Role of family size and composition in fertility desire, contraceptive adoption, and method choice in South Asia

Purpose: Gender preference has significant implications for desired family size, fertility decisions, and contraceptive adoption. This study examines how family size and composition affect reproductive behavior in three South Asian countries – Nepal, India, and Bangladesh – that are known for strong son preference.

Data: The data are from the 1998-99 India National Family Health Survey, the 2001 Nepal Demographic and Health Survey, and the 2004 Bangladesh Demographic and Health Survey. We analyze if the choice of the contraceptive method adopted (modern versus traditional; temporary versus permanent) and the desire for another child differ by parity and sex composition of surviving children.

Method: The research employs binary and multinomial logistic regression after controlling for potentially confounding factors and accounting for sampling weights and clustering in the survey design.

Results: Our analysis finds evidence of strong preference for boys in this region, which is more prominent in Nepal and India than in Bangladesh. Women with more sons are more likely to use contraception and possess a greater desire to have another child than those who have more daughters. This relationship persists even after controlling for socioeconomic factors. There is also evidence of preference for a daughter beyond a certain number of sons, especially in Bangladesh where such preference is evident after one son.

Recommendation: The findings highlight the persistence of preference for boys in South Asia and suggest that the fertility and family planning programs need to identify women with certain parity and sex composition of children in assessing their fertility desires and needs for family planning services.