Determinants of couples’ decision-making in the uptake of modern contraceptives in Uganda

Abstract

Couples’ decision-making in contraceptive use is an important health intervention in family reproductive health issues. To understand more about this variable, the general objective of this study was formulated to explore the determinants of couple decision making in uptake of modern contraceptives among women in Uganda. The study was based on a sample of 1,159 women who had made joint decisions to avoid pregnancy with their partners. The study used secondary data from 2016 Performance Monitoring Accountability (PMA 2020) Uganda and descriptive, chi-square test and binary logistic regression model were used to examine couples’ decision making on family planning. The findings of the study show that 73% of the women were involved in discussion with partners before using contraceptives while 27% did not have any discussion with their partners on family planning method. At multivariate level of analysis, women who were aged (35-39) years at 1st contraceptives use (OR=0.26; 95%CI=0.13-0.52) had reduced odds of couples’ decision making on contraceptives use as compared to those women aged (15-19) years. Women who had 4-6 children (OR=0.26; 95%; CI=0.10-0.70) had reduced odds of decision making on contraceptives use as compared to those who had no children. Women with higher education had increased odds (OR=2.25; 95% CI=0.94-2.15) and there was a high likelihood of having couples’ decision on contraceptives use as compared to women with no education at all. Currently married women had higher odds (OR=10.14; 95% CI=4.49-22.90) of having couples’ decision making on contraceptives as opposed to those cohabiting. In addition, women who were from western region had increased odds of (OR=2.52; 95% CI=1.124-2.723) having couple decision making on contraceptives as opposed to those women from central region. In conclusion, couples’ decision making on contraceptives increases the likelihood of using contraceptives. Therefore, government and other stakeholders should include strategic interventions in contraceptive uptake programs to raise women’s status through creating educational and encouraging more visible involvement in household decision making. Also, there is a need to advocate for joint decision-making and improved interpersonal communication between couples which may encourage couples to access and demand for the right method of contraceptives appropriate to use which will increase contraceptives uptake.