Spousal Communication and Family Planning Behavior in Navrongo: A Longitudinal Assessment

TLDR

Family‑planning programs in sub‑Saharan Africa performed poorly in the 1980s, partly due to male alienation, and lack of spousal communication has been linked to low contraceptive use, though most studies were cross‑sectional and causal direction remained unclear. The study asks whether spousal communication predicts contraceptive use or whether contraceptive use generates communication among couples. Longitudinal data from the Navrongo Health Research Centre panel survey were used to test the causal relationship. Both cross‑sectional and longitudinal analyses show that spousal communication predicts contraceptive behavior even after controlling for other factors.

Abstract

The poor performance of most family planning programs in the 1980s, especially in sub-Saharan Africa, generated concern among researchers and led to a quest for explanations. In most countries, the alienation of men from participation in these programs was subsequently identified as one of the major causes, a finding that led researchers to redirect their attention to couples instead of individuals as the focus of such programs. Lack of spousal communication about family planning was identified as one reason for the low level of contraceptive use among women. Subsequent research has persistently demonstrated a positive relationship between spousal communication and contraceptive use. Most prior studies on this topic have been based on cross-sectional data, so that whether the identified relationships are causal remains unclear. Does communication, in fact, predict contraceptive use, or does the use of contraceptives generate communication among couples? This study addresses the question of causality by using longitudinal data from the Navrongo Health Research Centre panel survey. Results from both cross-sectional and longitudinal analysis demonstrate that spousal communication does, indeed, predict contraceptive behavior, even when other factors are controlled.