Masculine interest behind high prevalence of female contraceptive methods in rural Nepal.

OBJECTIVE: This article explores the nexus between intraspousal power relations and couples' participation in contraceptive decision-making. Further, it discloses whether perceived gender roles and privilege influence couples' contraceptive behaviour in rural Nepal.
METHODS: Two hundred and twenty-three couples from 197 randomly selected households from two rural population clusters in eastern Nepal were interviewed. Additionally, 40 key informants were included to collect in-depth qualitative information. The conclusion provides the essence of the results from quantitative and qualitative analyses.
RESULTS: Out of 10 independent variables regarding the social power status of the wives and husbands (education, age, occupation, personal income, household headship, political participation, social participation, access to mass media, exposure to psychological assault and physical assault from husband), four variables, namely education, personal income, exposure to psychological assault and physical assault demonstrated significant influence on wives' participation, while no one variable showed association with husbands' participation in contraceptive decision-making. Despite the husband's domination, husband-wife joint involvement in making contraceptive decisions was common. However, stereotyped gender roles and privilege appeared to be influential in deciding the types of methods to use, to shift the methods, and to terminate using contraception.
CONCLUSION: As an unequal conjugal relationship is one of the factors responsible for the husband's domination in the decision-making process, women's empowerment should be an entry-point for the transformation of gender discriminatory attitudes and behaviour. Women's empowerment enhances an equal conjugal relationship, and thereby helps in achieving equal partnership in reproductive health decision-making.