What Influences Contraceptive Use among Young Women in Urban Squatter Settlements of Karachi, Pakistan?

Interviews were conducted in squatter settlements in Karachi Pakistan with Muslim women 30 years old or younger their husbands and their mothers-in-law to explore factors that influence couples contraceptive use. Univariate and multivariate regression analyses were conducted to examine the associations between contraceptive use and several variables including social and demographic characteristics; religious beliefs; communication about family planning (FP) among the three family members; womens mobility and decision-making capability; acceptance of information about FP in the mass media; and exposure to FP messages from health care workers. Univariate analyses indicate that women who reported using modern contraceptive methods were significantly more likely to be literate (odds ratio 1.7) to be exposed to an urban environment (1.8) and to have had at least 5 live births (2.0). According to multivariate analyses women who were literate who were of high economic status whose mother-in-law reported discussing FP with them and who had received FP messages from health care workers were two-three times as likely to use contraceptives as were other women. In addition women who said it was appropriate for FP messages to be delivered through mass media were 50% more likely to use contraceptives. The long-term goals of improving womens education levels and economic status are important for increasing contraceptive prevalence in Pakistan. At the same time policy-makers should initiate short-term interventions such as engaging religious leaders in FP programs encouraging the outreach efforts of community health care workers and targeting mothers-in-law with FP messages as these are likely to be effective in increasing womens contraceptive use. (authors)