Determinants of Contraceptive Norms in Rural Bangladesh

M. Nurul Islam, Dhaka University

DETERMINANTS OF CONTRACEPTIVE NORMS IN RURAL BANGLADESH M Nurul Islam, Ph.D. Professor, Department of Statistics University of Dhaka Dhaka-1000, Bangladesh E-mail: shakil@dotbd.com EXTENDED ABSTRACT The experience of demographic transition from developed countries suggests that fertility and mortality changes have occurred with accompanying social and economic development, but in some developed countries, fertility decline has occurred in the absence of any economic development. Bangladesh provides evidence that fertility can decline in the midst of poverty. Women in Bangladesh hold a low status in society and rarely work outside their home They do not have the freedom to decide how many children they want, when to have them, whether they can use contraception or terminate a pregnancy, etc. The ideology of motherhood often is central in the patriarchal structure. Motherhood is often forced by depriving young women of adequate contraceptive information. Due to traditional custom and norm, an adolescent girl in Bangladesh is forced into early marriage. Early sexual experience, combined with a lack of information and services, increases the risks of unwanted and too early pregnancy. Gender discrimination due to patriarchal society is deeply rooted in Bangladeshi culture. Although religion is a very powerful tool for influencing the community, it has influenced women's lives negatively. Family is the institution where gender roles are most specified and ingrained. The man is considered the head of the household. The son preference that is prevalent in Bangladesh leads discrimination of girls in health, nutrition, education and other opportunities. According to the Bangladeshi custom, the son controls most property and other productive resources, which are inherited usually from fathers by sons'. While the girl child is considered a liability, the son is expected to continue the family line and provide old age security for his parents. Lack of economic independence leads to further lack of reproductive control. Cultural and religious considerations are stronger systematic barriers in attaining reproductive rights. Despite the serious constraints outlined above, what changes have occurred in the cultural norms and values that have prompted poor women to adopt contraception? Is it due to change in the attitudes towards family size? Is there any evidence that son preference has declined? Is there any evidence to support the hypothesis that participation in the micro-credit program has increased poor women's mobility and earning capability and as a consequence, they are empowered and their autonomy, decision making power and status have improved? What is the relationship between the participation of micro-credit programs and their reproductive behavior? This study has attempted to address the above issues, in general, in the light of social and cultural context of Bangladesh. In particular, this study investigates the cultural norms and values that have effect on the contraceptive behavior. Data Sources Data for this study were obtained from Population Development and Evaluation Unit (PDEU) of Planning Commission. PDEU, which as part of their routine research works, collected the data; Multi-stage sampling design was used to obtain the data. The survey covered all the administrative divisions of Bangladesh. A total of 3963 currently married women were interviewed to collect the relevant information keeping in mind the objectives of the study. Methods Both bivariate and multivariate techniques were used to analyze data. Bivariate analyses have provided some basic understanding about the respondent's demographic and reproductive behavior. To identify the important variables that have significant effects on the independent variables, logistic regression analysis was carried out. To determine which variables discriminate between users and non-users of contraception, discriminant analysis was also used. Finding It is found from the analysis that women's credit groups bring about change, not only in the status of that particular group in the community, but also within each woman. This gives identity to women and change becomes a feasible option. The experience of micro-credit programs working with poor women shows that work related to health when linked with programs to secure women's income and livelihood through income generation activities,. women can also learn to negotiate health costs through the greater exposure and knowledge Women who can control their earning and can participate in household decision matters will ultimately determine the extent of women's empowerment. It is also evident that micro-credit program can create enabling conditions for the poor women that support, reinforce and match grassroots efforts made by the women for their empowerment. An important research question is that whether the group-based credit programs for the poor significantly changes reproductive behavior. The findings of this study provide evidence that women's participation in group-based credit programs increase contraceptive use but its impact on fertility will be small because most of the women who join credit programs are generally older and by the time they enter into the grouped based credit programs they complete their average desired family size. Despite this, there is a remarkable change in the reproductive behavior of credit women. Respondent's attitudes towards current family size were investigated and the information in this regard suggests that average family size has been declining. About the reasons of falling family size, three fourths of the respondents opined that it was due to increase in acceptance of family planning methods and the remaining respondents gave reason that average family size has been declining because everyone is conscious of keeping small family for the better future of their children. Community leaders, religious leaders and other elite members of the community advise the couples in favor of small family and encourage them to accept family planning methods. There has been a tremendous change in the attitude of community leaders compared to that of 15 years before. Today most of the community leaders have more positive attitude towards family planning than it had been 15 years before. It is found that newly married couples face some problems to adopt modern family planning methods. It has been observed that mother- in- laws in many instances desire a baby soon after marriage. Two-thirds of the respondents stated family members and relatives now -a -days support to use contraceptives by the newly married couples but they think that it is better to adopt contraception after having one child. This is a social norm and should be viewed in the context of policy consideration. A minority of the community peoples and relatives think it is a bad indication about newly married couples of not having any child within 3 years of their marriage. Generally mother- in- laws are traditional and they do not like their sons to have used family planning before having a birth soon after marriage. This attitude has changed over the years. It is widely held that Islam is opposed to birth control, and that Muslim religious leaders are against family planning. Respondent's opinion on religious bar about family planning has been declining since majority mentioned religious issue is not as important as was viewed before in accepting family planning, The hypothesis relating to women's freedom and mobility outside the homestead is significantly related to the use of contraception. For example, women who have autonomy to visit clinic, their contraceptive use rate is higher than that of other women. Similarly, higher score of mobility has significant effect on the use of contraception. Participation in household decision making matters is positively correlated with the use of contraception suggesting that women who can take decision on their reproductive choice be empowered. Poor women's involvement in credit program give them opportunity to go outside the home and they are enable to earn independently and as a result they are exposed to modem views and have independent ability to negotiate with their reproductive choices. The finding further demonstrates that women belongs to BRAC are more likely to be higher contraceptive users than other credit organizations. This may be due to the reason that BRAC has begun to provide FP services along with the credit programs but the other organizations have no such service delivery effort in their program components.