4 replies, 3 voices Last updated by Profile photo of Zoe Hendrickson Zoe Hendrickson 1 week, 1 day ago
  • Creator
    Topic REPLY
  • #96682
    Profile photo of Shristi Mainali
    Shristi Mainali
    Moderator

    Hello and Greetings from Nepal!

    Most of the Family Planning programs are centered for the cohabitating couples in the Nepalese context. However, there are many male migrants from the country  thus many non-cohabitating women do not want to use FP methods as their husbands are abroad. But once husbands come back on the visits, it has been leading to many unplanned/unintended pregnancies among them. Thus, is there any strategy by which we could convince the non-cohabitating couples as well to use the FP methods?

  • Author
    Replies
  • #96685
    Profile photo of Zoe Hendrickson
    Zoe Hendrickson
    Moderator
    @zoe.hendrickson

    Hi Shristi!

     

    You raise an interesting point and one that is important to think about in places where spousal separation and labor migration are common parts of life. We often heard in the field as well as in our baseline and endline surveys that non-cohabitating women do not want to use FP methods as their husbands are abroad – often this is linked to not having sex while their partners are gone. I did my dissertation research on this topic actually, and it may also be linked with the fact that couples often do not discuss family planning while the husband is away as well as fears about how they might be treated at health facilities or community suspicions about why they are using when their husbands are away. A strategy to convince non-cohabitating couples to use FP methods might be useful for some couples, but not necessarily all. In addition, it would be challenged by the barriers I’ve mentioned above. Instead, it might be more useful to address partner communication, decision-making, and timely family planning uptake once the husband returns. That means focusing on the return event in programming. As we found in our endline survey, the majority of women who intended to use family planning when their husband returned planned to start AFTER he comes back – there is space there to encourage couples to talk about contraception and decide which method to use prior to the return so that women can start using earlier (and therefore reduce the risk of unplanned/unwanted pregnancies). As programs try to grapple with the effects of spousal separation and migration, paying attention to women’s self-identified family planning needs and prioritizing their reproductive autonomy will be important.

     

    Do others have any ideas for strategies that might work with migrant couples?

     

    🙂 Zoé

    • #96797
      Profile photo of Shristi Mainali
      Shristi Mainali
      Moderator
      @shristi111

      Thank you Zoe and Lindsey for the insightful sharing regarding the topic. Surely the societal barriers and norms cause the hindrances among the non-cohabitating couples in accessing the FP service.

  • #96693
    Profile photo of Lindsey Leslie
    Lindsey Leslie
    Moderator
    @lleslie

    Thanks for bringing up this topic, Shristi!

    Your post (and Zoe’s response) serves as a reminder that FP usage is very contextual, and involves many players. The FP needs of non-cohabitating women will shift as husbands travel to and from Nepal for work, which impacts how they may engage with service providers. In Nepal, we found that provider bias related to FP usage-– including restricting the use of specific methods and/or limiting access for some groups- also seemed to be a pretty consistent barrier preventing FP usage among migrant couples. So to improve FP uptake among non-cohabitating couples, we also approached facility-based providers to address provider bias. Part of our approach included developing a scenario-based, mhealth smartphone app for use by facility-based health workers. The interactive app includes video, quizzes, and text to help this cadre of health worker appreciate the mechanics, as well as the benefits, of improved FP counseling.

    So to answer your original question, Shristi, I think SBCC programs should explore best practices and work from multiple angles to ensure all couples find the right FP method for their family.

  • #96813
    Profile photo of Zoe Hendrickson
    Zoe Hendrickson
    Moderator
    @zoe.hendrickson

    Thanks, Lindsey, for highlighting this interesting angle taken by the HC3 Project! What are other avenues through which to address provider- or facility-level barriers or challenges? What about other societal barriers?

You must be logged in to reply to this topic.