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Abstract
BackgroundWomen in Nepal have low status, especially younger women in co-resident households. Nepal also faces high levels of household food insecurity and malnutrition, and stagnation in uptake of modern family planning methods.ObjectiveThis study aims to understand if household structure and food insecurity interact to influence family planning use in Nepal.MethodsUsing data on married, non-pregnant women aged 15–49 with at least one child from the Nepal 2011 Demographic and Health Survey (N = 7,460), we explore the relationship between women’s position in the household, food insecurity as a moderator, and family planning use, using multi-variable logistic regressions. We adjust for household and individual factors, including other status-related variables.ResultsIn adjusted models, living in a food insecure household and co-residing with in-laws either with no other daughter-in-laws or as the eldest or youngest daughter-in-law (compared to not-co-residing with in-laws) are all associated with lower odds of family planning use. In the interaction model, younger-sisters-in-law and women co-residing with no sisters-in-law in food insecure households have the lowest odds of family planning use.ConclusionThis study shows that household position is associated with family planning use in Nepal, and that food insecurity modifies these associations–highlighting the importance of considering both factors in understanding reproductive health care use in Nepal. Policies and programs should focus on the multiple pathways through which food insecurity impacts women’s reproductive health, including focusing on women with the lowest status in households.
Highlights
Planning is a key factor in improving both women and children’s health and socio-economic status
This study aims to understand if household structure and food insecurity interact to influence family planning use in Nepal
Non-pregnant women aged 15–49 with at least one child from the Nepal 2011 Demographic and Health Survey (N = 7,460), we explore the relationship between women’s position in the household, food insecurity as a moderator, and family planning use, using multi-variable logistic regressions
Summary
Planning is a key factor in improving both women and children’s health and socio-economic status. The 2011 Nepal Demographic and Health Survey (DHS) found a small decrease in the use of modern family planning methods (from 44% in 2006 to 43% in 2011), overall family planning use (modern and traditional) increased slightly (from 48% in 2006 to 50% in 2011) [2]. Research has suggested that high rates of spousal separation, increased use of abortion, emergency contraception, and traditional methods, and lack of focus on hard to reach and vulnerable populations for services, could be contributing to the lack of continued increase in modern method uptake in Nepal [2, 4]. Nepal faces high levels of household food insecurity and malnutrition, and stagnation in uptake of modern family planning methods.
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