Abstract
BackgroundThis study examined the relationship between male out-migration and family planning (FP) behaviour of women in rural Bihar.MethodsData was collected from 937 currently married women aged 15–34 years from two districts of Bihar, namely Nawada and Gopalganj. Respondents were selected through a multi-stage systematic sampling and were recruited from both low and high male out-migration blocks. Differences in FP outcomes—use of modern contraceptive methods, intention to use contraceptives in next 12 months and access to FP services—were assessed by volume of migration, husband’s migration status, frequency of return, and duration of husband’s stay at home during visits.ResultsWomen with migrant husbands were about 50% less likely to use modern contraceptive methods. Further, the odds of using modern contraceptives was about half among women with migrant husbands if they resided in high out-migration areas (HMA) than low out-migration areas (LMA) (15% vs 29%, AOR: 0·50, p = 0·017). A higher proportion of women with migrant husbands, specifically from HMA, reported greater intention of using contraceptives in next 12 months than their counterparts (37% vs 23%, AOR: 1·83, p = 0·015). Similarly, access to FP services was negatively associated with the volume of male out-migration, specifically for women with migrant husbands.ConclusionsThe migratory environment as well as the migration of husbands affect contraceptive use and access to FP services among women. Given that a significant proportion of married males leave their home states for work, it is imperative that FP programs in migration affected areas plan and implement migration-centric FP implementation strategies.
Highlights
This study examined the relationship between male out-migration and family planning (FP) behaviour of women in rural Bihar
This study examined the macro and micro effects of male out-migration on contraceptive use behaviour and access to FP services among women in rural Bihar
Women with migrant husbands were about 50% less likely to use modern contraceptive methods, regardless of whether they resides in high or low male out-migration area (LMA: 29% vs 34%, adjusted odds ratios (AORs) = 0·51, p = 0·009; High male out-migration area (HMA): 15% vs 26%, AOR = 0·43, p = 0·002)
Summary
Study setting The state of Bihar is located in the Eastern part of India and consists of 38 districts, with a population density of 1102/km2 [24]. The study collected a range of socio-economic and demographic factors including age, education of women, caste, working status, number of living children, membership in self-help groups (SHGs), ownership of mobile phone, daily exposure to mass media and monthly household income. These variables were used and included as covariates while examining the effects of migration on FP outcomes. For each combination of FP outcomes (use of modern contraceptives, intention to use and access to FP services) and migration characteristics (migration status of husband, frequency of return and duration of stay at home), separate logistic regression models were fitted. All the analyses were carried out using STATA version 16·0 (StataCorp., College Station, TX, USA)
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