Men on the move and the wives left behind: the impact of migration on family planning in Nepal

Posted by Nicole Moran on August 22, 2019 at 3:25 pm



Abstract

Migration in Nepal is longstanding, and increased from 2.3% of the total population in 2001 to 7.2% in 2011. The estimated 1.92 million migrants are predominantly men. Consequently, 32% of married women have husbands working abroad.  Positive impacts of husbands’ migration include increased accrual of money and material items and improvement in women’s decision-making power, particularly for the management of resources and household affairs.20. Unfortunately, these benefits can also complicate familial relationships and may place a greater burden on women’s well-being. Social structures are complicated as many married women live with their in-laws who typically assume decision-making power, including access to health services.  While  This study compares access to reproductive health services, fertility awareness, and decision-making power among a sample of married women aged 15–24 years (n = 1123) with migrant husbands (n = 485), and with resident husbands (n = 638). Predictably, women with migrant husbands had significantly lower contraceptive use than other married women (9.3% vs 30.3%, respectively), and expressed a higher intention to become pregnant in the next year. Despite their intentions, women with migrant husbands scored lower on a fertility awareness index, were less likely to discuss pregnancy planning with their spouse, and less likely to describe their relationships positively. Decision-making for both groups of married women was dominated by both husbands and in-laws in different ways. Yet, across multiple normative scales, fewer women with migrant husbands felt pressure to conform to existing social norms. Married women with migrant husbands reflect a subset of women, with unique fertility issues and desires. Interventions that increase knowledge of fertility among this subset of women, promote healthy preconception behaviours. Linking women for counselling opportunities throughout the pre and postnatal periods may help improve health outcomes for mothers and children.

Married women with migrant husbands reflect a subset of women with unique fertility issues and desires. These women are more likely to desire pregnancy despite their husbands’ absence. Interventions that increase this subset of women’s knowledge of fertility, promote healthy preconception behaviours and link women for counselling opportunities throughout the pre and postnatal periods may help improve health outcomes for mothers and children. For example, improving healthy communication between women and their migrant husbands prior to home visits may improve relationship quality. For some women with migrant husbands, interventions should include in-laws and focus on ensuring women’s autonomy over their health, movement and financial decision-making. Such interventions may prove to be timely as the rate of Nepal’s female-headed households continues to rise.


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