Spousal Communication Research Articles

Validation of a family planning self-efficacy measure with married women in Bihar, India: Findings from the Bihar Integrated Family Planning Survey

ObjectivesAdapting and testing a novel measure of family planning self-efficacy (FPSE) capturing reproductive agency and examining its association with fertility intention and contraceptive use in India. Study DesignData were analyzed from 13,901 non-sterilized, currently married women of reproductive age (15-49 years) in the Bihar Integrated Family Planning Survey (BIFS) 2021. We adapted an FP Self Efficacy measure previously developed in Guatemala comprising women’s agency to overcome barriers to accessing, discussing and using contraception, regardless of family pressure and social judgment. We used factor analyses to assess construct metrics including reliability and validity. Regression analyses were used to examine the associations of FPSE with key family planning outcomes, adjusted for age, education, caste/tribe status, religion, parity, age at marriage and family type. ResultsThe BIFS women’s sample was relatively young (35% below 25 years of age), with 43% reporting no education and over half (52%) married before 18 years of age. The 9-item FPSE scale demonstrated high reliability (Cronbach’s α=0.82) with two factors – self-efficacy to access and discuss contraception versus self-efficacy to use contraception in the face of resistance. Higher FPSE was associated with spousal communication [AOR: 2.35 (95% CI: 2.18, 2.54), traditional [AOR: 1.24 (95% CI: 1.12,1.36)] and reversible modern contraception [AOR: 1.58 (95% CI: 1.43,1.75)], and fertility intention [AOR: 1.13 (95% CI: 1.01,1.25)]. ConclusionFP Self Efficacy was found to be a reliable and valid measure associated with spousal communication, reversible contraception use and fertility intention. ImplicationsInnovations in measurement to understand reproductive agency, such as family planning self efficacy, place women’s choice as important goals of FP programming. Placing women’s choice and agency as goals of FP programs can help in meeting community needs and the demand for contraceptive use.

Understanding the patient-spouse communication experience during chemotherapy for gastric cancer: A qualitative study

Purpose This study examines how patients with gastric cancer and their spouses communicate about the illness, assessing the impact of positive or negative communication on their psychological adaptation and the intimacy of their relationship as a couple. Method Employing The Relationship Intimacy Model of Couple Adaptation to Cancer, this study used purposive sampling with the principle of maximum variation to select participants. Sixteen pairs of patients with gastric cancer and their spouse caregivers, hospitalized in the oncology department of a tertiary hospital in Jingjiang City, Jiangsu Province, from March to July 2023, were chosen for semi-structured face-to-face interviews. The recorded data were transcribed within 24 h following each interview and supplemented with field notes. Directed content analysis was employed for the qualitative content analysis. Results The interview data revealed three themes and six subthemes. Theme 1: The impact of negative patient-spouse communication, with the subthemes being (i) a decline in couples’ relationship intimacy and (ii) reduced psychological adaptation. Theme 2: The impact of positive patient-spouse communication, with the subthemes being (i) enhanced couples’ relationship intimacy and (ii) increased psychological adaptation. Theme 3: The impact of protective concealment, with the subthemes being (i) declined couples’ relationship intimacy and psychological adaptation, and (ii) increased couples’ relationship intimacy and psychological adaptation. Throughout the chemotherapy period, patients with gastric cancer and their spouses experienced both positive and negative forms of patient-spouse communication. This underscores the significance of acknowledging protective concealment within couples. Moreover, the study highlights how the dynamics of couples’ relationship intimacy and psychological adaptation are influenced by both positive and negative communication patterns surrounding the illness. Conclusions For patients with gastric cancer and their spouses, it is crucial for nurses to emphasize the importance of spousal disease communication during chemotherapy. Efforts should be made to mitigate one-sided, conflictual communication and avoidance behaviors, and to adopt appropriate communication strategies in terms of content and timing to deeply promote couple communication. Additionally, there is a need to focus on the physical and psychological stress of protective concealment in couples.

Barriers to modern contraceptive utilization in Ethiopia.

