THE EFFECT OF HUSBAND COUNSELING ON NORPLANT(R) CONTRACEPTIVE ACCEPTABILITY IN BANGLADESH

A pilot study of the effect of husband counseling on NORPLANT(R) contraceptive acceptability was con ducted at four family planning clinics in Bangladesh. The study objectives were to compare discontinuation rates and user satisfaction among accepters whose husbands received counseling about the method versus those who did not. Of a total 617 subjects enrolled in the study which began in 1988, about two-thirds (408) of the husbands were counseled at admission or at the one-month follow-up visit while the remainder of the husbands (209) were not counseled. Follow-up visits were scheduled at one and six months after NORPLANT(R) implants insertion, and every six months thereafter until the close of the study in 1991. Some evidence was found that counseling husbands of NORPLANT(R) implants accepters may reduce discontinuation rates. At the end of 36 months, a difference of 10 percentage points in total discontinuation rates was observed between the husband-counseled group (32 per 100 women) and the husband-not-counseled group (42 per 100 women). The husband counseling had the most impact at clinics with higher discontinuation rates. Based on Cox's proportional hazards regression model results, the hazard for discontinuation among the accepters in the husband-counseled group was 0.81 times the hazard for those in the husband-not-counseled group. Satisfaction with NORPLANT(R) implants did not differ between the two groups. Although these results are not striking, they do suggest a potential positive effect of husband counseling on NORPLANT(R) contraceptive acceptability. In future studies, the counseling of husbands should be more intensive and standardized.