Spousal Communication Research Articles

Male involvement in family planning in Northern Nigeria: A review of literature

Background: Demand and utilization of family planning (FP) in Northern Nigeria has been consistently low. Evidence from literature has demonstrated that male involvement in FP programming can be successful in increasing demand for FP services. Materials and Methods: A search of peer-reviewed and gray literature was carried out to explore the status of male awareness and utilization of FP methods, and the barriers to male involvement in FP, in Northern Nigeria. Results: Males in the region generally have a good awareness of FP. However, they had negative perceptions, low levels of usage of FP, and poor spousal communication about FP. Sociocultural and religious barriers played major roles in hindering male involvement in FP. Misconceptions about FP, such as that FP is a woman’s activity and that it also encourages promiscuity among women, were factors limiting its acceptance. Conclusion: There is a need to address the misconceptions and equip men with complete and correct information about FP. There is also a need for research on effective strategies to address the sociocultural and religious barriers to male involvement in FP in Northern Nigeria and the development of effective culturally sensitive male-involvement FP initiatives.

'No time for health:' exploring couples' health promotion in Indian slums.

Joint involvement of couples is an effective strategy to increase contraceptive use and improve reproductive health of women. However, engaging couples to understand how their gender attitudes affect their personal and family health is an idea in search of practice. This mixed-methods study explores opportunities and barriers to couples' participation in health promotion in three slums of Delhi. For each couple, surveys and semi-structured interviews were conducted with husbands and wives individually to contrast self and spousal work, time, interest in health, sources of information related to health and depth of knowledge (n = 62). Urban poverty forces men to work long hours and women to enter part-time work in the informal sector. Paid work induces lack of availability at home, lack of interest in health information and in performing household chores and a self-perception of being healthy among men. These factors inhibit men's' participation in community-based health promotion activities. Women's unpaid work in the household remains unnoticed. Women were expected to be interested in and to make time to attend community-based health-related activities. Men recalled significantly less sources of health information than their spouse. Men and their wives showed similar depth of health-related knowledge, likely due to their spousal communication, with women acting as gatekeepers. Health promotion planners must recognize time constraints, reliance on informal interpersonal communication as a source of health information and the need to portray positive masculinities that address asymmetric gender relations. Innovative, continuous and collaborative approaches may support couples to proactively care about health in low-resource settings.

Factors related to married or cohabiting women's decision to use modern contraceptive methods in Mahikeng, South Africa.

BackgroundSexual and reproductive decision-making has emerged as an important health indicator in family reproductive health issues. While there is evidence of male dominance in sexual and reproductive health decisions, the role of socio-demographic factors on women’s decision to use contraception is not well understood.AimThis study aimed at exploring the socio-demographic factors associated with married women’s decision-making to use contraception.SettingThe study was conducted in Mahikeng local municipality in the Modiri Molema District Municipality.MethodsData were generated in Mahikeng from married and cohabiting women, aged 18–49 years, from a survey comprising 568 participants. Data were collected on women’s demographic characteristics and contraceptive behaviour. Descriptive, bivariate and multivariate analyses were used to examine factors related to decision-making on contraceptive use.ResultsThe result revealed that 57% of the participants were currently using contraception and 45% stated jointly-made decision regarding the use of contraception. Decisions on use of contraceptives were associated with education, occupation, religion, duration of union and home language. Other factors associated with decision-making on contraceptive use were perception on husband’s right to sex, use of force for sex and spousal communication about sex.ConclusionEmpowering women to use contraception to meet their fertility desire should aim at improving their socio-economic status and spousal communication. Family planning providers should recognise socio-cultural barriers under which the relationships exist and how women can navigate these contextual factors.