Contraception is a critical service for women to control their reproductive health, allowing them to determine the number and spacing of their children prevent unintended pregnancies, reduce the risk of morbidity and mortality from associated with childbirth, and reduce the likelihood of abortions. Despite its benefits, the utilization of modern contraceptive methods remains low in certain regions of Ethiopia, Particularly in Afar and Somali, which are also experiencing high fertility rates. However, there is a substantial gap in understanding the sociocultural barriers that hinder the adoption of modern contraception in these regions. This study aims to explore these barriers to contraceptive use among women of reproductive age in Afar and Somali regions, providing qualitative insights that are essential for designing effective strategies to improve contraceptive service utilization. Asequential mixed method approach was employed, including scoping review and qualitative interviews. Scoping review focused on qualitative or mixed-methods studies conducted in Ethiopia and published between 2013 and 2023 in English, Selecting 14 articles Additionally, qualitative data were collected from Afar and Somali regions through In-depth interviews with women aged 15-49 who are married or in consensual union, and key informant interviews with health extension workers and contraception providers at health center. A total of 20 in-depth interviews and 07 key informants were conducted. Thematic analysis was used to analyze the data. The integrated findings from the scoping review and qualitative study reveal various barriers and determinants influencing contraceptive use among women in Ethiopia. Barriers includes religious or cultural beliefs, myths and misconceptions, fear of side effects, lack of knowledge and misinformation, negative attitude towards contraceptives, partner opposition, socio-cultural factors, fear of being judged by family and friends, and lack of communication between husband and wife, husband altitude, distance from health facility, availability of service and different contraceptive choice, separate room for family planning services, and cost of contraceptive method and transportation. The scoping review corroborates these findings, emphasizing on the role of socio-demographic, economic, cultural, religious, health service, and knowledge-related factors. Higher education, urban residence, higher income, mass media exposure, spousal communication, family size, and access to quality health services were associated with increased utilization, while lack of awareness, misconceptions, myths, side effects, fear of infertility, partner opposition, social stigma, and cultural norms decreased utilization. The study recommended promoting contraceptive use, challenging socio-cultural norms through Social Behavioural Communication and Counselling (SBCC), engaging partners and community members, and improving the quality of care.

Spousal Communication on Reproductive Tract Infections Among Reproductive Aged Women Attending Reproductive Health Unit in Thika Level 5 Hospital, Kenya

Spousal Communication on Reproductive Tract Infections Among Reproductive Aged Women Attending Reproductive Health Unit in Thika Level 5 Hospital, Kenya

Promoting gender equity in a home visits programme: a qualitative study in Northern Nigeria

BackgroundGender inequities remain critical determinants influencing maternal health. Harmful gender norms and gender-based violence adversely affect maternal health. Gendered division of labour, lack of access to and control of resources, and limited women’s decision-making autonomy impede women’s access to maternal healthcare services. We undertook a cluster randomized controlled trial of universal home visits to pregnant women and their spouses in one local government area in Bauchi State, North-Eastern Nigeria. The trial demonstrated a significant improvement in maternal and child health outcomes and male knowledge, attitudes and behaviours. This paper qualitatively evaluates gender equity in the home visits programme.MethodsThe research team explored participants’ views about gender equity in the home visits programme. We conducted nine key informant interviews with policymakers and 14 gender and age-stratified focus group discussions with men and women from visited households, with women and men home visitors and supervisors, and with men and women community leaders. Analysis used an adapted conceptual framework exploring gender equity in mainstream health. A deductive thematic analysis of interviews and focus group reports looked for patterns and meanings.ResultsAll respondents considered the home visits programme to have a positive impact on gender equity, as they perceived gender equity. Visited women and men and home visitors reported increased male support for household chores, with men doing heavy work traditionally pre-assigned to women. Men increased their support for women’s maternal health by paying for healthcare and providing nutritious food. Households and community members confirmed that women no longer needed their spouses’ permission to use health services for their own healthcare. Households and home visitors reported an improvement in spousal communication. They perceived a significant reduction in domestic violence, which they attributed to the changing attitudes of both women and men due to the home visits. All stakeholder groups stressed the importance of engaging male spouses in the home visits programme.ConclusionThe home visits programme, as implemented, contributed to gender equity.

