Communication key for family planning

4 reports published by Demographic and Health Surveys (DHS) include information from husbands of the wives interviewed in the main part of the survey. All are from Africa--Burundi (1987), Ghana (1988), Kenya (1988) and Mali (1987). These surveys of husbands indicate the importance of programs that work to improve communication between spouses about family planning. In particular, they show a positive association between contraceptive prevalence and husband and wife communication about family planning. Husbands and wives were asked how often they discussed family planning in the past year. In Kenya, with a 27% contraceptive prevalence rate--the highest among the 4 countries--about 2/3 of the couples had discussed family planning during the past year. In Ghana, with a rate of 13%, and in Burundi, at 9%, about 1.2 of the couples had discussed family planning during the year. Mali had the lowest contraception prevalence rate of 5% and the least communication among the couples, with only 1.4 discussing family planning during the year. The importance of communication also emerges in data on methods used. In all 4 surveys, the wives reported lower use of male methods than did their husbands. Estimates of use of female methods were more consistent between husbands and wives. Questions were not exactly the same in all 4 surveys, so summaries for each country vary slightly. In Burundi, about 2 of 5 husbands said they used periodic abstinence, compared to about 1 of 5 wives. Husbands said 0.7% used condoms, with 0.3% of the wives giving that response. Husbands an wives agreed that there was no use of male sterilization. The use of vasectomy in Africa is considerably lower than for other regions of the world (see chart below). Ghana showed a similar pattern. Husbands said 2.1% of couples used condoms, compared to 0.3% according to the wives. Husbands also indicated more widespread use of periodic abstinence than did the wives. In contrast, except for pill use, husbands and wives gave similar responses for use of female methods. In Kenya, 1 of every 2 husbands said they were using family planning, compared to about 1 of every 4 wives. The largest discrepancy was in the data for use of periodic abstinence, where 3 times more husbands than wives said they were using this method--26% compared to 8%. Only in Mali, where total contraceptive use is only 5%, were responses from husbands and wives consistent. Even here, husbands gave higher rates of condom use (0.5%) than did wives (none). When it comes to choosing a method of family planning, women apparently think first of female methods. In general, women assume that their husbands will not be interested in using contraception themselves. Women may, however, underestimate their husbands interest or participation in family planning. Or men could be overstating the use of male methods. These DHS husband surveys suggest that programs aimed at both men and women should encourage more and better communication between spouses about family planning. More data related to communication on family planning will soon become available. Other DHS husbands surveys in various stages of completion are from Pakistan, Cameroon, Tanzania, and Egypt.