Contraceptive methods choice in Pakistan: determined or predetermined.

The author explores the factors affecting ever and current use of contraception, the continuity of use and shifting of methods, and method selection among women in Pakistan. Data are analyzed for 6364 currently married women aged 15-49 sampled in the 1990-91 Pakistan Demographic and Health Survey. The analysis found woman's age to be more important than the number of living children in the selection of methods by women; the continuity of contraceptive use tends to be determined by attitude driven by fertility desires; women's lifestyle becomes important only when female conventional methods are considered; greater provision and accessibility to various methods increases the probability that women in major urban areas will practice sterilization, while increased program coverage seems to increase the chances that women in small urban areas will practice either sterilization or other conventional female methods; rural women are more likely than urban women to adopt modern methods; and the ability to go to a clinic alone is important only when modern methods are compared in general against traditional methods. The use of sterilization increases among older women, those in urban areas, and those with some education, while the probability to use a conventional female method is high among women with higher parity, younger in age, residents of rural areas and small towns, and those who watch television at least once per week. The use of condoms increases significantly in women from major urban areas, with low parity, and from middle age cohorts. In general, however, current use and ever use of contraception is influenced by sociodemographic and lifestyle factors, while continuity and method selection are affected by either demographic or sociocultural factors.