Unmet family planning need: differences and levels of agreement between husband-wife, haryana, India

Research question: Is there agreement between husbands and wives regarding unmet need of family planning?

Hypothesis: The unmet need of family planning is perceived more by women then their husbands.

Objective: 1) To ascertain the unmet needs of family planning for husbands and wives. 2) To ascertain the level of agreement between husbands and wives regarding unmet needs of family planning.

Design: A cross-sectional survey

Setting: Dayalpur village in Intensive field practice area of Comprehensive Rural Health Services project (CRHSP), Ballabgarh, Haryana.

Study period: July 2003- June 2005.

Participants: included 200 married couples selected by simple random sampling.

Statistical analysis: Level of agreement between husbands and wives was analyzed using Kappa statistics.

Results: Unmet need for family planning was 11% (22 out of 200) for husbands and 17.5% (35 out of 200) for wives. The difference was seen both in unmet need for spacing (M-3.5% vs. F-6%) as well as limiting family size (M-7.5% vs. F-11.5%). Overall, 93.5% concordance was observed amongst husbands and wives. In all the cases where disagreement was seen (6.5%), wives reported having unmet need for contraception whereas their husbands perceived none. The unadjusted Kappa statistic was 0.73 and prevalence adjusted Kappa was 0.88.

Conclusion: Unmet need for family planning was significantly higher for wives compared to husbands. Despite high degrees of agreement amongst the couples, the nature of disconcordance reinforces the need for policy makers to take into account the perspective of men.