以及为什么选择特定方法进行了有价值的研究。这项研究的结果可能导致政策建议，有助于尼泊尔以及其他国家制定计划生育和生殖健康政策。

This study will explore contraceptive choice among women who reside in Kathmandu valley, Nepal. Kathmandu valley is well-served by health, family planning and social services providing women access to the full range of contraceptive alternatives. Given the availability of temporary contraception methods, it is somewhat surprising that sterilization and injectables are widely used. Our research centers on whether the government's campaign to reduce fertility in rural areas has created a preference for sterilization and injectables even in urban areas where in reality a wider range of choices are accessible and available or are issues of women's status and patriarchal family structure more important in determining contraceptive choice? In this study we propose to examine how women's preference to use a specific method is influenced by socio-economic and demographic factors as well as women's empowerment. Similarly, we will examine indirect influences of the government and non-government sector regarding policies regarding family planning and media messages on family planning. Finally, we will examine the broader implications of women's choice of method for their reproductive health and how this choice reflects knowledge of reproductive health. Both quantitative and qualitative methods will be used for the study. The data for the quantitative study will come from the 2001 Nepal Demographic and Health Survey. Qualitative methods employed in the field include focus group discussions with approximately 150 married women and men in three urban districts of the Kathmandu Valley. Key-informant interviews of non-government (NGO) workers, family planning workers and policy makers, and content analysis of government/NGO policies and documents will also be other methods employed for the qualitative component. The broader impacts of this study include the following. Researchers, students, and policymakers interested in understanding how women decide to use a specific method will find this research important for improving reproductive health. Increasing contraceptive use in developing countries, particularly in urban areas, makes valuable research on how and why women choose specific methods. Results from this research could lead to policy recommendations that would aid in the development of family planning and reproductive health policies in Nepal as well as in other national settings.