Facilitating inter-spousal communication for birth spacing--a feasibility study of Pakistani couples for policy implications.

OBJECTIVE To test three practices introduced to couples for adaptation of a non-permanent modern method of family planning and the role that each partner played during the process. SETTING Urban and sub-urban areas of Karachi, Lahore, and Quetta. METHODS 'Behavioral trials' was conducted which is a formative research method in which researcher and participants negotiate behavior(s) that the participant agrees to try for a specific amount of time. Interviews were conducted on 72 married couples (144 men and women) living in urban and sub-urban areas of Karachi, Lahore and Quetta. Study participants were either non-users of modern methods of family panning, or using traditional methods. The three behaviors negotiated were: a) Discuss benefits of birth spacing with spouse; b) discuss specific methods of family planning and decide on the most appropriate one and c) initiate use of a modern temporary method of family planning. RESULTS After the introduction of first practice, of 72 couples 38 reported failure to initiate the discussion with their spouse. Where women initiated the discussion the response from spouse was not as favorable as where men initiated the discussion. After introduction of second practice 28 couples were successful in discussing about selection of a family planning method. Twenty-four couples finally selected and used a method. Traditional users were more likely to adopt a modern method than non-users, especially those with 3-5 children. CONCLUSION Strategies to cultivate a culture of inter-spousal communication on use of family planning methods should be developed as a component of family planning programs.