Associations between Contraceptive Decision‐Making and Marital Contraceptive Communication and use in Rural Maharashtra, India. Issue 4 (3rd October 2022)

• Record Type: Journal Article
• Authors: Nazarbegian, Melody; Averbach, Sarah; Johns, Nicole E.; Ghule, Mohan; Silverman, Jay; Lundgren, Rebecka; Battala, Madhusudana; Begum, Shahina; Raj, Anita
• Is Part Of: Studies in family planning. Volume 53:Issue 4(2022)
• Page Start: 617
• Page End: 637
• Publication Date: 2022-10-03
• Subjects: Birth control -- Periodicals; 363.9605
• DOI: 10.1111/sifp.12214
• Languages: English
• ISSNs: 0039-3665

Abstract

Abstract: Women's contraceptive decision‐making control is crucial for reproductive autonomy, but research largely relies on the Demographic and Health Survey (DHS) measure which asks who is involved with decision‐making. In India, this typically assesses joint decision‐making or male engagement. Newer measures emphasize female agency. We examined three measures of contraceptive decision‐making, the DHS and two agency‐focused measures, to assess their associations with marital contraceptive communication and use in rural Maharashtra, India. We analyzed follow‐up survey data from women participating in the CHARM2 study ( n = 1088), collected in June–December 2020. The survey included the DHS (measure 1), Reproductive Decision‐Making Agency (measure 2), and Contraceptive Final Decision‐Maker measures (measure 3). Only Measure 1 was significantly associated with contraceptive communication (adjusted odds ratio [AOR]: 2.75, 95 percent confidence interval [CI]: 1.69–4.49) and use (AOR: 1.73, 95 percent CI: 1.14–2.63). However, each measure was associated with different types of contraceptive use: Measure 1 with condom (adjusted relative risk ratio [aRRR]: 1.99, 95 percent CI: 1.12–3.51) and intrauterine device (IUD) (aRRR: 4.76, 95 percent CI: 1.80–12.59), Measure 2 with IUD (aRRR: 1.64, 95 percent CI: 1.04–2.60), and Measure 3 with pill (aRRR: 2.00, 95 percent CI: 1.14—3.52). Among married women in Maharashtra, India, male engagement in decision‐making may be a stronger predictor of contraceptive communication and use than women's agency, but agency may be predictive of types of contraceptives used.