The dynamics of fertility decision-making among wives and their husbands in Chitwan, Nepal.

A disjunction exists between theoretical developments that highlight couple-dynamics and the role of men in fertility decision-making, and the single-sex, women-only surveys that are the basis for fertility research. This dissertation focuses on the couple as the reproductive unit and, in doing so, it addresses a persistent problem--the absence of men. Survey data offer a limited view of the fertility decision-making process, therefore extensive qualitative fieldwork and interviewing were done to augment a district-wide survey among wives and husbands (N = 1500 spouses) in rural Nepal. The first indications of fertility decline in the study area, Chitwan District, are a harbinger of social change in less-developed regions of South Asia. Although fertility remains high, profound changes in people's fertility-related attitudes and behaviors were observed. Despite broad-based consensus on the desirability of smaller families, couples were committed to having one, and often two, sons. A test of couples' decision-making priorities demonstrates that son preference often dominates family size considerations. Husbands are even more likely than wives to pursue the birth of sons at the cost of larger families. Qualitative interviews explain son preference, and suggest the existence of a two-son norm. The birth of two sons insures families against son-loss, and promotes the long-term economic and social well-being of households. However, some couples choose to deviate from the two-son norm, in the interest of smaller families. Logistic regression demonstrates the effects of 1, 2 and 3+ sons on the adoption of permanent and temporary contraceptive methods after births during a recent 10-year period. Decisions to adopt temporary methods after one son constitute a replacement strategy, or a sophisticated attempt by couples to preserve their potential to have additional sons, if need be. Permanent methods tend to be adopted after two (or more) sons. A final analysis suggests that couples with an unmet need for family planning are differentiated from current-users by their unwillingness to use temporary methods. Because their use remains at a minimum in Nepal, as in other regions of South Asia where programs have historically emphasized permanent sterilizations, there is considerable scope to temporary methods.Ph.D.Cultural anthropologyDemographyHealth and Environmental SciencesIndividual and family studiesPublic healthSocial SciencesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/130369/2/9722098.pd

Muslim and Non-Muslim Differences in Female Autonomy and Fertility: Evidence from Four Asian Countries

On the basis of research on paired Muslim and non-Muslim communities selected in India, Malaysia, Thailand, and the Philippines, the authors test the hypothesis that greater observed Muslim pronatalism can be explained by less power or lower autonomy among Muslim women. Indeed, wives in the Muslim communities, compared to the non-Muslim ones: 1) had more children, 2) were more likely to desire additional children, and 3) if they desired no more children, were less likely to be using contraception. However, the authors do not find that Muslim communities consistently score lower on dimensions of women's power/autonomy. Thus, aggregate-level comparisons provide little evidence of a relationship between lower autonomy and higher fertility. Individual-level multivariate analysis of married women in these paired settings similarly suggests that women's autonomy differentials do not account for the higher fertility, demand for more children, and less use of contraception among Muslim wives. These results suggest that explanations for Muslim/non-Muslim fertility differences lie elsewhere. Copyright 2002 by The Population Council, Inc..

Peer-to-peer sharing of social media messages on sexual health in a school-based intervention: opportunities and challenges identified in the STASH feasibility trial

Background: There is strong interest in the use of social media to spread positive sexual health messages through young people’s social networks. However, research suggests this potential may be limited by a reluctance to be visibly associated with sexual health content online, and by a lack of trust in the veracity of peer sources. Objective: To investigate the opportunities and challenges of using social media to facilitate peer-to-peer sharing of sexual health messages within the context of a secondary school-based and peer-led sexual health intervention (STASH; Sexually Transmitted infections And Sexual Health). Methods: Following training, and as part of their role, student-nominated peer supporters (aged 14-16) invited school friends to STASH trainer-monitored, private Facebook groups. They posted curated educational sex and relationships content within these groups. Data come from a feasibility study of the STASH intervention implemented in 6 UK schools. To understand student experiences of the social media component we used data from: 11 semi-structured paired and group interviews with peer supporters and their friends (collectively, ‘students’; n=41; aged 14-16); a web-based post-intervention questionnaire to peer supporters (n=88); and baseline and follow-up questionnaires to students in the intervention year group (n=680 and 603 respectively). We carried out thematic analysis of qualitative data and descriptive analysis of quantitative data. Results: Message-sharing by peer supporters was hindered by variable engagement with Facebook. The trainer-monitored and private Facebook groups were acceptable to student members (peer supporters and their friends), and reassuring to peer supporters, but led to engagement that ran parallel to – rather than embedded in –their routine social media use. The offline context of a school-based intervention helped legitimate and augment the Facebook posts; but even where friends were receptive to STASH messages, they did not necessarily engage visibly. Preferences for content design varied, but humor, color and text brevity were important. Preferences for online versus offline message-sharing varied. Conclusions: Invitation-only social media groups formed around peer supporters’ existing friendship networks hold potential in peer-based sexual health interventions. Ideally, interactive opportunities should not be limited to single social media platforms and should run alongside offline conversations. There are tensions between offering young people autonomy to engage flexibly and authentically, and the need for adult-oversight of activities for information accuracy and safeguarding. Clinical Trial: ISRCTN9736917