A phenomenological qualitative study of male-partners perspectives of maternity waiting homes in rural Ethiopia

BackgroundThe implementation of maternity waiting home (MWH) has been used as a strategy to improve maternal health outcomes in low-resource settings such as Ethiopia. However, MWH utilization is low in Ethiopia, and women's access to MWH depends largely on male partners' decisions. This study explored male-partners perspectives of MWHs including their experiences of paternal support in rural Ethiopia. Study designAn exploratory qualitative study with a phenomenological methodological orientation was performed. MethodsThis study was conducted in Ana-Lemo and Gibe districts of Hadiya Zone, in rural Southern Ethiopia. The study participants were male partners. A purposive sampling technique was used to recruit 47 participants. Data were collected from May 10–25, 2023. Four focus group discussions, 15 in-depth interviews, and observations were conducted. The interviews were audio-recorded, transcribed and the thematic content analysis was performed using ATLAS.ti 7.1.4 software. ResultsThis study showed that male-partners participated in spousal communication and provided practical support such as sharing household chores and financial support; however, they did not accompany their spouses to health facilities. Long distances, lack of transportation, poor referral services, and perceived poor quality of care were barriers to maternal health services. Furthermore, male-partners demonstrated poor awareness and unfavorable attitudes of MWHs. ConclusionsMale-partners participated in spousal communication, shared household chores and provided financial support to their spouses; however, they did not accompany them to health facilities. They had poor awareness and unfavorable attitudes of MWHs. Creating awareness among male partners may improve their attitude towards MWHs and other maternal health services in rural Ethiopia.

The Equity Impact of Universal Home Visits to Pregnant Women and Their Spouses in Bauchi State, Nigeria: Secondary Analysis From a Cluster Randomised Controlled Trial.

Socio-economically disadvantaged women have poor maternal health outcomes. Maternal health interventions often fail to reach those who need them most and may exacerbate inequalities. In Bauchi State, Nigeria, a recent cluster randomised controlled trial (CRCT) showed an impressive impact on maternal health outcomes of universal home visits to pregnant women and their spouses. The home visitors shared evidence about local risk factors actionable by households themselves and the program included specific efforts to ensure all households in the intervention areas received visits. To examine equity of the intervention implementation and its pro-equity impact. The overall study was a CRCT in a stepped wedge design, examining outcomes among 15,912 pregnant women. We examined coverage of the home visits (three or more visits) and their impact on maternal health outcomes according to equity factors at community, household, and individual levels. Disadvantaged pregnant women (living in rural communities, from the poorest households, and without education) were as likely as those less disadvantaged to receive three or more visits. Improvements in maternal knowledge of danger signs and spousal communication, and reductions in heavy work, pregnancy complications, and post-natal sepsis were significantly greater among disadvantaged women according to the same equity factors. The universal home visits had equitable coverage, reaching all pregnant women, including those who do not access facility-based services, and had an important pro-equity impact on maternal health.

A mother’s voice: Impacts of spousal communication training on child health investments

This study evaluates a communication training program for mothers in Uganda, motivated by prior evidence suggesting that mothers often prioritize children’s needs more than fathers. The program aims to enable women to effectively communicate their knowledge and preferences about child health to their husbands, thereby increasing investments in children’s health. Using a randomized experiment, we find that the program increases spousal discussion about the family’s health, nutrition, and finances. It also increases women’s and children’s intake of animal-sourced foods, as well as household spending on these foods. We find that birthweight of newborns increases. However, the program did not increase households’ adoption of measured health-promoting behaviors or improve other child anthropometric measures.

Examining the association between men's gender equitable attitudes and contraceptive outcomes in rural Maharashtra, India