Timely initiation of postpartum contraceptive utilization and associated factors among women of child bearing age in Aroressa District, Southern Ethiopia: a community based cross-sectional study

BackgroundGlobally, more than 90% of women during the first year of postpartum period want to either delay or avoid future pregnancies. The first year postpartum period is more crucial time to use modern contraceptives that enhance maternal and child health, so more attention should be given on time of initiating modern contraceptive utilization after delivery. Therefore, the aim of this study was to assess the magnitude and associated factors of timely initiation of postpartum contraceptive utilization among women of child bearing age in Aroressa district, Southern Ethiopia.MethodsThe study was conducted in Aroressa district from March 15 to April 15, 2017. A community based cross-sectional study design with interviewer administered structured and pretested questionnaire was used. Multistage sampling technique was employed involving a total of 695 women of child bearing age who delivered a child in the past 12 months prior to the study period. Data were cleaned, coded and entered into Epi data version 3.1, then exported to statistical package for social science version 20 for analysis. Descriptive statistics, Bivariate and Multivariate logistic regression analysis were done. p-value < 0.05 was used to consider significant variables.ResultsThe magnitude of timely initiation of postpartum contraceptive utilization was found to be 31.7% [95% CI (28, 36)]. Antenatal care [AOR = 1.94, 95% CI (1.23, 3.01)], postnatal care [AOR = 1.90, 95%CI (1.23, 2.94)], spousal communication on contraceptive methods [AOR = 1.63, 95% CI (1.09, 2.41)] and resumption of menses after delivery [AOR = 2.6, 95% CI (1.47, 3.81)] were predictors positively associated with timely initiation of postpartum contraceptive utilization.ConclusionThe magnitude of timely initiation of postpartum contraceptive utilization was low. Strengthening integration of family planning information with antenatal and postnatal care follow up and encouraging spousal communication by promoting information, education and communication activities is important to enhance contraceptive use on timely manner.

Inter-spousal communication: A means for achieving concordant fertility goals

Background: Spousal communication strategy has gained attention as an effective means of reducing couple’s fertility preferences, its continuous measurement cannot be overemphasised in literature Objecive: This study examined concordance and discordance in the desired number of children among couples in Nigeria. Methods: The study used the 2013 Couple dataset of Nigeria Demographic and Health Survey. The method of data analyses involved univariate, chi-square and binary logistic regression. Results: The result showed that 34% of couples agreed on common fertility desires, while 66% disagreed. The logistic regression analysis using Likelihood Ratio test, showed that couples communication significantly explained the indirect effects of background variables on concordant fertility desire (P<0.001). Conclusion: We therefore, recommend that couples’ communication on family size preferences be encouraged by programs geared towards achieving SDG-3,5 aimed at improving women and child health and gender equality in decision making.

Experiences of men’s involvement in antenatal education services in the rural Eastern Highlands Province of Papua New Guinea: a descriptive qualitative study.

Background: Appropriate antenatal education services that increase men’s involvement in pregnancy and childbirth is crucial for improving maternal and child health outcomes. However, in Papua New Guinea (PNG), men’s involvement in antenatal education services remains inadequate. This study aimed to describe experiences of men’s involvement in antenatal education services and identify factors that facilitate or restrict their involvement.&#x0D; Methods: A qualitative study was conducted among 17 men who have attended antenatal care (ANC) and involved in antenatal education sessions with their wives. Semi-structured and face-to-face interviews were employed to obtain detailed descriptions of men’s experiences and their perception of antenatal health education services, including factors that influenced their involvement. Data is generated from interviews. The findings are informed by the thematic analysis.&#x0D; Results: Three key themes that emerged were: (1) perception of ANC as women’s domain, (2) knowledge of antenatal education services, and (3) accessing of antenatal education services. Factors influencing men’s involvement were: strict gender roles, being responsible for pregnancy and spousal communication. Lack of knowledge, dissatisfaction with antenatal services, and lack of capacity to involve men were other reasons further observed.&#x0D; Conclusion: This study found negative perceptions; poor maternal knowledge and socio-cultural norms, inadequate information dissemination and poor men-friendly services influenced men’s involvement. Suggestions to strengthen men’s involvement require gender-inclusive and culturally appropriate antenatal education programs.

