This study will explore contraceptive choice among women who reside in Kathmandu valley, Nepal. Kathmandu valley is well-served by health, family planning and social services providing women access to the full range of contraceptive alternatives. Given the availability of temporary contraception methods, it is somewhat surprising that sterilization and injectables are widely used. Our research centers on whether the government's campaign to reduce fertility in rural areas has created a preference for sterilization and injectables even in urban areas where in reality a wider range of choices are accessible and available or are issues of women's status and patriarchal family structure more important in determining contraceptive choice? In this study we propose to examine how women's preference to use a specific method is influenced by socio-economic and demographic factors as well as women's empowerment. Similarly, we will examine indirect influences of the government and non-government sector regarding policies regarding family planning and media messages on family planning. Finally, we will examine the broader implications of women's choice of method for their reproductive health and how this choice reflects knowledge of reproductive health. Both quantitative and qualitative methods will be used for the study. The data for the quantitative study will come from the 2001 Nepal Demographic and Health Survey. Qualitative methods employed in the field include focus group discussions with approximately 150 married women and men in three urban districts of the Kathmandu Valley. Key-informant interviews of non-government (NGO) workers, family planning workers and policy makers, and content analysis of government/NGO policies and documents will also be other methods employed for the qualitative component. The broader impacts of this study include the following. Researchers, students, and policymakers interested in understanding how women decide to use a specific method will find this research important for improving reproductive health. Increasing contraceptive use in developing countries, particularly in urban areas, makes valuable research on how and why women choose specific methods. Results from this research could lead to policy recommendations that would aid in the development of family planning and reproductive health policies in Nepal as well as in other national settings.