BackgroundPrevious literature suggests that men reporting more gender-equitable attitudes are more likely to use condoms, but there is a paucity of data evaluating whether these attitudes are associated with contraceptive communication and use. The objective of this study is to test the hypothesis that men reporting more gender-equitable attitudes will be more likely to (a) engage in contraceptive communication with their wives and (b) that they and/or their wives will be more likely to use all forms of family planning, compared to men with less equitable attitudes. MethodsUsing cross-sectional dyadic survey data from young married couples from rural Maharashtra, India (N = 989), we assessed the associations between men's gender role attitudes and a) spousal contraceptive communication and b) contraceptive use by type (none, traditional, condoms, pills, or IUD). The contraceptive use outcome is based on wives' report. We assessed these associations via bivariate t-test (communication outcome) or ANOVA test (contraceptive type outcome), as well as unadjusted and adjusted logistic (communication outcome) and multinomial logistic (contraceptive type outcome) regression models. Adjusted models included sociodemographic factors selected a priori based on established associations with gender-equitable attitudes and/or our assessed outcomes. FindingsMen with more gender-equitable attitudes were more likely to discuss family planning with their wives (AOR = 1·05, 95%CI 1·03-1·07, p < 0·001) and to use condoms (ARRR = 1·03, 95%CI 1·00-1·06, p = 0·07). There was no association between gender-equitable attitudes and use of other types of contraception. InterpretationWhile gender-equitable attitudes among men may facilitate condom use and family planning communication in marriage, they do not appear to be linked with greater likelihood of use of more effective types of contraceptive use. This suggests that males supportive of gender equity may take greater responsibility for family planning vis a vis a less effective contraceptive, condoms, in the absence of more effective short-acting contraceptives for men. FundingThe National Institutes of Health [Grant number 5R01HD084453-01A1] and the Bill & Melinda Gates Foundation, Seattle, WA [grant number INV-002967].

Men's Migration and Women's Health in Rural Sub-Saharan Africa: The Role of Migration's Economic Returns and Spousal Communication

In this study, we investigate the association between men's labor migration and changes in their non-migrating wives’ self-rated health (SRH) over time using longitudinal data from rural Mozambique. In addition to comparing wives of non-migrants and wives of migrants, we account for variation in the economic impact of migration and in migrants’ phone communication with their spouses. We find that migrants’ wives are significantly less likely to report low SRH, compared to non-migrants’ wives, net of other factors. However, this net advantage is concentrated among migrants’ wives who receive frequent remittances and who report that their households’ conditions have improved thanks to husband's migration. We also find that women who engage in frequent phone communication with their migrant husbands have decreased likelihoods of low SRH, compared to migrants’ wives who do not communicate with their husbands during their migration and to women married to non-migrants, regardless of other characteristics. We interpret these findings within the context of multifaceted gendered implications of men's migration for left-behind women's health and wellbeing.

Exploring The State of Spousal Communication among Shift Workers: A Case Study of Health Sector Workers in Cape Coast, Ghana.

Purpose: The study investigated spousal communication among shift workers in the health sector in Cape Coast, Ghana. The research was aimed at examining the association between different shift-work schedule types and three spousal communication parameters: frequency, quality, and satisfaction.&#x0D; Design/Methodology/Approach: This study adopted a quantitative research approach and a cross-section survey design. A survey of 128 married shift workers across three urban health facilities participated in the study. The participants responded to the questionnaire instrument and the collected data was processed through the use of quantitative tools. The researcher utilized box plots as well as analyses of variance to discuss the relationships between communication parameters and shift schedules of participants.&#x0D; Findings: The researcher found that the frequency, quality, and pleasure of spousal communication might not be inherently impaired by shift work. The study also found no significant differences in schedule types between rotating and fixed shifts, nor did the direction of rotation impact quality. It is concluded that variables other than shift type may affect couples, including cultural influences, social support, and personal coping mechanisms.&#x0D; Research Limitation/Implications: The findings of this research are limited to the opinions of the participants, which means that the results may not be generalized to other contexts.&#x0D; Practical Implication: There is a need for hospitals to consider scheduling spouses outside the afternoon schedule since it has a significant effect on the frequency of spousal communication.&#x0D; Social Implication: The study encourages reexamining shift work's effects in different cultural contexts and suggests tailored interventions to support shift workers.&#x0D; Originality/Value: The study is based on the design and implementation of the researcher, and there is no evidence of publication of this work in any other journal by either the researcher or others. The work is an original piece and there is no other contributor aside from the researcher.

