Factors influencing the patterns of dominance in decision-making for the use of fertility control: evidence from the 1998 SADHS

[摘要] Context: Although over half of married South African women of reproductive age (15-49years) use a method of fertility control, 15 percent of them have an unmet need for familyplanning. Women’s unmet need for family planning is often attributed to traditional normsascribing decision-making power to men. However, rural-urban migration, exposure towestern style education; constitutional guarantee of gender equity and exposure tooutside influences via the internet and mass media make such an assumption untenablein contemporary society.Method: Using logistic regression, eight models are separately fitted for the independentvariables related to the background and socio-economic characteristics of the woman;the characteristics of the husband; their comparative characteristics; sexual andreproductive factors; sources of information and communication; reproductive as well asHIV/AIDS knowledge and attitudes. The final model, using backward stepwise analysis,estimates the effects of the factors associated with a joint or a male vs. a female patternof dominance in decision-making about using fertility control.Results: The final model shows that joint decision-making is positively correlated withfifth or higher birth order, being raised in a town, living in a household in the middlewealth quintile, having between four and five children; using fertility control to limit birthsgetting a lot of information about HIV/AIDS from the husband, spousal discussions aboutfamily planning and not knowing whether good nutrition stops HIV transmission. Maledominance is positively associated with having only one union, having the same amountof education as the husband or not knowing how much education he has, spousalcommunication about family planning, first marriage occurring 5-19 years ago, notknowing if the condom was used at last intercourse, knowing that condoms are used forfamily planning only, not getting information about family planning from posters andirregular exposure to the radio.Conclusions: In the era of the HIV/AIDS pandemic and emphasis on the reproductivehealth approach in family planning, there is a need for studies, at the local level, thatinclude both individuals in the relationship. Qualitative studies focusing on the nature,context and content of couple communication about sexuality and reproduction canprovide important information about gender relationships in the South African context.There is also a need to understand the effect of gender and community norms on sexualand reproductive decision-making. Studies on HIV discordant couples can provideimportant information on the impact of the epidemic on sexual and reproductive decisionmaking.Studies focusing on family formation can provide information on the impact ofsocial change on intergenerational and gender relationships as well as trends inreproductive attitudes and behaviours in transitional South African society

[发布机构] University of the Witwatersrand