Impact of universal home visits on maternal and infant outcomes in Bauchi state, Nigeria: protocol of a cluster randomized controlled trial

BackgroundMaternal mortality in Nigeria is one of the highest in the world. Access to antenatal care is limited and the quality of services is poor in much of the country. Previous research in Bauchi State found associations between maternal morbidity and domestic violence, heavy work in pregnancy, lack of knowledge about danger signs, and lack of spousal communication about pregnancy and childbirth. This cluster randomized controlled stepped-wedge trial will test the impact of universal home visits to pregnant women and their partners, and the added value of video edutainment.MethodsThe trial will take place in six wards of Toro Local Government Area in Bauchi State, Nigeria, randomly allocated into three waves of two wards each. Home visits will begin in wave 1 wards immediately; in wave 2 wards after one year; and in wave 3 wards after a further year. In each wave, one ward, randomly allocated, will receive video edutainment during the home visits. Female home visitors will contact all households in their catchment areas of about 300 households, register all pregnant women, and visit them every two months during pregnancy, after delivery and one year later. They will use android handsets to collect information on pregnancy progress, send this to a central server, and discuss with the women the evidence about household factors associated with higher maternal risks, using video clips in the edutainment wards. Male home visitors will contact the partners of the pregnant women and discuss with them the same evidence. We will compare outcomes between wave 1 and wave 2 wards at about one year, between wave 2 and wave 3 wards at about two years, and finally between wards with and without added edutainment. Primary outcomes will be complications in pregnancy and delivery, and child health at one year. Secondary outcomes include knowledge and attitudes, use of health services, knowledge of danger signs, and household care of pregnant women.DiscussionDemonstrating an impact of home visits and understanding potential mechanisms could have important implications for reducing maternal morbidity and mortality in other settings with poor access to quality antenatal care services.Trial registrationRegistration number: ISRCTN82954580. Registry: ISRCTN. Date of registration: 11 August 2017. Retrospectively registered.

Determinants of unmet need for family planning among married women of reproductive age in Burundi: a cross-sectional study

BackgroundHigh unmet need for family planning (32.4%) characterized Burundi in 2010. However, there has not been any study examining the relationship between unmet need and associated factors in Burundi. The present study aims at determining the demographic, socioeconomic and other factors underlying the unmet need for contraception among married women aged 15-49 in Burundi.MethodsThis study used data from the 2010 Burundi Demographic and Health Survey. Total unmet need, unmet need for spacing and for limiting were used as outcomes and demographic, socioeconomic and other factors as independent variables. After a descriptive analysis of the study population (n = 5421), the association between the three outcomes and the independent variables were analysed using logistic regression. Odds ratios with their 95% confidence intervals were calculated with statistical significance at p < 0.05.ResultsThis study showed that the likelihood of total unmet need decreased with age after 35+, with an adjusted Odds Ratio = 0.586 and 95% CI = 0.423-0.811, compared to women aged 15-24. Women with 4-5 and 6+ living children had higher odds [aOR = 1.850 (1.322-2.590) and 2.390 (1.616-3.534) respectively]. Odds of unmet need were lower among women with primary [aOR = 0.741 (0.618-0.888)] and secondary education [aOR = 0.555 (0.399-0.771)]. Women whose husband desired more children than them [aOR = 1.824 (1.411-2.358)] and those ignoring the husband’s desired children [aOR = 2.700 (2.176-3.350)] had higher odds than those desiring the same number as the husband. Women who had experienced the death of 1+ sons had higher odds [aOR = 1.285 (1.038-1.591)]. Middle [aOR = 0.670 (0.530-0.846)] and rich [aOR = 0.664 (0.541-0.817)] compared to poor, women living in the North [aOR = 0.611 (0.412-0.904)] compared to those from Bujumbura, had lower odds. Rural women had higher odds [aOR = 1.373 (1.018-1.852)] and those who had visited a health facility [aOR = 0.765 (0.608-0.961)] or had access to TV [aOR = 0.562 (0.375-0.843)] had lower odds.ConclusionTackling the unmet need for FP in Burundi requires scaling-up male involvement, promoting spousal communication, client-centred services, greater use of media, women’s education, child survival, and pro-poor policies.

