Spousal Communication and Family Planning Adoption: Effects of a Radio Drama Serial in Nepal

Abstract

Spousal communication and family planning (FP) use are closely linked but the pathways of influence especially within the context of exposure to a mass media campaign promoting FP are unclear. Panel data from a population-based survey in Nepal were collected over three waves from 1994-99 to evaluate the impact of a radio drama series among couples of reproductive age. Data from 1442 women were used to assess changes in couples FP decision making identify predictors of spousal communication and FP use in relation to program exposure and clarify temporal relationships among these variables. Women exposed to the program had significantly elevated odds of believing that their spouse approved of FP and of having discussed FP with their spouse (odds ratio 1.8-1.9). Those who communicated with their spouse had elevated odds of using FP (10.2). Spousal communication at baseline was associated with subsequent FP use independent of campaign exposure. In addition among couples who had not already been discussing FP exposure led to communication which in turn led to FP use. Over time husbands dominance in making FP decisions gave way to joint decision making and an increase in womens decision making power. New indicators are needed to capture campaign effects on individuals who are predisposed to use FP. Couples joint decision making should be promoted as a strategy for increasing FP use. Interventions are needed to improve womens autonomy and strengthen their negotiating capacity for FP use. (authors)