Perceptions of Partners' Fertility Preferences and Women's Covert Contraceptive Use in Eight Sub‐Saharan African Countries. Issue 3 (29th June 2022)

• Record Type: Journal Article
• Authors: Sarnak, Dana O.; Gemmill, Alison
• Is Part Of: Studies in family planning. Volume 53:Issue 3(2022)
• Page Start: 527
• Page End: 548
• Publication Date: 2022-06-29
• Subjects: covert contraceptive use -- fertility preferences -- couples; Birth control -- Periodicals; 363.9605
• DOI: 10.1111/sifp.12206
• Languages: English
• ISSNs: 0039-3665

Abstract

Abstract: Covert use of contraception is a common but underreported and understudied phenomenon where one partner uses contraception without the other's knowledge. We used Demographic and Health Survey couple data to examine the relationship between wives' perceptions of husbands' fertility preferences and type of contraceptive use (overt vs. covert) in Benin, Ethiopia, Kenya, Mali, Nigeria, Sierra Leone, Uganda, and Zambia using logistic regression. Wives who perceived that their husbands wanted more children than them had increased odds of using covertly, compared to those who perceived that husbands wanted the same number of children in all countries except Benin, and the strength of the relationships ranged from adjusted odds ratio (aOR) 2.89 (95 percent confidence interval (CI) 1.75–4.76) in Zambia to aOR 4.01 (95 percent CI 1.68–9.58) in Mali. Wives who reported not knowing their husbands' fertility preferences had increased odds of using covertly compared to wives who perceived that their husbands wanted the same number of children in all countries except Zambia, ranging from aOR 2.02 (95 percent CI 1.11–3.69) in Ethiopia to aOR 3.82 (95 percent CI 2.29–6.37) in Kenya. Our findings indicate that efforts to increase partner engagement to align couple's fertility preferences may encourage overt use.