Child bearing and sexual and reproductive health and rights in Dhaka slumsSAFE baseline survey findings

Sajeda Amin, Laila Rahman and Md. Irfan Hossain

Population Council

12 July 2012, icddr,b Sasakawa Auditorium, Dhaka

Sexual and reproductive health (SRH) rights- basic human rights

• Responsible, satisfying, safe sex life

• Freedom to decide if, when, how often to bear children

• Information and access to safe, effective, affordable and acceptable methods of fertility regulation of choice

• Health care services enabling women to go safely through pregnancy and childbirth

• Provide couples best chance of having a healthy infant

Objective

Explore factors associated with SRH rights related practices, attitudes, and knowledge of ever married15-29 years females of Dhaka slums

SampleEver married Currently married and

non-pregnant

2,989 2,542

Conceptual framework

Personal characteristicsAge, education, marital and work status, orphan hood, home division, migration status, wealth quintiles

Spousal characteristicsEducation, extra-marital relationship, child with other women, alcohol consumption, violent behavior

Marriage characteristicsTiming, number, registration, love marriage, girls’ consent, dowry demand

• 3 or more births• Menstruation regulation (MR), ANC, Delivery, PNC•Current FP use; STIs

• SRHR awareness• Attitude towards condom use by unmarried males

• Never heard of MR• Do not know of STIs• Adverse effect of teenage

pregnancy

FINDINGS

High risk childbearing & SRH practices

Childbearing by age group

Challenging attitude towards SRH rights

All should be able to enjoy sex lives that are safe and satisfying with dignity, equality, responsibility and mutual respect

Inadequate awareness on SRH issues

Current non-use of any modern contraceptive (odds ratios)

*Significant at p≤.05; **p≤.01; ***p≤.001. (r)- Reference category.

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Risk and protective factors for having an MR (odds ratios)

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*Significant at p≤.05; **p≤.01; ***p≤.001. (r)- Reference category.

Inequality in wealth and age matter in accessing non-medical or no care for delivery (odds ratios)

All couples should have best chance of having a healthy infant

*Significant at p≤.05; **p≤.01; ***p≤.001. (r)- Reference category.

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Factors associated with receiving non-medical or no assistance for post natal care by 42 days of delivery (odds ratios)

*Significant at p≤.05; **p≤.01; ***p≤.001. (r)- Reference category.

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Correlates of inadequate STI knowledge (odds ratios)

*Significant at p≤.05; **p≤.01; ***p≤.001. (r)- Reference category.

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Early marriage and husband’s violence behavior tend to contribute to three or more live births (odds ratios)

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*Significant at p≤.05; **p≤.01; ***p≤.001. (r)- Reference category.

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Conclusions Young, poor & less educated females are

more likely to be vulnerable to SRHR violation

Women’s current work status contribute to their positive attitudes and behaviors, but the inverse relationship with MR and work may indicate challenges faced by pregnant working women

Association of SRHR with early marriage and spousal characteristics indicate importance of involving males and early marriage prevention interventions

Educated girls in slums may be used as role models and peer promoters to improve SRHR

Thank You