A Lasee1, S Becker2

1Community Health Sciences department The Aga Khan University, 2Johns Hopkins School of Hygiene and Public Health (Baltimore, USA)

The standard definition of effective husband-wife communication regarding contraception is three-dimensional: whether the values of the spouses are similar (agreement); whether the values are communicated (discussion); and whether the communication is effective (empathy). We evaluated how communication between spouse(s) affects couple's current contraceptive use, and specifically the extent to which husband’s approval of family planning, affects contraceptive use by his wife.

The Kenya Demographic and Health Survey 1989 (KDHS) was used in this research. The KDHS is national in coverage and was designed to produce completed interviews with 7,500 women aged 15-49 with a subsample of 1,129 husbands of these women.

Ninety nine percent of couples knew at least one modern contraceptive method and 97 percent of both or either partner approved of family planning. Discussion was reported by 82 percent of both or either partner. Only 64% of wives and 75 % of their husbands could correctly predict their spouse's approval of family planning. The current use was 31.5 percent, 23% used modern methods, and 8.5% used traditional methods. The log odds of current use was twice as high (OR=2.0, p <.05) if both partners approved of family planning (agreement) than if only wife approved of family planning. However, approval by only the husband was not significantly related to the current use of contraception. The odds of using contraception were 2.2 times higher (p < .05) if couples reported discussion (active communication) on family planning than if they did not discuss family planning. The wife’s perception of her husband’s approval of family planning (empathy) was the most significant variable (OR=4.1, p < .0001).

The findings of the study suggest that "dialogue" increases the effectiveness of communication -- spouse's perception of the other partner's approval, which has been shown by the results of this study that the use is higher if wife perceives that husband approves than otherwise. The implications are that the family planning programs in Kenya and likely in other developing counties as well need to concentrate on the information, education and communication component with special emphasis on husband-wife communication.

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