Impact of Emotion Regulation and Emotional Arousal on Quality of Life and Adherence of Couples after Kidney Transplantation

Nonadherence to immunosuppressive medication increases the risk of graft failure. Maladaptive emotion regulation strategies (ERS) seem to be a risk factor for nonadherence, whereas for patients in relationships spousal support appears as a protective resource. Emotional arousal, objectively measured by the fundamental frequency (f0) during spousal supportive communication is associated with supportive behavior. This study examined the relationship between beliefs about immunosuppressive medication, quality of life, ERS, emotions and emotional arousal, assessed during social support interactions of both spouses of N=50 couples after kidney transplantation. Maladaptive ERS of the transplant recipient were associated with lower mental quality of life of the partner, marginally higher own negative affect and lower beliefs about medication. Maladaptive ERS of the partner showed negative correlations with own mental quality of life. Regarding f0, gender differences were found. Higher f0 of the male transplant recipient were associated with more maladaptive ERS of the female partner. Marginally significate correlations were found with lower own beliefs about medication. Higher f0 of the wife of the male transplant recipient showed correlations with lower own positive affect, more negative affect of the male patient and lower beliefs about medication. Higher f0 of female transplant recipients were associated with lower own maladaptive ERS and lower maladaptive ERS of the husband. The findings support the relevance of early interventions focusing on identifying and modifying maladaptive ERS for both the patient and partner.

Women's Empowerment and Fertility Behaviour among the Tribals of Rajasthan, India

Fertility has declined in India during the last few decades because of socio-economic development. Women's empowerment has been identified as an important determinant for demographic change. Tribals in India have relatively high fertility because of their traditional socio-cultural practices and poor economic condition. This study aims to examine the role of women's empowerment on fertility behaviour by utilising primary data collected from ten tribal dominated districts of Rajasthan. These tribal communities belong to the Bhils, the Meenas and the Saharias. Results reveal that women's empowerment is negatively associated with fertility behaviour. Women's education, employability, participation in decision-making, exposure to media and spousal communication bear significant impact on fertility behaviour. This study may have some implications for future studies and policy makers for regulating fertility.

Understanding Men's Perceptions of Human Papillomavirus and Cervical Cancer Screening in Kampala, Uganda.

PurposeThis preliminary study explores Ugandan men’s knowledge and attitudes about human papillomavirus (HPV), cervical cancer, and screening.MethodsA local physician led an education session about cervical cancer for 62 men in Kisenyi, Kampala in Uganda. Trained nurse midwives administered surveys to assess knowledge and attitudes before and after the education session.ResultsFrom the pre-education survey, only 24.6% of men had heard of HPV previously, and 59% of men had heard of cervical cancer. Posteducation, 54.5% of men believed only women could be infected with HPV and 32.7% of men believed antibiotics could cure HPV. Despite their limited knowledge, 98.2% of men stated they would support their partners to receive screening for cervical cancer, and 100% of men surveyed stated they would encourage their daughter to get the HPV vaccine if available.ConclusionsKnowledge of HPV and cervical cancer among Ugandan men is low. Even after targeted education, confusion remained about disease transmission and treatment. Ongoing education programs geared toward men and interventions to encourage spousal communication about reproductive health and shared decision making may improve awareness of cervical cancer prevention strategies.

Spousal communication on family planning, pregnancy, and delivery care among men in rural Northern Nigeria

