Spousal discordance on fertility preference and its effect on contraceptive practice among married couples in Jimma zone, Ethiopia

Reproductive Health

Olivier Degomme³  Marleen Temmerman³  Gily Coene¹  Tizta Tilahun² 

[1]Rhea, Research Centre on Gender and Diversity, Brussels University, Brussels, Belgium

[2]College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia

[3]International Centre for Reproductive Health, Department of Obstetrics and Gynecology, Ghent University, Ghent, Belgium

关键词: Spousal discordance;    Contraception;    Couples;    Fertility preference;   

Others  :  803792
DOI  :  10.1186/1742-4755-11-27

 received in 2013-07-13, accepted in 2014-03-25,  发布年份 2014

【 摘 要 】

Objectives

To assess spousal agreement levels regarding fertility preference and spousal communication, and to look at how it affects contraceptive use by couples.

Methods

We conducted a cross-sectional study to collect quantitative data from March to May 2010 in Jimma zone, Ethiopia, using a multistage sampling design covering six districts. In each of the 811 couples included in the survey, both spouses were interviewed. Concordance between the husband and wife was assessed using different statistics and tests including concordance rates, ANOVA, Cohen’s Κ and McNemar’s test for paired samples. Multivariate analysis was computed to ascertain factors associated with contraceptive use.

Results

Over half of the couples wanted more children and 27.8% of the spouses differed about the desire for more children. In terms of sex preference, there was a 48.7% discord in couples who wanted to have more children. At large, spousal concordance on the importance of family planning was positive. However, it was the husband’s favourable attitude towards family planning that determined a couple’s use of contraception. Overall, contraceptive prevalence was 42.9%. Among the groups with the highest level of contraceptive users, were couples where the husband does not want any more children. Spousal communication about the decision to use contraception showed a positive association with a couple’s contraceptive prevalence.

Conclusions

Family planning programs aiming to increase contraceptive uptake could benefit from findings on spousal agreement regarding fertility desire, because the characteristics of each spouse influences the couple’s fertility level. Disparities between husband and wife about the desire for more children sustain the need for male consideration while analysing the unmet need for contraception. Moreover, men play a significant role in the decision making concerning contraceptive use. Accordingly, involving men in family planning programs could increase a couple’s contraceptive practice in the future.

【 授权许可】

   
2014 Tilahun et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]United Nations: The Millennium Development Goals Report 2013. New York: United Nation; 2013:28-33.
• [2]Darroch E, Singh S: Trends in contraceptive need and use in developing countries in 2003, 2008, and 2012: an analysis of national surveys. Lancet 2013, 381(9879):1756-1762.
• [3]Central Statistical Agency [Ethiopia] and ORC Macro: Ethiopia Demographic and Health Survey 2005. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ORC Macro; 2006.
• [4]Becker S: Measuring unmet need: wives, husbands or couples? Int Fam Plan Perspect 1999, 25(4):172-180.
• [5]Yadav K, Singh B, Goswami K: Unmet family planning need: differences and levels of agreement between husband-wife, Haryana, India. Indian J Community Med 2009, 34(3):188.
• [6]Dodoo FN: Men matter: additive and interactive gendered preferences and reproductive behavior in Kenya. Demography 1998, 35(2):229-242.
• [7]Lasee A, Becker S: Husband-wife communication about family planning and contraceptive use in Kenya. Int Fam Plan Perspect 1997, 23(1):15-20.
• [8]Central Statistical Agency [Ethiopia] and ORC Macro: Ethiopia Demographic and Health Survey 2011. Central Statistical Agency and ORC Macro: Addis Ababa, Ethiopia and Calverton, Maryland, USA; 2012.
• [9]Dibaba Y: Factors influencing Women’s intention to limit child bearing in Oromiya, Ethiopia. Ethiop J Health Dev 2009, 23(1):19-27.
• [10]Gebreselassie T, Govindasamy P: Levels and Trends in Unmet Need for Family Planning among Adolescents and Young Women in Ethiopia. Calverton, Maryland, USA: ICF International; 2013. Available from: http://dhsprogram.com/pubs/pdf/FA72/FA72.pdf webcite
• [11]Berhane A, Biadgilign S, Amberbir A, Morankar S, Berhane A, Deribe K: Men’s knowledge and spousal communication about modern family planning methods in Ethiopia. Afr J Reprod Health 2011, 15(4):24-32.
• [12]Central Statistical Agency (Ethiopia): The 2007 Population and Housing Census of Ethiopia. Addis Ababa, Ethiopia: Central Statistical Agency;
• [13]Altman DG: Practical Statistics for Medical Research. London: Chapman and Hall/CRC}; 1991.
• [14]Byrt T, Bishop J, Carlin JB: Bias, prevalence and kappa. J Clin Epidemiol 1993, 46(5):423-429.
• [15]Mak HKF, Yau KKW, Chan BPL: Prevalence-adjusted bias-adjusted kappa values as additional indicators to measure observer agreement. Radiology 2004, 232(1):302-303.
• [16]Bankole A, Singh S: Couples’ Fertility and contraceptive decision-making in developing countries: hearing the Man’s voice. Int Fam Plan Perspect 1998, 24(1):15-24.
• [17]Pearson E, Becker S: Couple Unmet need for family planning and application to three West African Countries, poster presented for IUSSP. Johns Hopkins University USA: Johns Hopkins University; 2013.
• [18]Takruri A: Husbands’ and wives’ fertility desires and behaviours in Minya, Egypt: dancing a duet or two solos? The Johns Hopkins University, 2012, PhD dissertation
• [19]Reynar AR: Fertility decision -making by couples amongst the Luo of Kenya January 1, 2000. PhD Dissertations available from ProQuest. Paper AAI9965553. http://repository.upenn.edu/dissertations/AAI9965553 webcite
• [20]Kamal N, Lim C: The influence of husbands on the contraceptive use of women in Nepal; (unpublished) downloaded on February 11 2014. http://centers.iub.edu.bd/chpd/Wrk%20Pap_NKamal_Feb%2010-08.pdf webcite
• [21]Perez, Tita Lorna L: Perceived Husbands’ influence on contraceptive Use among married women in Metro Cebu, Philippines: Mahidol University, (MA thesis); 2000. http://imsear.hellis.org/handle/123456789/128703 webcite
• [22]Link CF: Spousal communication and contraceptive use in Rural Nepal: an event history analysis. Stud Fam Plann 2011, 42(2):83-92.
• [23]Lwelamira J, Mnyamagola G, Msaki MM: Knowledge, Attitude and Practice (KAP) towards modern contraceptives among married women of reproductive age in Mpwapwa District, Central Tanzania. Curr Res J Soc Sci 2012, 4(3):235-245.