Factors associated with contraceptive use in rural Nepal: Gender and decision-making.

INTRODUCTION: Gender norms and roles influence many decisions related to reproductive health behaviours including contraceptive use. There are very few studies related to gender norms and decision-making in contraceptive use in Nepal, hence this paper addresses these issues in a quantitative study. METHODS: A secondary data analysis of a primary study conducted in 2012 as a quantitative cross-sectional study in four villages of a hilly district in Nepal. This study included data that were collected from either the woman or the man in 440 couples of childbearing age with at least one child. The secondary analysis included (adjusted) regression analysis to investigate factors associated with contraception use with the variables of interest being gender roles and decision-making, whilst considering demographic and socio-economic controls. RESULTS: The secondary data analysis found gender roles were associated with current/ever use of contraceptives as reported by the respondents. Socio-economic factors such as husband's and wife's education and gender roles such as indicators showing sharing of childcare responsibilities affected contraceptive use positively. However, decision making regarding contraceptive use was not found to be associated with current/ever use of contraceptives. CONCLUSION: Gender has a role in the use of contraceptive, however decision-making may not be associated with contraceptive use. Educational, health promotional and family planning programmes are recommended to promote use of contraceptives. It is important that husbands get involved in these programmes to encourage discussions related to contraceptive use