Left-behind women’s behaviour regarding contraceptive use: A case study of selected Grama Niladari Divisions in the Kandy District

Abstract

Sri Lanka has shown a trend of male dominance in international labour migration in recent years. A large proportion of these males are married and leave their wives behind when they migrate for a contract period. Migration results in many behavioural and role changes among left-behind women, but research usually highlights the more visible socio-economic changes, such as women taking on household financial management and the resulting empowerment. Though migration also results in less visible changes, for example, in sexual relations and contraceptive use, which is important for reproductive wellbeing, these have not been adequately addressed in Sri Lankan research. To address this gap, this study examines contraceptive use among left-behind wives. The study is based on primary data collected in 2015 from 79 purposively selected left-behind women of reproductive age through a questionnaire as well as through in-depth interviews with 15 of these women in selected Grama Niladari Divisions in the Kandy District. Quantitative data were analysed through bi-varaite analysis while content analysis was used for qualitative data. Results revealed that other than sterilized women, all used contraceptives only during spousal visits. A contraceptive method shift was observed after migration; approximately 80% shifted to condom use (mainly from) injectables and pills. The method switch was due to condoms being the most practical: they posed no health issues for women, and spousal visits were unplanned and short. Condoms were used only for pregnancy prevention though they offer protection from STIs, which is a risk faced by many left-behind wives. Around 65% of the women reported concern regarding their husbands’ STI risk, but none discussed condom use as a protective method. Since condom use is high and it is a STI protection mechanism, whether used intentionally or not, and there is a lack of spousal dialogue on reproductive risk behaviours, it is important to make high quality condoms available and easily accessible in the interests of the reproductive wellbeing of leftbehind women.