Partner Attitudes a Major Factor in Contraceptive Use By Married Cambodian Women

A new study by researchers at the University of North Carolina and Population Services International finds that partner support for contraception—or lack thereof—has a very strong influence on married Cambodian women’s contraceptive use. Authors Ghazaleh Samandari and colleagues analyzed the relationship between attitudes of partners, elders and peers and contraceptive use among married Cambodian women aged 15–49 who wished to delay childbirth. According to their findings, the influence of these groups’ views, whether for or against contraceptive use, depended on how many children the women already had.

More than half (58%) of the 706 women the authors surveyed in 2007 reported not using a modern contraceptive method, although virtually all of them had at least some knowledge of modern methods and where to obtain them. Women who believed that their partner thought it was a good idea for them to practice contraception were almost three times as likely as other women to use a modern method. However, women who reported having a partner who made the final decision about contraception and those who were nervous about talking with their partner about contraception were only about half as likely as others to use a method. In addition, women who agreed that one should not practice family planning if an elder opposed it were less likely than others to be contraceptive users.

Samandari and colleagues then examined the relationship between social support and contraceptive use by the number of children a woman had, a first among studies of its kind. Although partner support for contraceptive use remained positively associated with method use for all women, regardless of how many children they had, for women with two or fewer children, peer norms were the factor most strongly associated with contraceptive use. Those who agreed that most couples in their community used contraceptive methods were more than four times as likely to use a method as those who did not agree. Women with two or fewer children were also less influenced than those with more children by partners’ negative attitudes toward contraception.

Conversely, among women with three or more children, peer attitudes had no influence on contraceptive use, although the influence of partners’ and elders’ attitudes was strong: The odds of using a modern contraceptive among women who believed elders’ negative opinions of contraception should be respected and those whose husband made the final decisions on contraception were half those among other women. The authors believe these findings may reflect cultural differences between more traditional women, who tend to have a greater number of children and are highly influenced by their partners, and less traditional women, who tend to have fewer children and may rely more on their peers.

Given the great importance of social support in enhancing contraceptive use, Samandari and her colleagues conclude that family planning programs should work to make contraceptive use more widely accepted among partners, elders and the overall community. Furthermore, the authors believe family planning programs should strongly encourage communication and joint decision making about contraceptives for couples desiring to plan their families.

The study, "The Role of Social Support and Parity on Contraceptive Use in Cambodia," appears in the September 2010 issue of International Perspectives on Sexual and Reproductive Health.

Also in this issue of International Perspectives on Sexual and Reproductive Health:

"Associations Between Early Marriage and Young Women's Marital and Reproductive Health Outcomes," by K.G. Santhya of the Population Council, New Delhi, et al.;

"Self-Reported Abortion-Related Morbidity: A Comparison of Measures in Madhya Pradesh, India," by Laura Nyblade of the International Center for Research on Women et al.;

"Introducing Female Condoms to Female Sex Workers in Central America," by Natasha Mack of Family Health International, et al.;

Viewpoint, "Masturbation: Breaking the Silence," by James Shelton.