Background: Male partner's approval is a key determinant of contraceptive use for women living in Sub-Saharan Africa and improving men's support and couple communication is a cornerstone of family planning programs. However, approval is often only measured through the women's perception of their partner's opinion.
Methods: This study conducted in Kinshasa compares contraceptive approval variables from matched male and female partners (n = 252 couples) to establish the frequency of (in)accurate perceptions by the woman, then test their association with modern contraceptive use. Additional regressions estimate individual and couple variables associated with (in)correct perceptions.
Results: Results confirm women are poorly aware of their partner's opinion but indicate that perceived approval or disapproval by the woman is a much stronger determinant of modern contraceptive use than her partner's actual opinion. Higher educational achievement from the woman is the strongest driver of misunderstanding her partner's approval.
Conclusions: Women's perceptions of partner's approval are much stronger determinant of contraceptive use than the latter's actual opinion, and stereotyping men's opinion of family planning is a common error of appreciation. However, findings also suggest these misunderstandings might serve women's capacity to negotiate contraceptive use.
RéSUMé: CONTEXTE: L’approbation du conjoint est un facteur clé de l’utilisation des contraceptifs chez les femmes vivant en Afrique subsaharienne, et l’amélioration du soutien des hommes et de la communication au sein du couple est une pierre angulaire des programmes de planification familiale. Cependant, l’approbation conjugale n’est souvent mesurée qu’à travers la perception des femmes de ce que pensent leurs partenaires. MéTHODES: Cette étude menée à Kinshasa compare les variables d’approbation de l’utilisation contraceptive entre les hommes et les femmes formant un couple (n = 252 couples) pour établir la fréquence des perceptions (in)exactes des femmes, puis teste leur association à l’utilisation contraceptive moderne. Des régressions additionnelles permettent d’estimer les variables individuelles et des couples associées à ces perceptions (in)exactes. RéSULTATS: Les résultats confirment que les femmes ont une faible connaissance de l’opinion de leurs partenaires quant à l’utilisation contraceptive, mais indiquent que la perception par ces femmes d’un avis favorable ou défavorable est un déterminant bien plus fort de l’utilisation contraceptive moderne que l’opinion réelle des partenaires. Le niveau d’études plus élevé de la femme est le facteur le plus largement associé à une perception erronée de l’avis de son partenaire. CONCLUSIONS: Les perceptions des femmes de l’avis de leurs conjoints sont un déterminant bien plus fort de l’utilisation contraceptive que l’opinion réelle de ces derniers, et stéréotyper l’opinion des hommes concernant la planification familiale est une erreur d’appréciation courante. Cependant, les résultats de recherche suggèrent aussi que ces malentendus pourraient servir la capacité des femmes à négocier leur utilisation de la contraception.
Keywords: Contraception; Couple communication; Men; Partner approval; Sub-Saharan Africa.
Research indicates that women living in Sub-Saharan Africa may not use contraceptive methods if their partner disapproves. However, there are methodological gaps in how this relation has been measured so far. For example, women are often the only ones asked whether their partner approves of contraception and surveys rarely assess how women know of their partner’s disapproval and how strongly it has been communicated to them, nor do they ask said partner for his actual opinion on the matter.In this study we address some of those questions by interviewing men and women from married couples separately and comparing their opinion of family planning use. The research uses a population-based survey conducted among couples living in military camps in the capital city of the Democratic Republic Congo, Kinshasa.The results show that women overall are poorly aware of their partner’s actual opinion, but act based on those perceptions, nonetheless. In particular, women whose husband disapproves of family planning but (falsely) perceive his approval have some of the highest odds in our cohort for contraceptive use. Conversely, women in a “false negative” scenario (husband approves but they perceive disapproval) are less likely to use modern contraception. Additional analysis indicates that this latter scenario is more common among women who are more educated than their partner, possibly because they are stereotyping his family planning desires. The findings and the discussion also raise the possibility that women may however benefit from ignoring their partners’ true wishes in order to fulfill their own contraceptive choice.
© 2022. The Author(s).