COUPLES FERTILITY AND CONTRACEPTIVE DECISION-MAKING IN DEVELOPING-COUNTRIES - HEARING THE MANS VOICE

Context: Family planning research, policy and programs in developing c ountries have traditionally given little attention to men's role in re productive decision-making. Men's exclusion from family planning effor ts may have ramifications for their preferred family size and attitude s toward contraceptive use. Methods: Demographic and Health Survey dat a collected in 18 developing countries between 1990 and 1996 were used to directly compare husbands' and wives' attitudes toward fertility a nd contraception. Logistic regression analyses were conducted to exami ne how these attitudes affect couples' contraceptive behavior. Results : Men and women in these countries desire fairly large families; howev er, husbands tend to want more children than their wives and to want t he next child sooner. The proportion of couples in which partners' ide al family size differs by two children or more ranges from 30% (in Ban gladesh) to 72% (in Niger). In most couples, either both spouses want more children or both want no more, but in 10-26%, their desires diffe r. Modern method use is low in most of these countries, but husbands a re more likely than their wives to report such use. Combining each spo use's fertility intentions into a couple analysis, while controlling f or their demographic characteristics, significantly predicts modern me thod use in nine of 14 countries for which data are available; in six of these countries the wife's fertility preference has a greater impac t than the husband's Conclusions: Spouses may have disparate reproduct ive goals, and data from both partners are necessary to ascertain thes e differences. Fertility and family planning programs and research mus t continue to expand their focus on men's attitudes and behavior.