Women's contraceptive decision-making control is crucial for reproductive autonomy, but research largely relies on the Demographic and Health Survey (DHS) measure which asks who is involved with decision-making. In India, this typically assesses joint decision-making or male engagement. Newer measures emphasize female agency. We examined three measures of contraceptive decision-making, the DHS and two agency-focused measures, to assess their associations with marital contraceptive communication and use in rural Maharashtra, India. We analyzed follow-up survey data from women participating in the CHARM2 study (n = 1088), collected in June–December 2020. The survey included the DHS (measure 1), Reproductive Decision-Making Agency (measure 2), and Contraceptive Final Decision-Maker measures (measure 3). Only Measure 1 was significantly associated with contraceptive communication (adjusted odds ratio [AOR]: 2.75, 95 percent confidence interval [CI]: 1.69–4.49) and use (AOR: 1.73, 95 percent CI: 1.14–2.63). However, each measure was associated with different types of contraceptive use: Measure 1 with condom (adjusted relative risk ratio [aRRR]: 1.99, 95 percent CI: 1.12–3.51) and intrauterine device (IUD) (aRRR: 4.76, 95 percent CI: 1.80–12.59), Measure 2 with IUD (aRRR: 1.64, 95 percent CI: 1.04–2.60), and Measure 3 with pill (aRRR: 2.00, 95 percent CI: 1.14—3.52). Among married women in Maharashtra, India, male engagement in decision-making may be a stronger predictor of contraceptive communication and use than women's agency, but agency may be predictive of types of contraceptives used.

中文翻译：

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印度马哈拉施特拉邦农村地区避孕决策与婚姻避孕沟通和使用之间的关联


妇女的避孕决策控制对于生殖自主权至关重要，但研究很大程度上依赖于人口与健康调查 (DHS) 措施，该调查询问谁参与决策。在印度，这通常评估联合决策或男性参与。新措施强调女性能动性。我们研究了三项避孕决策措施、国土安全部和两项以机构为重点的措施，以评估它们与印度马哈拉施特拉邦农村地区婚内避孕药具沟通和使用的关系。我们分析了 2020 年 6 月至 12 月收集的参与 CHARM2 研究的女性 ( n = 1088) 的后续调查数据。调查包括 DHS（措施 1）、生殖决策机构（措施 2）和避孕最终结果决策者措施（措施 3）。只有措施 1 与避孕沟通（调整后优势比 [AOR]：2.75，95% 置信区间 [CI]：1.69–4.49）和使用（AOR：1.73，95% CI：1.14–2.63）显着相关。然而，每项措施都与不同类型的避孕药具使用相关：措施 1 使用安全套（调整后相对风险比 [aRRR]：1.99，95% CI：1.12–3.51）和宫内节育器 (IUD)（aRRR：4.76，95% CI） ：1.80–12.59），使用宫内节育器测量 2（aRRR：1.64，95% CI：1.04–2.60），使用避孕药测量 3（aRRR：2.00，95% CI：1.14–3.52）。在印度马哈拉施特拉邦的已婚女性中，男性参与决策可能比女性的能动性更能预测避孕药具的沟通和使用，但能动性可能可以预测所使用的避孕药具的类型。