Intention to Use Modern Contraception among Spouses of Women With Diabetes and its Associated Factors

Women with diabetes are at high risk of adverse pregnancy outcomes if glycemic control is poor. Delaying pregnancy with effective contraception is crucial to allow diabetes to be optimised. Lack of encouragement and disapproval from the husbands leads to poor contraceptive use among women. Therefore, this study assessed the intention to use modern contraception among spouses of women with diabetes and its associated factors. A cross-sectional study was conducted in two clinics from December 2022 to March 2023. A total of 207 men aged 18 years and above, with wives having diabetes, within the reproductive age group were recruited. An online questionnaire was distributed, comprising sociodemographic characteristics, reproductive aspects, including intention for modern contraception use, past experience of contraception, spousal communication, a desire for children, and received contraceptive counselling. Knowledge of diabetes-related pregnancy risk and perception of contraception use in women were also included in the questionnaire. Only 52.7% of men had the intention. Educational level (AOR 2.41, 95% CI: 1.17-4.96), previous experience (AOR 3.3, 95% CI: 1.55-6.99), spousal communication (AOR 2.63, 95% CI: 1.19-5.85), wife’s age (AOR 0.94, 95% CI: 0.89-0.99) and perception towards contraception (AOR 0.98, 95% CI: 0.96-0.99) were the significant factors. Efforts should be made to ensure men have knowledge and correct perceptions towards contraception.

Spousal communication and socio-demographic variables as predictors of domestic violence among married couples

The menace of domestic violence has continued to shake many marriages in Nigeria with attendance consequences on the couples, children and society. Studies have examined factors predicting domestic violence with contradicting results. Therefore, this study examined spousal communication and socio-demographic predictors of domestic violence among married couples. The study adopted cross-sectional survey design while purposive sampling technique was used to select three communities in Ketu Local Government Area in Lagos State. Data were collected from 250 participants using validated questionnaires. Data collected were analysed to test two hypotheses. The result showed significant relationship between spousal communication, income level and domestic violence. Also, the result indicated that spousal communication and income level jointly predicted domestic violence. Furthermore, spousal communication, income level, number of children and length of years in marriage independently predicted domestic violence. The study concluded that spousal communication and socio-demographic variables were strong predictors of domestic violence. It is recommended that married couples should create quality time for communication among themselves&#x0D; &#x0D; KEY WORDS: &#x0D; domestic violence; income level; spousal communication&#x0D; &#x0D; ABSTRAK&#x0D; Ancaman kekerasan dalam rumah tangga terus mengguncang banyak pernikahan di Nigeria dengan konsekuensi yang terjadi pada pasangan, anak-anak, dan masyarakat. Studi telah menguji faktor-faktor yang memprediksi kekerasan dalam rumah tangga dengan hasil yang bertentangan. Oleh karena itu, penelitian ini menguji komunikasi antarsuami-istri dan prediktor sosiodemografi dari kekerasan dalam rumah tangga di antara pasangan yang sudah menikah. Studi ini mengadopsi desain survei lintas-seksional sementara teknik pemilihan sampel yang disengaja digunakan untuk memilih tiga komunitas di Wilayah Pemerintahan Lokal Ketu di Negara Bagian Lagos. Data dikumpulkan dari 250 peserta menggunakan kuesioner yang telah divalidasi. Data yang terkumpul dianalisis untuk menguji dua hipotesis. Hasil menunjukkan hubungan yang signifikan antara komunikasi antarsuami-istri, tingkat pendapatan, dan kekerasan dalam rumah tangga. Juga, hasil tersebut menunjukkan bahwa komunikasi antarsuami-istri dan tingkat pendapatan secara bersama-sama memprediksi kekerasan dalam rumah tangga. Selain itu, komunikasi antarsuami-istri, tingkat pendapatan, jumlah anak, dan lamanya tahun dalam pernikahan secara independen memprediksi kekerasan dalam rumah tangga. Studi ini menyimpulkan bahwa komunikasi antarsuami-istri dan variabel sosiodemografi merupakan prediktor kuat dari kekerasan dalam rumah tangga. Disarankan agar pasangan yang sudah menikah menciptakan waktu berkualitas untuk berkomunikasi di antara mereka sendiri.Top of FormBottom of Form&#x0D; &#x0D; KATA KUNCI&#x0D; KDRT; tingkat pendapatan; komunikasi antar suami-istri

Spousal communication and information sharing: Evidence from migrants and their spouses

Do spouses misreport information to each other to influence household decision-making? I analyze this question using a novel field experiment among Filipino migrants in the UAE and their spouses staying behind in the Philippines. Both migrants and their spouses staying behind have biased beliefs about each other’s finances. By experimentally varying spousal observability of reported information, I show that spouses staying behind underreport their income by 31 percent when it is observable to migrants. Among both migrants and their spouses staying behind, women are more likely to underreport income. Income is underreported when migrants do not communicate about or demand control over the household’s finances. These reporting patterns are consistent with a theory of strategic misreporting to influence migrant remittances.

