Determinants of Effective Family Planning Communication Among Couples in Harar, Eastern Ethiopia: A Community Based Matched Case-Control Study

Abstract Introduction Effective spousal family planning communication is determined by various socio-economic, demographic, family planning knowledge and attitude, and exposure of couples to family planning message on media. Women' equality with men in terms of educational status, relative power of each spouse and women's social and economic vulnerability dictates couples' communication on family planning and other reproductive health issues. Methods A community based matched case-control study was conducted in twelve kebeles of Harar Urban Health and Demographic Surveillance System. A total of 1010 cases (married couples) and 1010 controls (married couples) of whose wives were in the reproductive age participated in the study. The selection of the study participants was made using simple random sampling. Results In this study, husband's desire for more children (aOR=0.2; 95%CI: 0.11, 0.41), wives desire for more children (aOR=0.1; 95%CI: 0.06, 0.34) and fewer children (aOR=0.4; 95%CI: 0.19, 0.84), couples' approval of family planning use (aOR=2.3; 95%CI: 0.65, 8.37) and women's family planning counseling by health workers (aOR=2.1; 95%CI: 1.12, 3.8) were significantly associated with effective spousal family planning communication Conclusion In conclusion the results revealed that policies and programs aimed at promoting family planning should strengthen family planning information, education and communication activities to enable couples concord on their desired number of children and develop positive attitude towards family planning.