Introduction: Communication between a husband and wife is necessary for joint decision-making on reproductive health issues. This study assessed the practice of spousal communication and reasons for not engaging in spousal communication among married men in two rural communities in Northern Nigeria. Materials and Methods: It was a cross-sectional study conducted among 411 married men selected through multistage sampling. Data were collected using a structured interviewer-administered questionnaire containing open- and close-ended questions and analyzed using SPSS Statistics version 17.0. Results: All of the men were Muslim and Hausa-Fulani, with mean age 37.3 ± 10.9 years. Overall, spousal communication was adequate in 204 (49.6%) of them. It was highest on whether or not wife should attend antenatal care (ANC) (68.3%), importance of ANC (66.3%), and services available at the health facility during ANC and delivery (55.6%). It was lowest on whether or not the couple should use family planning (22.4%), when to get pregnant (21.0%), husband's or wife's feeling about family planning (21.0%), and number of children to have (14.6%). The most common reason given for not engaging in spousal communication was that religion forbids the act and such discussion is not important. Conclusion and Recommendation: More effort should be put into improving spousal communication, especially in relation to family planning and birth preparedness. Such effort must address harmful cultural and religious beliefs, possibly by collaborating with religious leaders.

Spousal Communication and Contraceptive Use among Married Couples in Rural Areas of Akwa Ibom State, Nigeria

AbstractThe study ascertained the influence of spousal communication about family planning on contraceptive use among married couples in the rural areas of Akwa Ibom State, Nigeria. Data for the study were obtained from one hundred and fifty married couples using multi-stage sampling procedure. The data were analyzed using descriptive statistics and multiple regression. Results indicate that 71.3% of the respondents were females with an average age of 38 years while 28.7% of them were males with an average age of 49 years; fourteen years was the respondents’ average years of marriage. Findings also show that barrier methods, hormonal contraceptives and injectables were the contraceptive methods highly used by the respondents; and majority of the married couples had a favourable spousal communication about family planning disposition. Multiple regression analysis result shows that contraceptive use by the respondents was significantly influenced by their spousal communication about family planning. It is recommended, among others, that intervention programmes of Governmental and Non-Governmental agencies in Akwa Ibom State emphasize the importance of spousal communication about family planning in their programmes and encourage same among targeted beneficiaries of such programmes.

Factors Associated with Accessing ICDS Services among Women in Rural Rajasthan, India

Background: The Integrated Child Development Services (ICDS) Scheme, launched in 1975 by the Government of India, provides various health services to children and their mothers at ICDS centres. Objectives: The purpose of this study is to understand 1) the extent to which women living in Rajasthan, India utilize services provided by ICDS centres and 2) the factors that are associated with their use. Methods: Freedom from Hunger and Freedom from Hunger India Trust, in collaboration with two local partners in Rajasthan, India, conducted a baseline assessment with 403 pregnant women and women with young children belonging to self-help groups to compare use of ICDS centres with key demographic variables and measures of poverty, food security and nutrition, curative care related to diarrhea, coping strategies, and household decision-making. Results: The results revealed that households that accessed ICDS services were more likely to report receiving nutrition information from ICDS centres, to purchase ORS in the last year, and to give oral rehydration solution (ORS) to children who had diarrhea. Women who decide how much food to serve each family member or spend money without discussing it first with someone else were more likely to receive benefits from ICDS centres. Those who spoke with their spouse about household nutrition needs were less likely to report accessing ICDS services. Conclusion: Interventions aimed at increasing utilization of ICDS centres in this region may find it beneficial to increase female participation in health care decisions, likely through spousal communication and gender relations.

Family Planning Adoption and Unmet Needs: Spousal Agreement in Rural Varanasi.

Background:There have been very few studies in India where both partners' involvement in family planning is seen. The present study was undertaken to assess the spousal agreement level regarding family planning adoption and unmet needs.Materials and Methods:Married couples where wife was in reproductive age group (15–44 years) were included. A pretested, semi-structured interview schedule was used for the study. Sterilized couples were excluded. Interview of both husband and wife was done on the same day but in isolation.Results:There was excellent to poor agreement was reported among husbands and wives in fertility desire (κ = 0.769), current use of contraception (κ = 0.581), unmet need for family planning (κ = 0.416), ideal family size (Spearman correlation = 0.329), and approval for the use of contraception (κ = 0.300). In 6.1% of cases, husband-only unmet need was reported.Conclusion:There is need to encourage spousal communication so that they can make informed decisions on contraceptive choice. Husband-only unmet need for family planning was found, so man may be a potential entry point of national demographic health surveys to improve the contraceptive usage among couples and reduce the unmet need of them.