Assessing Knowledge, Attitude and Practice among Married Men towards Family Planning in Sarlahi District, Madhesh Province

INTRODUCTION: Acknowledging a man’s perspective on family planning methods and service is vital for the overall health of the family. A holistic approach involving both partners is key to effective family planning and healthier family life. Therefore, the study aims to find the knowledge, attitude and practice among married men towards family planning at Kabilasa municipality of Sarlahi district. MATERIALS AND METHODS: A cross-sectional descriptive study was carried out Multistage random sampling technique was used for the selection of wards as well as the participants. The total of 164 participants whose wife was in age group (15-49 years) was interviewed. The data was analysis was done by using SPSS 23 version software. RESULTS: Total of 164 participants was interviewed. Higher percent (67.7%) of participants were in age group 30-44 years. almost all (98.2 %) of participant heard about family planning method where meaning of family planning revealed as limiting number of child with higher percentage (88.3%) followed by birth spacing were (81.8 %).96.4% supported the concept of family planning About 98.8% of the participants expressed that the Spousal communication and decision making are essential for family planning, 84.1% of them stated that family planning is women’s business. Only 27% male had ever used family planning methods though, about 56.7% wives were using Depo as contraceptive. CONCLUSIONS: It can be inferred that a majority of participant possessed knowledge regarding family planning method, highlighting the pervasiveness of information on reproductive health within the surveyed population. However, it perceived as a women’s responsibility, with men often neglecting their role.

Resilience Communication Mitigates the Negative Relational Effects of Topic Avoidance: Evidence from Parental Caregiving and COVID-19 Pandemic Contexts.

Communicating about hardships with close others can be challenging, leading to avoidance of hardship-related topics. Although typically considered relationally damaging, topic avoidance could serve as a beneficial or neutral strategy when paired with relationally affirming communication. The current research investigates if the resilience communication processes outlined in the communication theory of resilience mitigate the negative relational effects of topic avoidance. Hypotheses are tested in two different contexts: sibling communication during parental caregiving (N=207) and spousal communication in the first months of the COVID-19 pandemic (N=598). The processes of crafting normalcy, communication networks, and productive action were beneficial across contexts. When participants reported higher engagement in these processes, topic avoidance was not significantly related to relationship satisfaction. At lower engagement levels, topic avoidance was negatively related to relationship satisfaction. Nuance between contexts existed. For example, humor moderated the effect of sibling caregiving topic avoidance but not spousal COVID-19 topic avoidance.

The effect of exposure to intimate partner violence of female nurses on communication skills and burnout levels

PurposeAlthough intimate partner violence is a type of violence that women are frequently exposed to, its victims are adversely affected by violence at various levels, bio-psycho-socially. This study was conducted to determine the relationship between exposure to spousal violence, communication skills and burnout levels in female nurses. Material and methodsThe study was carried out in a descriptive and cross-sectional research design. The study was conducted in a university hospital in the Black Sea region of Turkey in September 2021. Sample selection was not made in the study, and female nurses who agreed to participate in the study were included in the study. The study's sample size is 165 female nurses. A personal Information Form, Intimate Partner Violence Scale, Communication Skills Scale, and Burnout Scale were used to collect data. FindingsIt was concluded that the exposure of female nurses to spouse violence significantly affects their communication skills and there is a significant relationship between nurses' communication skills and burnout levels (P = 0.001). Practical implicationsThe attitudes and behaviors of nurses who are strong in the caregiving process are very important. Personal characteristics, communication styles and body language of nurses who are exposed to partner violence are reflected in nursing care practices and affect the caregiving process. In this context, prevention and intervention approaches for intimate partner violence of female nurses should be known.

