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This paper describes discrepancies in spouses' reports of the use of female‐controlled, nonvisible contraceptive methods using data from rural Nepal that were collected monthly from both spouses of 822 couples between 2008 and 2016. We find that spouses in about half of couples provided discrepant reports during the period of observation, and these discrepancies occurred in 14 percent of the months of observation. We then investigate these discrepant reports as possible indicators of incomplete transparency regarding reproductive choices and examine whether they are associated with wives' education and spouses' relative education levels. We find, first, that wife's educational attainment was negatively associated with discrepant reports of contraceptive use, independent of spouses' relative educational attainment. At the same time, these models suggest that educational differences between husbands and wives were associated with discrepant reports. Couples in which wives had more education than their husbands faced greater odds of discrepant reports of contraceptive use, relative to couples in which spouses had similar education. Among couples in which husbands had more education than wives odds of wife‐only reporting were lower, relative to couples with similar levels of education. These findings offer important new insights into spousal dynamics that may influence transparency regarding contraceptive use. [ABSTRACT FROM AUTHOR]

Social norms related to fertility may be driving pregnancy desire, timing and contraceptive use, but measurement has lagged. We validated a 10‐item injunctive Fertility Norms Scale (FNS) and examined its associations with family planning outcomes among 1021 women and 1020 men in India. FNS captured expectations around pronatalism, childbearing early in marriage and community pressure. We assessed reliability and construct validity through Cronbach's alpha and exploratory factor analysis (EFA) respectively, examining associations with childbearing intention and contraceptive use. FNS demonstrated good reliability (α = 0.65–0.71) and differing sub‐constructs by gender. High fertility norm among women was associated with greater likelihood of pregnancy intention [RRR = 2.35 (95% CI: 1.25,4.39); ARRR = 1.53 (95% CI: 0.70,3.30)], lower likelihood of delaying pregnancy [RRR = 0.69 (95% CI: 0.50,0.96); ARRR = 0.72 (95% CI: 0.51,1.02)] and greater ambivalence on delaying pregnancy [RRR = 1.92 (95% CI: 1.18,3.14); ARRR = 1.99 (95% CI: 1.21,3.28)]. Women's higher FNS scores were also associated with higher sterilization [RRR = 2.17 (95% CI: 1.28,3.66); ARRR = 2.24 (95% CI: 1.32,3.83)], but the reverse was noted for men [RRR = 0.61 (95% CI: 0.36,1.04); ARRR = 0.54 (95% CI: 0.32,0.94)]. FNS indicated better predictive value among women compared to men for key reproductive outcomes. This measure may be useful for social norms‐focused evaluations in family planning and warrants cross‐contextual study. [ABSTRACT FROM AUTHOR]

Women's contraceptive decision‐making control is crucial for reproductive autonomy, but research largely relies on the Demographic and Health Survey (DHS) measure which asks who is involved with decision‐making. In India, this typically assesses joint decision‐making or male engagement. Newer measures emphasize female agency. We examined three measures of contraceptive decision‐making, the DHS and two agency‐focused measures, to assess their associations with marital contraceptive communication and use in rural Maharashtra, India. We analyzed follow‐up survey data from women participating in the CHARM2 study (n = 1088), collected in June–December 2020. The survey included the DHS (measure 1), Reproductive Decision‐Making Agency (measure 2), and Contraceptive Final Decision‐Maker measures (measure 3). Only Measure 1 was significantly associated with contraceptive communication (adjusted odds ratio [AOR]: 2.75, 95 percent confidence interval [CI]: 1.69–4.49) and use (AOR: 1.73, 95 percent CI: 1.14–2.63). However, each measure was associated with different types of contraceptive use: Measure 1 with condom (adjusted relative risk ratio [aRRR]: 1.99, 95 percent CI: 1.12–3.51) and intrauterine device (IUD) (aRRR: 4.76, 95 percent CI: 1.80–12.59), Measure 2 with IUD (aRRR: 1.64, 95 percent CI: 1.04–2.60), and Measure 3 with pill (aRRR: 2.00, 95 percent CI: 1.14—3.52). Among married women in Maharashtra, India, male engagement in decision‐making may be a stronger predictor of contraceptive communication and use than women's agency, but agency may be predictive of types of contraceptives used. [ABSTRACT FROM AUTHOR]

Modern agricultural farms offer huge potential in creating employment opportunities, which, in turn, are expected to reduce fertility. The Ethiopian government has recently leased out millions of hectares of farmland to investors under highly concessionary terms. However, little is known regarding women's farm employment effect on their fertility. Using survey data, this paper analyzed this link in the context of Saudi Star and Merti Agricultural Development farms. Results showed lower odds of fertility intention among employed women compared to non‐employed women where employment is measured more broadly. This result at a glance appears to be consistent with conventional theory which considers children as resulting from parental choice relative to other essential household goods constrained by resource shortages in the household's utility maximization framework. Where employment is measured rather narrowly (standard way) as in most socioeconomic research, however, the odds of fertility intention is higher. The two results were expected to be reversed since fertility was expected to be lower where employment is measured more narrowly than broadly where a range of employments are included. Additionally, effects associated with the recent establishment of Saudi Star farm compared to the more matured farms in Merti are likely to reduce fertility intention. [ABSTRACT FROM AUTHOR]

Globally, millions of unintended pregnancies occur each year resulting in a host of social, economic, and health‐related problems. Improving knowledge of and access to family planning services is an effective way to prevent unintended pregnancy, and research suggests that men's involvement promotes greater contraceptive uptake. To explore this issue, we assess contraceptive knowledge, attitudes, and behaviors among Sierra Leonean men who experienced an unplanned pregnancy. Findings indicate that men's participation in family planning was limited due to barriers including inadequate knowledge about contraception, poor access to services, and gender norms that consider family planning a woman's responsibility. As a result, men often resorted to a pattern of control that put the onus of contraceptive use on women and blamed women when they became pregnant, without considering their own role in pregnancy prevention. We suggest that family planning policies and interventions both engage men and address the barriers to their participation in reproductive health. [ABSTRACT FROM AUTHOR]