Factors affecting the achievement of fertility intentions in urban Nigeria: analysis of longitudinal data

BackgroundMaternal mortality ratio in Nigeria is among the highest in the world with an estimated 160 women dying every day of complications related to pregnancy and childbirth. In addition to appropriate management of complications related to pregnancy and childbirth, preventing unwanted pregnancies is an effective way to reduce maternal deaths. Identifying potentially modifiable factors associated with the achievement of fertility intentions is critical for developing behavior change interventions that will contribute to reducing maternal mortality.MethodsThe data analyzed came from a longitudinal design with data collected in 2010/2011 and 2014 from the same group of women of reproductive age in six Nigerian cities. The data were collected as part of efforts to evaluate the effects of the Nigerian Urban Reproductive Health Initiative (NURHI). A total of 10,672 women were interviewed at the two points in time but the analyses in this manuscript were limited to 1921 in-union women who reported that they desired no more children at baseline in 2010/2011. The principal analytic method was multivariable regression adjusted for clustering at the enumeration area level. The analysis controlled for socio-demographic and household variables, ideational characteristics, and contraceptive use at baseline.ResultsAbout two thirds of the women who desired no more children at baseline have neither had any children nor were pregnant at endline. The strongest predictors of the achievement of fertility intentions include parity, age, religion, residence, spousal communication about family size, perceived severity of another pregnancy, and spousal agreement about family size.ConclusionA comprehensive strategy to help women avoid unwanted pregnancies should include efforts to increase women’s understanding about effective ways to prevent unplanned pregnancies and strengthen self-efficacy for contraceptive use. Promoting spousal communication about reproductive issues, engaging men, promoting smaller family sizes and changing pronatalist attitudes should also be part of such a strategy.

Couple\u2019s concordance and discordance in household decision-making and married women\u2019s use of modern contraceptives in Bangladesh

BackgroundAlthough a large body of studies documents that women’s autonomy in the household is associated with better reproductive health outcomes, these studies typically examined autonomy only from women’s point of view. The current study employs husband’s and wife’s perspectives together to examine the relationship between the decision-making arrangements in the household and the women’s use of modern contraceptives in Bangladesh.MethodsThe study used the couple dataset of 2007 Bangladesh Demographic and Health Survey. The sample was comprised of 3336 married couples. Binary logistic regression models were used to examine the associations between the selected items on household decision-making and the use of modern contraceptives.ResultsOur results indicate that the couples disagree considerably as to who in the household exercises the decision-making power. The pattern of decision-making regarding visiting family and relatives emerged as an important predictor of use of modern contraceptives in the multivariate regression analysis. The results suggest that compared to the couple’s concordant joint decision-making, the husband-only decision-making is associated with lower odds of contraceptives use (OR 0.49; 95% CI 0.28–0.85). Only a small part of this association is explained by spousal communication about family planning issues while the socio-demographic correlates hardly affected the association. On the contrary, the wife-only decision-making did not result in increased contraceptives use (OR 0.71; 95% CI 0.45–1.13).ConclusionsThe study findings imply that women’s greater autonomy may not necessarily result in improved reproductive health behavior, and therefore, a balance of power in the spousal relationship is warranted.

Familial correlates of unmet need for contraception among currently married women: a comparative study of three Sub-Saharan African Countries

Using data from the 2010 Malawi, 2013-14 Togo and 2011 Uganda DHS, the study explored the relationship between unmet need for contraception (unmet need) and family factors. The analysis was based on data for 15,528 currently married women aged 15-49 in Malawi, 6,282 in Togo and 5,417 in Uganda. Multinomial regression models were used to analyse the data. Results show that Malawian and Togolese women in female headed households have a higher risk (p<0.001) of having unmet need for spacing over no unmet need. Spousal agreement on fertility desire significantly reduced unmet need among Malawian women. Therefore family factors to some extent do influence unmet need in these countries. The findings indicate the importance of coming up with strategies which will encourage spousal communication in order to aid males and females to be equal partners in family planning.

