Couples' Agreement on Gender Norms and Modern Contraceptive Use in Urban Nigeria

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  • March 20, 2019
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  • Sahay, Kashika
    • Affiliation: Gillings School of Global Public Health, Department of Maternal and Child Health
Abstract
  • Around the world, socially defined responsibilities, decision making ability, and control over resources vary for men and women; with men usually having more power than women in social situations. In Nigeria, gender inequity is high and use of family planning (FP) methods is low. However, few studies have examined couples’ agreement on gender norms and how (and if) this relates to modern contraceptive use in urban areas. This dissertation uses a two-paper format to analyze data collected from men and women in four Nigerian cities (Abuja, Ibadan, Ilorin and Kaduna) as part of the Measurement, Learning & Evaluation Project. I retrospectively matched data on 2,184 married couples to investigate couples’ agreement on gender norms (attitudes towards wife beating, household decision making, and restrictions on wife’s activities) and modern contraceptive use between 2010-2014. In the first paper, I present evidence of high inequity among couples on specific gender norms: namely, restrictions on contraceptive use, beating if unfaithful, and husband deciding large household purchases. Adjusted multivariate analysis found couples where both partners favored restricting wife’s activities had 0.31 times lower odds (95% CI: 0.21, 0.45) of using modern contraception as compared to couples who both disapproved of restrictions on wife’s activities. Couples that disagreed about restrictions on wife’s activities had 0.57 times lower odds of using modern contraception as compared to couples that both disapproved of restrictions in multivariate analysis. The wife beating and household decision making measures had more mixed associations with modern contraceptive use. In the second paper, using reproductive calendar data, I find that 37.5% of women adopted modern contraception within the extended postpartum period (i.e.18 months after a birth event). Couples’ agreement on gender norms was not associated with modern contraceptive adoption in this period. However, other variables such as women’s education status and work status were significantly associated with contraceptive adoption, supporting existing evidence on the importance of gender equity. These analyses suggest that even if an individual endorses an equitable viewpoint, their partner’s disagreement could prevent or discourage modern contraceptive use. Understanding of gender norms may promote healthy reproductive lives for married couples in urban Nigeria.
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  • In Copyright
Advisor
  • Martin, Sandra
  • Barden-O'Fallon, Janine
  • Ibrahim, Joseph
  • Babalola, Stella
  • Speizer, Ilene
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2017
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