Abstract
Family planning (FP), considered as an encouraging trend for development, is thought to be positively correlated with family health and well-being and negatively correlated with poverty levels. Despite being a priority goal of government and development agencies, in a heterogeneous society like Nepal, FP can be an issue that needs to be dealt with consideration for religious and cultural beliefs of different sections of society. Despite steady progress in achieving FP goals, minority populations have lagged behind the rest of the country in achieving improved family health outcomes; Muslim community being one such example. This study aims to explore the existing situation of FP use in Muslim communities and to identify key policy-related issues affecting the access to and utilization of FP services. Mixed approach was used in Kapilbastu district, which accommodated the larger proportion of Muslims in Nepal. Interview was conducted among 160 married women using semi-structured questionnaire. Focus group discussion, key informant interviews, and consultative meeting were the qualitative techniques employed in this study. Quantitative data were analyzed using descriptive and inferential statistics (Chi-square test), while qualitative data by thematic approach. More than half of women (56.0%) expressed their interest in FP use, while reported users were just below the quarter (24.0%). Husband approval and secrecy of their personal identity affect use of any method of contraception. Future plan for children and prior information regarding FP found to affect current use of FP, significantly. FP word itself was found to be stigmatizing, so women prefer replacing the word FP with culturally appropriate one. Furthermore, incorporating it into comprehensive package for improving women's health will definitely contribute to improve access and uptake of services. Discrepancy exists between current use and desire for use of FP among Muslim women in future. This highlights the inadequacy of implementing the current blanket policy and programs related to FP and offer ways to move forward with the national FP agenda ensuring the cultural rights and non-discrimination of women.
Highlights
Nepal is a diversified and pluralistic country in terms of ethnic, linguistic, and religious composition
On account for such population dynamics, it should be noted that prevailing practices may discriminate individuals or group of that community, and development policies of the country must be based on the notion of “pluralism.” It recognizes the uniqueness and prevailing values of each community and creates an enabling environment, whereby diverse religions, cultures, and traditions can coexist in a nation
Such comprehensive package will benefit women of marginalized community, but for all as well. Such policies will help to improve access and uptake of family planning (FP) services in communities where it is generally believed that couple does not use contraceptives as they are grappled with inhibitions to adopt FP on religious grounds. This operational research explored the issue of FP in Muslim community, where it is still considered as taboo and provides in-depth understanding of policy gaps and key recommendations using mixed method approach
Summary
Nepal is a diversified and pluralistic country in terms of ethnic, linguistic, and religious composition. As reported in census 2011, currently, there are altogether 125 caste/ethnic groups, 123 languages are spoken as mother tongues, and 10 different types of religions are followed across country [2]. On account for such population dynamics, it should be noted that prevailing practices may discriminate individuals or group of that community, and development policies of the country must be based on the notion of “pluralism.” It recognizes the uniqueness and prevailing values of each community and creates an enabling environment, whereby diverse religions, cultures, and traditions can coexist in a nation.
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