Changes in Couples' Communication as a Result of a Male-Involvement Family Planning Intervention

Abstract

Research suggests that spousal communication and male involvement in decision making can positively influence family-planning use and continuation. However, few existing studies explore the dynamics of this communication and how they factor into family-planning decision making. Building upon a recent evaluation of a theory-based male-involvement intervention in Malawi, this study aimed to fill this gap by examining the role of communication in the intervention's success, through semi-structured in-depth interviews with male participants and female partners of study participants. Results support the idea that communication is an integral component of successful interventions to increase male involvement in family planning. Participants reported improvements in spousal communication, increased frequency of communication, and an increase in shared decision making as a result of the study, which directly contributed to their family-planning use. This effect was often mediated through increased knowledge or reduced male opposition to family planning. Further analysis of communication and decision-making dynamics revealed shifts in gendered communication norms, leading to improvements in spousal relationships in addition to contraceptive uptake. This study shows that interventions can and should encourage spousal communication and shared decision making, and it provides an effective model for involving men in family-planning use.

Acknowledgments

This work is made possible by the generous support of the American people through the U.S. Agency for International Development. The contents are the responsibility of Family Health International and do not necessarily reflect the views of the U.S. Agency for International Development or of the U.S. government. Financial assistance was provided by the U.S. Agency for International Development under the terms of Cooperative Agreement No. GPO-A-00-05-00022-00, the Contraceptive and Reproductive Health Technologies Research and Utilization Program.

Notes

¹Mass media and edutainment in particular have also been proven effective at reaching men and motivating spousal communication (Piotrow et al., 1992; Rogers et al., 1999), however due to the rural setting of this study and existing resources, peer education was a more feasible and appropriate approach.

²A more extensive discussion of these findings and their interpretation are presented Shattuck et al. (2011).

Note. FP = family planning.

Note. FP = family planning.

Note. Patterns of decision making were not mutually exclusive (i.e., a participant could describe one decision as being male dominated and another as a joint decision).

^*Not every participant discussed the decision to use family planning (12 men, 27 women).

^**Not every participant discussed the decision on choice of method (12 men, 21 women).