Abstract
Enormous population growth is badly affecting the socio-economic, cultural, demographic, and political development
of the country. Unchecked population growth is serous threat to national development and integration. Preferences for
large families and unfavourable attitude towards contraception are growing challenging for government need to be
investigated on scientific ground. The main objective of this study is to identify the determinants of reproductive
health–family size and contraceptive use within the socio-economic, cultural and demographic framework. The
socioeconomic factors include education of husband and wife, occupation of both, family income, and family structure.
The demographic factors are related to current age, family size and sex preference, and marriage pattern, Cultural
factors are found in terms of gender roles: wife’s participation in the decision-making process, husband-wife
communication on contraceptive, religiosity, physical cost of contraceptive, normative cost of contraceptive, and
program factors in terms of availability and accessibility of reproductive health facilities, utilization behavior of health
facilities, and attitude of health facilities, and attitude of health providers. The study was conducted in two randomly
selected districts-Peshawar and Kohat. The study was conducted in urban areas including with the random selection
of three communities from each district. 60 users of contraceptive from the family planning clinics and 60 non-users
from each community were selected using systematic random sampling technique. In this way the total sample size
was 720 (360 users of contraceptives and 360 non-users of contraceptive). A well-structured interviewing schedule
consisting of open-ended and close-ended questions was prepared to explore the research objectives.
Inferential and multivariate analysis demonstrates the importance of socio-economic factors to determine the
respondents’ family size and their choices about the use or not-use of contraception. Gender roles and relationship in
terms of spousal communication, women participation in decision-making process regarding family and non-family
matters also play an important role in influencing reproductive health status. The cost of contraception –physical and
normative–is a strong predictor of contraceptive use. Positive attitude of health care providers towards their clients in
providing health care services does affect positively the utilization of health facilities available at the health care
outlets resulting in improved women reproductive health status.
