How Attitudes Toward Family Planning and Discussion Between Wives and Husbands Affect Contraceptive Use in Ghana

Abstract

Data on 661 married couples obtained from the 1988 Ghana Demographic and Health Survey were analyzed by multiple logistic regression to examine the attitudes and preferences of couples towards family size family limitation and contraceptive use as well as the degree of communication and discussion between husbands and wives. Both the husband and wife in 77% of couples shared like attitudes toward family planning. 73% of these couples approved of family planning. Yet 39% of the wives either did not know or misreported their husbands attitude. Even though 76% agreed that they wanted no more children only 44% reported the same responses on ideal family size. Only 35% of wives and 39% of husbands who knew at least one contraceptive method had talked to their spouse about family planning in the last 12 months. Wifes approval of family planning had a significant positive effect on current contraceptive use (relative risk [RR] = 11.75; p < 0.01) when the researcher controlled for background factors. While husbands approval did not have a significant effect (RR = 1.81). Significant independent variables of current contraceptive use included urban residence (RR = 1.53; p < 0.01) wifes attitude toward family planning (RR = 8.85; p < 0.01) and discussion of family planning between spouses (RR = 2.15-2.17; p < 0.01). These findings suggest that due to the considerable discrepancies between responses of wives and husbands one needs to interview both men and women to improve understanding of family planning decision making. They also indicate that the attitudes and preferences of the wife carry more weight in determining whether to adopt contraceptive than do those of the husband.