| subtitle |
DHS Qualitative Research Studies No. 21 |
| Author(s) |
Sarah Staveteig Neera Shrestha Sunita Gurung Kathryn T. Kampa ICF, Rockville, Maryland, USA |
| Date |
2018-05-01 |
| Country |
Nepal |
| Language |
English |
| Table of contents |
TABLES ........................................................................................................................................................ v
FIGURES ..................................................................................................................................................... vi
ACKNOWLEDGMENTS ............................................................................................................................. vii
ABSTRACT.................................................................................................................................................. ix
1 STUDY OBJECTIVES AND CONTEXT .......................................................................................... 1
1.1 Study Objectives ................................................................................................................. 1
1.2 The Nepal Situation............................................................................................................. 2
1.3 Eastern Nepal ..................................................................................................................... 5
1.4 Barriers to Family Planning ................................................................................................. 5
1.4.1 Prior frameworks .................................................................................................... 5
1.4.2 The framework used in this study .......................................................................... 7
1.5 Report Contents .................................................................................................................. 9
2 DATA AND METHODS ................................................................................................................. 11
2.1 Study Design ..................................................................................................................... 11
2.2 Interviewer Training and Pretesting .................................................................................. 14
2.3 Fieldwork ........................................................................................................................... 15
2.4 Response Rate and Data Processing ............................................................................... 16
3 CHARACTERISTICS OF RESPONDENTS .................................................................................. 19
3.1 Background Characteristics .............................................................................................. 19
3.2 Fertility Preferences .......................................................................................................... 21
3.3 Family Planning ................................................................................................................. 23
3.3.1 Sources of information about methods ................................................................ 26
3.3.2 Reasons for nonuse of family planning ................................................................ 32
3.3.3 Role of husband ................................................................................................... 34
3.3.4 Role of religion ..................................................................................................... 38
4 FAMILY PLANNING AMONG COUPLES WITH A MIGRANT HUSBAND .................................. 41
4.1 Migration Patterns ............................................................................................................. 41
4.2 Use of Family Planning ..................................................................................................... 43
4.3 Plans for Husband’s Return .............................................................................................. 47
5 OTHER POTENTIAL BARRIERS TO FAMILY PLANNING ......................................................... 53
5.1 Insufficient Knowledge of Methods or Services ................................................................ 53
5.2 Personal Aversion to (Commodity-Based) Family Planning ............................................. 54
5.2.1 Rumors and secondhand reports of side effects ................................................. 55
5.2.2 Personal experience with side effects.................................................................. 56
5.2.3 Attitudinal opposition and method suitability ........................................................ 58
5.3 Husband’s Opposition to (Commodity-Based) Family Planning ....................................... 60
5.4 Perceived Low Fecundability ............................................................................................ 61
5.5 Access-Related Barriers ................................................................................................... 63
5.5.1 Geographic inaccessibility ................................................................................... 63
5.5.2 Service quality barriers ........................................................................................ 64
5.5.3 Administrative accommodation barriers ............................................................... 66
5.5.4 Lack of affordability .............................................................................................. 69
6 INTERACTIONS WITH THE HEALTH SYSTEM AROUND FAMILY PLANNING ....................... 71
6.1 At and After Birth ............................................................................................................... 71
6.2 At and After Abortion ......................................................................................................... 73
6.3 Community Health Personnel ........................................................................................... 78
7 DISCUSSION AND CONCLUSIONS ............................................................................................ 83
7.1 Key Findings ..................................................................................................................... 83
7.2 Limitations ......................................................................................................................... 85
7.3 Policy Implications ............................................................................................................. 86
7.3.1 Implications for Nepal .......................................................................................... 86
7.3.2 Implications for other low-income settings ........................................................... 88
7.3.3 Implications for future follow-up surveys .............................................................. 88
7.3.4 Implications for survey measurement of key contraceptive outcomes ................ 90
REFERENCES ............................................................................................................................................ 93
APPENDIX A: COMPARISON OF RESPONSES TO REPEATED QUESTIONS ABOUT KEY TOPICS ... 97
APPENDIX B: RESPONDENTS’ SUGGESTIONS FOR IMPROVEMENT OF CONTRACEPTIVE
SERVICES IN NEPAL ........................................................................................................ 99 |
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https://dhsprogram.com/pubs/pdf/QRS21/QRS21.pdf
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