conception or contraception men‘s role in the decision making process in minya, egypt
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Conception or Contraception Men‘s Role in the decision making process in Minya, Egypt. Adel Takruri PhD Candidate Johns Hopkins Bloomberg School of Public Health October, 2010. Fertility in Egypt. TFR in Egypt was 3.1 in 2005 In Southern rural Egypt: 3.8 - PowerPoint PPT PresentationTRANSCRIPT
Conception or ContraceptionMen‘s Role in the decision making process in Minya, Egypt
Adel TakruriPhD Candidate
Johns Hopkins Bloomberg School of Public Health
October, 2010
Fertility in Egypt
•TFR in Egypt was 3.1 in 2005•In Southern rural Egypt: 3.8
•Contraceptive use in Egypt in 2005: 57%•In Southern rural Egypt: 41%
•Unmet need for contraception in 2005: 7% in Northern Egypt
•17% in Southern Egypt•Decelerating fertility•Decrease unwanted fertility or wanted fertility?
Source: EDHS, 2005
The benefits of reducing fertility
•At the household level•Educational opportunity•Lower maternal mortality•Better nutrition
•At the economic level•Better job opportunities•Poverty reduction
•At the environmental level•Better sanitation•Less strain on natural resources•Less environmental degradation
Source: Greene & Merrick, 2005
Reproductive InterventionsThe missing actor?
•Family planning programs mostly target women•Reproductive health studies rarely include men•Most family planning surveys collect data from women•Reproductive health services mainly focus on women
The question?
•Do men matter?
Study Objectives
•To determine the effects of husbands desire for more children on contraceptive use•To determine factors that empower women to use contraception•To determine the influence of husbands attitudes towards family planning on wives attitudes and subsequent use of contraception
Study data
•A panel survey of three years: 2004, 2005, and 2007
•Included 1927 couples
•Based on the questions asked in DHS
Conceptual framework of the influences of community, couple, and individual level factors on fertility intentions and behaviors
Husband’s Knowledge and
Attitudes
Wife’s Knowledge and
Attitudes
Contraceptive use or nonuse
Fertility outcome
Partners’ age
Partners’ schooling
Partners’ employment
Parity
Residence
Son preference
Couplecommunication
CultureModernityPatriarchy Fatalism
Religion
Policies
FP servicesavailability
Media
Socialnetworks
CoupleCommunity
Husband’sIntentions
Wife’sIntentions
Proximate/Individual Outcomes
Adapted from Becker 1996
Background Variables
A BC
D
E
F
G
H I
Shaded variables will not be included in the analysis
Preliminary ResultsUse of contraception in relation to men-related factors
OR 95% CI
Heard about FP past 6 months 1.3 (1.08-1.55)
Staff talked about FP 2.06 (1.2-3.4)
Staff talked about side effects FP 0.56 (0.21-1.5)
Thought most people use FP 1.3 (1.08-1.55)
Desire for a future child•86% of couple are concordant in their desire for a future child•14% are discordant
Contraception among couples in which the woman wants to stop childbirth and the man want more children
Woman's Schooling Percent contracepting Not contracepting
Attended School 80.3 19.7
No Schooloing 76.6 23.4
Number of children
Less than 4 81 19
4 or more 73 27
Age
30 or less 85 15
Above 30 61 39
Discussed FP with husband
Yes 83 17
No 74 26
Pending hypothesis?Spouses influence each other
Wife’s desire
Husband’s desire
Wife’s desire
Husband’s desire
Policy Implications
•Including men men in reproductive and family planning services•Empowering women to take control of their fertility•Encouraging communication between spouses
Further Research•How to define or refine the concept of unmet need to include husbands, wives or couples (Becker 1999)•How do couples negotiate their fertility and contraceptive desires
•Who initiates the discussion•Verbal or nonverbal expressions
•How to include men in reproductive health•With wives•Separately •Men groups
•Men’s attitudes towards involvement? Childbearing and rearing are women’s issues?•What is the value of children for men and for women?•Unwanted fertility versus wanted fertility
•Informed •Free from influence