Bangladesh Condom User Survey 1983.

Abstract

Over 5000 married persons with the wife between 18-37 years were successfully interviewed in 1983 to collect information on 5 selected explanations of the Bangladesh gap defined as that apparent discrepancy between high and increasing sales or distribution versus low reported use of condoms. The 5 explanations were: wives may underreport contraceptive use especially of a male method like condoms; some couples may receive free condoms or may buy condoms but then fail to use them; the annual supplies needed by condom users are greater than the approximately 100 pieces assumed by the family planning social marketing program as the standard couple year of protection; some couples may use condoms so irregularly that they do not consider themselves to be condom users; and that a significant number of condoms are used for noncontraceptive purpose e.g. balloons. 2747 of the sample lived in affluent urban areas and 2527 in semi-rural areas. There was clear evidence that women in semi-rural areas substantially underreport condom use. Only 2.8% of individual females in the semi-rural areas reported that they and their husbands correctly used condoms. This figure contrasted with 4.1% reported by individual males 4.5% by wives and 7% by their husbands. If only the couples in the semi-rural samples were considered and the couple was counted as using condoms if 1 or both of the partners reported current use of condoms the prevalence rose to 8.1%. For urban affluent couples the rate increased to 34% from around 30% reported individually by couples. In the affluent urban samples 5-6% reported getting condoms free some time in the past compared with 2-4% in the semi-rural areas. Another 2-3% of urban and semi-rural never users could not remember receiving any condoms. Estimates of need for condoms ranged from 126-146 annually for current regular users in affluent urban areas with fewer 104-118 for semi-rural respondents. Mens estimates were generally higher than womens. Despite continued uncertainties about annual needs it was established that urban users reported higher needs than rural users that men gave higher estimates than women and that regular users needed more than irregular users. There was no question that not all users used condoms regularly. 61-64% of all urban current condom users reported that they used condoms every time; another 17-29% said they used them some of the time. Very irregular use was reported by 4-6%. More irregular use was reported by rural male respondents. To obtain a rough indication of the frequency of misuse respondents werre asked about instances of misuse observed in the previous month. In the urban samples 6-8% of the women and 21-25% of the men reported seeing misuse. Based on the survey findings underreporting by wives especially in semi-rural areas appeared to be the most significant explanation of the gap. The 2nd most plausible explanation was that annual supply requirements are over 100.