Fertility preferences and contraceptive use among couples in sub-Saharan Africa

Abstract

Fertility remains high and contraceptive use is low in much of sub-Saharan Africa despite high levels of unmet need for contraception and clear evidence of excess fertility. Using data from recent Demographic and Health Surveys this paper revisits the issue of gender differences in fertility goals, and how these differences may contribute to the lack of substantial declines in fertility in the region. The results show that most spouses agreed with respect to their fertility preferences, whether in terms of desired number of children or desire for a future birth. When there were disagreements, men tended to want more children than their spouses. In most countries, contraceptive use among couples was not associated with differences in spouses’ desires for a future birth. However, for the few countries where a significant association was observed, couples were less likely to be using a method when the wife wanted to have more children and more likely to be using one when she wanted to stop childbearing. To ensure open and sustained use of contraception within a union, family planning programs must continue to involve men by helping them understand the importance of fewer and well spaced births for the health of women and their children.