Determinants of contraceptive use and future contraceptive intentions of women attending child welfare clinics in urban Ghana

BackgroundFamily planning is an integral component of maternal and child health services in Ghana. Although knowledge on contraception is universal and most women attend maternal and child health services, contraceptive use remains low among women after delivery. This study aimed to determine factors influencing current use and future contraceptive intentions of women who were attending child welfare clinics within 2 years of delivery in Sunyani Municipality, Ghana.MethodsWe conducted an analytical cross-sectional study among mothers in six selected health care facilities. Data was collected on their socio-demographic characteristics, reproductive and contraceptive experiences and future contraceptive intentions. Categorical variables were compared using the chi-squared (χ2) test. Factors associated with current use and future contraceptive intentions were determined using Poisson regression with a robust error variance to estimate crude and adjusted relative risks (RRs) with 95% confidence intervals (CIs). P < 0.1 was considered statistically significant.ResultsA total of 590 women were recruited into the study. Overall, 50.2% of the women were using contraception, 30.7% modern and 19.5% traditional methods. Compared to previous use, more women were using and would prefer the more effective contraceptive methods in future. Significant factors associated with current contraceptive use were, level of education (p = 0.02), discussing family planning during antenatal care (adjusted RR, 1.28; 95% CI, 1.07-1.53), or with one’s partner (adjusted RR, 1.22; 95% CI, 1.01-1.47) and previous contraceptive use (adjusted RR, 1.91; 95% CI, 1.56-2.33). Family planning discussions during child welfare clinic (adjusted RR, 1.12; 95% CI, 0.99-1.26) or with one’s spouse (adjusted RR, 1.20; 95% CI, 1.08-1.34), desire to space children (adjusted RR, 1.35; 95% CI, 1.17-1.55), previous (adjusted RR, 1.15; 95% CI, 1.05-1.27) and current (adjusted RR, 1.11; 95% CI, 1.01-1.22) contraceptive use were predictive of clients’ intention to adopt family planning in the future.ConclusionEffective counselling on family planning during antenatal and child welfare clinics, and encouraging spousal communication on contraception are likely to increase contraceptive use after delivery.

Influence of Spousal Communication about Family Planning and HIV/AIDS-related Issues on Modern Contraceptive Use in Nigeria

Contraceptive use in Nigeria at 15 per cent is low, despite a high human immunodeficiency virus (HIV) prevalence of 3.4 per cent and fertility rate of 5.7 per cent. We assessed the levels of spousal communication on family planning and contraception (FPC) and HIV/acquired immune deficiency syndrome (HIV/AIDS), influence of demographic characteristics on this communication and association between this communication and the respondents’ health behaviours. We used a cross-sectional and nationally representative data on reproductive health and HIV/AIDS-related issues from randomly selected 30,752 men and women of reproductive age. Descriptive statistics, Pearson chi-square (c2) and logistic regression were used to analyze the data at 5 per cent significance level. About 61 per cent of the respondents were 25–49 years old and mostly from rural areas (65 per cent). Only 20 per cent of the respondents discussed HIV/AIDS with their spouses within 12 months preceding the survey while 15 per cent discussed FPC. A discussion of both HIV/AIDS and FPC among spouses was reported among 9 per cent compared to 26 per cent who reported discussing either. Respondents aged 35–39 years had higher odds of discussing HIV/AIDS (Odds Ratios [OR] = 7.06:6.16–8.09) than those aged 15–19 years. Urban dwellers also had higher odds (OR = 1.24:1.16–1.31) of HIV/AIDS discussions than rural respondents. Modern contraceptive use was 35 per cent and 23 per cent among respondents who discussed FPC and HIV/AIDS compared to 8 per cent and 9 per cent, respectively, among those who did not. Spousal communication on FP and HIV/AIDS was low and has influenced contraceptive use and HIV positivity in Nigeria. There is a need to encourage spousal discussion on FP and HIV/AIDS, especially among the rural dwellers and the poor and uneducated as a strategy for improving modern contraceptive use.