Spousal communication and family planning adoption: Effects of a radio drama serial in Nepal

CONTEXT, Spousal communication and family planning use are closely linked, but the pathways of influence, especially within the context of exposure to amass media campaign promoting family planning, are unclear. METHODS. Panel data from a population-based survey in Nepal were collected over three waves, from 1994 to 1999, to evaluate the Impact of a radio drama serial among couples of reproductive age. Data from 1,442 women were used to assess changes in couples' family planning decision-making, Identify predictors of spousal communication and family planning use in relation to program exposure, and clarify temporal relationships among these variables. RESULTS: Women exposed to the program had significantly elevated odds of believing that their spouse approved of family planning and of having discussed family planning with their spouse (odds ratios, 1.8-7.9)Those who communicated with their spouse had elevated odds of using family planning (10.2). Spousal communication at baseline was associated with subsequent family planning use, independent of campaign exposure. In addition, among couples who had not already been discussing family planning, exposure led to communication, which in turn led to family planning use. Over time, husbands' dominance in making family planning decisions gave way to joint decision-making and an Increase in women's decision-making power. CONCLUSIONS:, New indicators are needed to capture campaign effects on individuals who are predisposed to use, family planning. Couples joint decision-making should be promoted as a strategy for increasing family planning use family ventions, are needed to improve women's; autonomy and strengthen their negotiating capacity for family planning use.