Background: Inter-spousal communication plays a crucial role in facilitating couples
for adopting family planning practices and lowering the risk of early pregnancy and
adverse reproductive health consequences. The present study was conducted to
understand the effect of a community based intervention package on awareness
and motivation for contraceptive use to delay pregnancy among young married
couples through improving intra-spousal communication.
Methods: A quasi-experimental research design used for a sample survey of 1680
young married women from two districts of India. The program was developed
and implemented to increase knowledge and access to services for improved
sexual and reproductive health of young married women through a multi-pronged
intervention involving community mobilization, advocacy, micro planning and
capacity building of frontline functionaries and district health care providers. The
effect of intervention on the reproductive health of young married women was
assessed through baseline and end-line evaluation.
Results: The findings suggest that 18 months of community based intervention
had significantly improved couple communication on family planning (Intervention
area: 43% vs. Control area: 13% point change) as well as utilization of contraception
among young married women in the intervention area (27% point change) as
compared to control area (5% point change). Regression analysis has indicated
that young couples in the intervention area were more likely to discuss about
contraceptive use (OR: 3.38; p<0.01) than the control area. In both districts, there
was an impressive increase in proportion of women, who reported that they could
communicate with their husbands on contraceptives usage. Further the study
showed that those women who had communicated about contraceptive use with
their husbands were more likely to use contraceptive (OR: 9.53; p<0.01) than
those not communicate about it.
Conclusion: Inter-spousal communication is an effective strategy for enhancing
family planning practices among young couples, especially, where early marriage
is still prevalent, fertility rate is high and contraceptive use rate is relatively
low. There is an urgent need to plan interventions through engaging males and
facilitating inter-spousal communication for healthy family planning decisions and
practices.