Despite efforts to improve contraceptive coverage, unmet need remains consistently high in Nepal. This pattern appears largely driven by contraceptive non-use during spousal migration. Our mixed-methods study reinterviewed a subsample of 2016 Nepal DHS respondents. Fieldwork included gathering in-depth data on contraceptive coverage among women whose husbands were currently or usually absent. Our analysis confirms that cultural taboos discouraging contraceptive use during spousal separation contribute to high unmet need, but more nuanced themes emerged. Of concern, we found that despite knowledge of his return date, many respondents tended to be poorly prepared for contraceptive use when their husbands returned. Respondents reported discomfort in broaching the issue of contraceptive preparedness; many of those who prepared mistakenly believed that hormonal methods would provide immediate protection. Beyond unmet need, these patterns show important gaps in contraceptive coverage of migrant couples and suggest the importance of improving contraceptive education and messaging around contraceptive preparedness.
Presented in Session 252. Mixed Methods