Date of Award

12-2023

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

Dr. Sarah Saleem

Second Advisor

Sir. Iqbal Azam

Third Advisor

Dr. Shiyam Sunder

Department

Community Health Sciences

Abstract

Introduction: Marital satisfaction is one of the key elements of family health which can be affected by many factors including a child’s gender preference among spouses. These strong preferences for child’s gender can have significant implications on marital dynamics affecting satisfaction among married couples particularly when conflicting preference is present. Thus, having a preference can change the relationship between a couple and their degree of Marital Satisfaction. Other factors can also impact marital satisfaction which can include education status of husband and wife, birth of first child, number of children, household income, etc.
Objective: The study investigated the association between spousal child’s sex preference and marital satisfaction among women and also determined the factors affecting marital satisfaction. Methods: This cross-sectional study was conducted in Jinnah Post Medical Centre, JPMC, a tertiary care hospital in Karachi between June to August. Married women having at least one child were included in the study. Women having children from previous marriage were excluded. A total of 254 participants were recruited through non-probability purposive sampling and an informed consent was obtained from them. Evaluation and Nurturing Relationship Issues, Communication, and Happiness (ENRICH) marital satisfaction scale was used which was pre-tested and content validated. Data analysis was done using Stata version 15 and Multiple linear regression analysis was used to assess the association of child’s gender preference and other sociodemographic and participants characteristics with marital satisfaction scores. Page 6 of 86
Results: Among 254 participants, the mean age of married women was 28.19±5.41. Thirty five percent (35%) of the married women showed spousal preference for child’s sex. Marital satisfaction was associated with spousal child’s gender preference, gender of first child, urban location, living status with husband, and husband’s education status. The overall mean marital satisfaction score was 98.94±6.93. Among married women who had spousal preference for child’s sex the estimated mean score of marital satisfaction is 3.13 (95% CI: 0.37, 5.88) units higher as compared to married women who had no spousal preference for child’s sex. Moreover, the estimated mean score of marital satisfaction is 4.38 (95% CI: 1.63, 7.13) units higher among those women having first child son when compared to those having a first child daughter. Living status with husband, urban location and husband’s education status were other significant predictors of marital satisfaction.
Conclusion: Spousal’s child’s gender preference was significantly associated with higher scores of marital satisfaction. Notably, a son preference was observed with higher marital satisfaction scores when first born was a son when compared to a daughter. To improve marital satisfaction among couples, the study recommends providing counseling on gender equity at younger ages in schools to both boys and girls and to young couples at the time of marriage. At policy level, a clause can be added in the Nikah Nama relating daughters as ‘Allah kee rehmat’ and, emphasizing the equal value of both sons and daughters. Addressing educational disparities and enhancing effective communication between couples is also essential to improve marital satisfaction among spouses.

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1

Last Page

86

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