Misconceptions and Spousal Communication about Family Planning among Women of a Rural Community in Ekiti State, Nigeria

Purpose: Communication between the spouse on family planning issues predisposes to the approval of the man for the wife to use contraceptives. Most don’t even initiate communication as a result of misconceptions surrounding family planning. This study examined how misconception and spousal communication affect the use of family planning.&#x0D; Methods: The study was a cross sectional study carried out in a rural community. Multistage sampling technique was used in selecting 464 women of reproductive age group. A semi-structured questionnaire was used to collect information from the participants by trained research assistants. Data was entered into SPSS version 25 and analysis was carried out. Univariate analysis was done using mean, and tables, bivariate analysis was done using chi square and level of significance was set at p &lt; 0.05.&#x0D; Results: The mean age of the respondents was 32.5 ± 8.1, 110 (23.7%) had ever used contraceptive. Out of the respondents, 150 (32.3%) agreed that family planning can cause infertility and 188 (40.5%) agreed that it makes women gain weight. One hundred and seventy-six (37.9%) had discussed family planning with their husbands out of which 167 (94.9%) got approval from them. Among respondents that discussed family planning with their husband, 66 (37.5%) of them had ever used family planning and those that didn’t discussed only 44 (15.3%) ever used contraceptive. This difference is statistically different with p value of p &lt; 0.05.&#x0D; Unique Contribution to Theory, Policy and Practice: Spousal communication increases the utilization of family planning therefore; women should be encouraged to discuss with their husbands. This study will contribute to policy on improvement of family planning utilization when married couples are allowed to attend joint session focused on educating couples on the need, benefits and misconceptions surrounding family planning.

To use or not to use: Exploring factors influencing the uptake of modern contraceptives in urban informal settlements of Mumbai.

Rapid urbanization and a high unmet need for family planning in urban informal settlements point to the significance of identifying gaps that exist in the path of voluntary uptake of contraceptives. We undertook this study to better understand the perspectives related to family planning among women living in informal settlements of Mumbai. We used a mixed-methods approach, including a cross-sectional survey with 1407 married women of reproductive age and face-to-face in-depth interviews with 22 women, both users and non-users of modern contraceptives. 1070 (76%) of the participants were using modern contraceptives and women's age, education, parity, socioeconomic status and exposure to family planning interventions were the main determinants of contraceptive use. Poor contraceptive awareness before marriage coupled with social norms of early childbearing and completing family resulted in unplanned and less spaced pregnancies even among current users. In such cases, women either continued with the pregnancy or opted for abortion which sometimes could be unsafe. The decision to use contraceptives was taken in most cases after achieving the desired family size and was also influenced by belief in traditional methods, fear of side effects, spousal/family awareness and counselling by frontline workers. We recommend strengthening of sexual and reproductive health component of adolescent health programs. It is pertinent to inform women about their reproductive rights and most importantly empower them to practice these rights. This can be achieved by increasing women's age at marriage and continued promotion of formal education. Widespread misconceptions related to the side effects of modern methods need to be mitigated via counselling. Referral, follow-up, and suggestions on available choices of contraceptives should be given in case women face any side effects from the use of contraceptives. At the same time, improving spousal awareness and communication regarding family planning will allow couples to make informed decisions. Finally, roping in role models in the community will create an environment conducive to operationalizing rights-based family planning.

'The wife should do as her husband advises': Understanding factors influencing contraceptive use decision making among married Pakistani couples-Qualitative study.

This paper explores the perceptions and attitudes of married couples which prevent them from using modern contraceptive for purpose of family planning, based on semi-structured interviews with 16 married couples from rural Pakistan. This study, with married couples, not using any modern contraceptives, discussed issues of spousal communication and religious norms using qualitative methods. Despite near universal knowledge of modern contraceptives among married Pakistani women, the use continues to be low, with high unmet need. Understanding the couple context about reproductive decision making, pregnancy and family planning intentions is imperative to helping individuals fulfil their reproductive desires. Married couples may have varying intentions and desires about family size; a lack of alignment between partners may lead to unintended pregnancies and affect uptake and use of contraception. This study specifically explored the factors which prevent married couples from using LARCs for family planning, despite their availability, at affordable prices in the study area of rural Islamabad, Pakistan. Findings show differences between concordant and discordant couples regarding desired family size, contraceptive communication and influence of religious beliefs. Understanding the role that male partners play in family planning and use of contraceptives is important in preventing unintended pregnancies and improving service delivery programmes. This study also helped identify the challenges married couples, particularly men have in understanding family planning and contraceptive use. The results also show that while men's participation in family planning decision making is limited, there is also a lack of programs and interventions for Pakistani men. The study findings can support development of appropriate strategies and implementation plans.