Collections > Electronic Theses and Dissertations > Contraceptive Behavior in the Western Chitwan Valley of Nepal: Effects of Season, Natural Resource Responsibility, Women's Status, and Accessibility of Family Planning Services
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The main objective of this study was to examine the potential for a host of contextual factors at multiple levels (including season, natural resource responsibility, women's status, and service accessibility) to affect contraceptive behavior and fertility in the Western Chitwan Valley of Nepal. This question was addressed using data from the Chitwan Valley Family Study, a long running and data intensive data collection effort based at the Population Studies Center at the University of Michigan. This dissertation found evidence to support the hypothesis that unmet need for contraception and past contraceptive discontinuation are both significantly related to and interact to affect future fertility and contraceptive behavior. It was also found that there were seasonal patterns in contraceptive use in the Western Chitwan Valley, suggesting that the monsoon was a particularly vulnerable time for potential and actual contraceptive users. Finally this research concludes that women's status, natural resource responsibility, and accessibility of services have the potential to interact to affect contraceptive behavior. Overall it can be concluded from this dissertation research that contextual factors directly affect and interact to affect contraceptive behavior. This research demonstrates that multiple factors have the potential to interact both within (such as individual unmet need and contraceptive histories) and across (such as season and natural resource responsibility) levels of contextual hierarchies to influence contraceptive use dynamics. This more thorough contextual understanding of contraceptive behavior in Nepal provides insights into some of the barriers to contraceptive use in this setting, such as seasonal disruption in contraceptive use, which have never before been examined. This dissertation also represents a wider and more unique line of inquiry into the broader contextual influences on behavior than is currently represented in the literature on contraceptive use dynamics.