Population Council Research that makes a difference

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

Abstract

"Does spousal perspective lead communication toward family planning use? Evidence from young married couples in central India"
Nizamuddin Khan

Several studies have documented that lack of spousal communication on fertility preferences is one of the factors constraining the use of family planning. Research carried out in the past suggests that the husband’s approval of and discussion about family planning are important predictors of a woman’s contraceptive use and fertility desires. This increased awareness of male roles has resulted in efforts 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.

It is important to state here that the present analysis is based on the responses given by both the wives and the husbands. A research question set, "Does inter-spousal communication improve contraceptive practices in terms of opinions and decisions related to family planning use?" it is hypothesized that higher extent of communication between spouses towards family planning is likely to enhance contraceptive use.

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), Phase-II, Round-II sampling frame, conducted in Ratlam district in 2004. 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.

It is observed that 39 percent of the wives and 37 percent of husbands reported that they had discussed matters related to family planning with their spouses in the last one year. Couples, who had discussed family planning methods with their spouses, were also asked about the frequency of discussion. It is found that majority of the couples had discussed it with the spouse for '3 or more times'. Thirty-eight percent of wives and 33 percent of husbands reported to have rarely discussed family planning (one or two times) with the spouse in the last one year. It is very interesting to note that 70 percent of husbands reported that their wives initiated the discussion on family planning. It is found that majority of husbands (41 percent) and wives (34 percent) had discussed it immediately after marriage. More than one-fourth of the couples reported that they discussed the use of family planning after having their first or second child.

It is found that couples were more likely to use any contraceptive methods when both the spouses approve of family planning (55 percent) as compared to approval by either the husband (21 percent) or by the wife (27 percent). Discussion about family planning methods among couples is also found to be an important factor in determining contraceptive use. It is found that of the couples who reported joint discussion on family planning methods, 69 percent of them were using family planning methods as compared to only 33 percent of couples who did not discuss in last one year. However, among the couples where only the wife reported discussion, 63 percent of them were currently using methods as compared to 43 percent of couples where only the husbands reported discussion.

Findings from multivariate analysis show that approval of family planning had significant impact on current use of the method. Couples where both the spouses approved of family planning methods were 2.3 times were more likely to use family planning methods than other couples when controlling the other socio-economic characteristics. Similarly, discussion about family planning was found to be an important determinant of current use of family planning among the couples. After controlling for other covariates in model, couples where both the spouses discussed about family planning in last one year were 2.4 times more likely to use family planning than the couples who did not discuss. The findings suggest that in order to enhance family planning use as well as bringing down the unmet need, inter-spousal communication may be promoted as strategically.

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