Husband-Wife Agreement, Power Relations and Contraceptive Use in Turkey

Abstract

There are very few couple-level studies of communication and decision making regarding contraceptive use in the Middle East. In Turkey-a predominantly Muslim nation that has a secular democracy and is undergoing considerable social change-fertility has declined significantly, men play a major role in contraceptive practice and women's position in society is increasingly contested. These factors make Turkey a particularly interesting country for couplelevel studies.Traditionally, the measurement of contraceptive use has been based solely on women's self-reports of current use. Although this is methodologically convenient, the individual and subjective experiences of partners may differ. A more comprehensive measure of a couple's contraceptive use requires information from each partner. Moreover, because contraceptive practice and fertility are interrelated, the married couple is the appropriate unit of analysis, especially in societies such as those in the Middle East, where the vast majority of contraceptive use and almost all births occur within marriage.For this region, only a few fertility and family planning surveys have collected data from men or couples. The 1992 Egyptian Demographic and Health Survey (DHS) included a subsample of husbands, and the 1992 Moroccan DHS interviewed married and unmarried men aged 20-70, but we could not identify any couple-level studies using these data. The 1985 Jordan Husbands' Fertility Survey interviewed the husbands of women who were currently married when interviewed in the 1983 Jordan Fertility and Family Health Survey. Although one study presented some comparisons of spousal reports about contraceptive knowledge and family planning attitudes from these two Jordanian surveys, 1 the comparisons were purely descriptive and limited in scope, and responses for husbands and wives were from different survey years. The 1988 Turkish Population and Health Survey collected limited data from men. A comparison of spousal reports revealed a high percentage of agreement about fertility measures, but only about three-quarters of the women knew their husbands' age and level of education (72% and 78% agreement, respectively, between spouses). 2 A decade later, the 1998 Turkish DHS collected detailed couple-level data, including data on gender expectations and attitudes from each partner, which are analyzed in the current study.This study has three objectives. First, it assesses the extent of interpartner concordance on self-reported aspects of reproductive decision making and behavior. Such an assessment may permit verification of the accuracy of either BACKGROUND Couple-Level Concurrence About Contraceptive UseThe level of spousal agreement regarding fertility and family planning remains an area of scholarly contention. Although high concurrence would be expected because of daily partner contact and common living conditions, cross-national studies of couple concurrence on contraceptive method use show frequent discrepancies between husbands' and wives' reports. [4][5][6][7][8] In one s...

Prevalence, Perceptions and Factors Contributing to Long Acting Reversible Contraception Use among Family Planning Clients, Jimma Town, Oromiya Region, South-West Ethiopia

“…This may again partly explain women's lack of decision making power over their contraceptive choice or their partners' influence. In fact, there are many evidences including a study in Turkey and Bangladesh that indicated spousal attitude and approval influence contraceptive use [18,19].…”

Extent of Awareness of Birth Control Methods and Their Use by Women in a Peri-Urban Area of Accra, Ghana

“…Such power relations tend to be less important in non-marriage situations such as those involving career-minded young women who are unmarried and have consensual relations with men. The analysis of the influences of power relationships, within marriage and informal unions, on the use of contraceptives by women show mixed results [32].…”

Partner Support for Family Planning and Modern Contraceptive Use in Luanda, Angola

“…Several studies have examined how wife's and husband's fertility intentions predict future fertility and contraceptive use and results indicate that incorporating both spouses' attitudes improves predictability compared to including just one spouse's attitudes [1][2][3][4][5] . Results vary regarding which spouse's fertility intentions has greater predictive value.…”