The Gap Between Reproductive Intentions and Behavior: a study of Punjabi Men and Women, Population Council, 1997

Population Council

This study was carried out in the context of rapid changes in fertility preferences and contraceptive practice in Pakistan. Demographic surveys show that there has been a decline in ideal family size and a subsequent increase in the percentage of women using contraception. The data collection was through a cross sectional representational survey as well as qualitative interviews and focus group discussions with women and a smaller sample of their husbands. Though many women expressed the desire of delaying pregnancy or terminating childbirth completely almost 50% had never used contraception. The study focuses on 'unmet need perspective', which focuses on fertility preferences thereby providing the context for considering contraceptive behavior. Son preference is another factor that this study takes into account. The findings indicate that social and not the monetary costs are a major consideration with women which include a) women's perception that their husbands disapprove of contraception, b) fear of detrimental side effects and c) concerns about social, cultural and religious acceptability of contraception. This research does not ignore the contextual factors and highlights the point that family planning attitudes and behaviors cannot be understood in isolation from gender relations and issues of women's autonomy. The data indicates that women's autonomy in decision-making varies with the type of decision. Furthermore unmet need for family planning shows systematic variation according to women's autonomy and spousal communication. The gender comparison reveals relatively little husband-wife disagreement about fertility preferences; nevertheless the focus of concern regarding use of contraception may vary. Thus the study recommends that efforts to eliminate unmet need of contraception should be broad based and multi faceted and the interventions aimed at men and women should have different emphasis.

Key words: Contraceptive Prevalence, Fertility Preferences, Unmet Need, Social Costs, Decision Making Power, and Family Planning.