Population Council Research that makes a difference

2011 International Conference on Family Planning
29 November–2 December 2011

Abstract

"Does interspousal communication minimize gap in unmet need for family planning between husband and wife? An investigation from young married couples in central India"
Nizamuddin Khan

Background
This paper introduces the concept of men's unmet need for family planning and explains its programmatic relevance. Numerous studies reveal that a range of obstacles other than physical access to services prevents women from using family planning. This increased awareness of male roles has resulted in effort to collect data on fertility attitudes and preferences from young married couples. Parallel data was collected from 418 young married couples from Ratlam district of Madhya Pradesh, India. About four-year difference in education is found between spouses, with husband having completed an average of 6.6 years and wife 2.9 years of schooling. Wife has been married 17 years, on average and has 2 births.

Research question
Does inter-spousal communication minimize gap in unmet needs for family planning between husbands and wives?

Hypothesis
The unmet need of family planning is perceived more by women then their husbands.

Objective
Major objective is to discover the unmet needs of family planning for husbands and wives.

Methodology
A total of 418 couples (wives aged between 15–30 years and their husbands) were interviewed successfully from 25 rural and 12 urban Primary Sample Units (PSUs) in the study area of Ratlam District, Madhya Pradesh, India. The sampling unit in the present study was adopted from the District Level Household Survey under Reproductive and Child Health Project (DLHS), Round-II sampling frame, 2004. As the present study is focused on the couples of younger age, (women of age group 15–30 years), it is found that over all 670 couples were available in the DLHS sampling frame for the present study. The study explored similar information using individual questionnaire from both husband and wife. Therefore, to minimize the chances of bias in reporting, the emphasis has given for interviewing both the spouses simultaneously. Of the 418 couples, 57 percent were interviewed simultaneously (same day and same time), 29 percent were interviewed same day but different time, and 13 percent of the couples where husbands interviewed after completing the interviews of their wives. Data was analyzed using Statistical Package for Social Sciences. Findings are represented in the form of bivarivate, multivariate tables.

Results
Findings reveal that 18 percent of couples had an unmet need for family planning. Unmet need was reported more by wives (22 percent) than their husbands (16 percent). Among couples who approved of family planning, 19 percent of wives and 14 percent of husbands reported unmet need for family planning compared to 50 percent of couples who disapproved of family planning. Interestingly, among couples where only wives approved of family planning, unmet need had not reduced but at the same time among couples where only the husbands approved, unmet need was reported less compared to their wives (63 percent versus 21 percent). Couples, who discussed matters related to family planning in the past one year, unmet need for family planning was lower (12 percent) compared to other couples who had not discussed (21 percent). While comparing the spousal reporting agreement, unmet need was reported more by wives (34 percent) and by husbands (21 percent) in the case where only husband reported discussion. Findings from multivariate analyses shows that couples who discussed about family planning in last one year prior to survey were less likely to report unmet need (Odd Ratio 0.46; p<0.10) as compared to couples who did not discuss. Couples where both the spouses were literate, significantly less likely to report unmet need. Couples who had two or more living children were significantly more likely to have unmet need than couples with no living child. Couples, who belonged to the highest wealth quintile, were significantly less likely to have unmet need than the couples in the lowest wealth quintile. Approval of family planning had a significant impact on the risk of having unmet need among couples; where both the spouses approved of family planning, were significantly less likely to have unmet need.

Conclusion
Findings reveal that husbands report less unmet need for family planning than their wives. The findings also reveal that husbands perceive positively towards awareness, approval of and discussion about family planning. Despite high degrees of agreement amongst the couples, the nature of disconcordance reinforces the need for policy makers to take into account the perspective of men. Policymakers and program managers can strengthen family planning programs by understanding and using data on unmet need, considering the characteristics of women and couples who have unmet need, and working to remove obstacles that prevent individuals from choosing and using a family planning method.

 

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