The influence of spouses over each other's contraceptive attitudes in Ghana.

ABSTRACT

PIP: Quantitative information from 1010 matched husband-wife pairs derived from Ghana Demographic and Health Survey (DHS) data collected in 1988 and qualitative information from focus group research in Ghana were used in the analysis. 2 possible mechanisms that might affect a spouse's beliefs and/or behavior include the selection effect and the dominance effect. These 2 effects together comprise the spousal influence effect, which measures the extent to which an individual influences a spouse's reproductive attitudes. The distribution in the Ghana DHS of the individual variables for husbands and wives that were used in the regression analysis indicated that 60% of the men had some form of formal education, but only about 43% of their wives had gone to school. Among 54% of couples, both spouses approved of family planning (FP) and 21% disapproved of it. 49% of uneducated and 54% of educated wives of uneducated men, respectively, approved of FP. For husbands with primary education, this proportion rose to 62 and 82% for uneducated and educate wives. The net of the effects of education or being married to a man who wanted no more children increased a woman's odds of contraceptive approval by as much as 80%. For uneducated wives, the probability of contraceptive approval for those married to uneducated husbands was 0.48, compared with 0.65 for those married to husbands with only primary education. The corresponding probability for educated wives was 0.69 and 0.82, respectively. The probability of contraceptive approval among men with secondary or higher education increased from 0.84, if their wives were uneducated, to 0.88, if their wives had some formal education. Results from both data sources showed that spousal influence, rather than being mutual or reciprocal, was an exclusive right exercised only by the husband. The limited impact of FP programs in Ghana and most of sub-Saharan Africa was attributable to the continued neglect of men as equal targets of such programs.