Couples’ fertility intentions and contraceptive use in Ethiopia

Abstract Background: While fertility and family planning studies have primarily centred around women, the perspectives of men within couples remain insufficiently explored in sub-Saharan African countries, including Ethiopia. This study seeks to delve into fertility and family planning behaviours within couples in Ethiopia. Methods: The analysis draws from data collected in 2005, 2011, and 2016 Ethiopia Demographic and Health Surveys (EDHS), encompassing 15,854 couples. Data analysis mostly based on simple descriptive analysis and trends. The relationship between couple’s fertility intentions and contraceptive use was examined using multivariate regression models, adjusting for several covariates. Results: At the couple level, a substantial proportion (37.4%) of husbands express a greater desire for children than their wives, with regional disparities observed. This preference discrepancy ranges from 27.4% in Tigray to 53.5% in Afar. Only 18% of Ethiopian couples share similar desired family sizes. Notably, the preference for larger families is prominent among married, rural, less educated, and higher parity men. Regarding fertility preferences, approximately 54% of Ethiopian couples agree on their future fertility plans, while 46% have discordant views. Analysis reveals that about one-fifth of couples aim to cease childbearing, with a similar proportion aiming to delay the next birth by two or more years. The findings affirm that couples in agreement about their fertility goals are significantly more likely to use contraceptives compared to those with discordant fertility preferences. Multivariate analysis, accounting for various factors, confirmed that couples with an aligned desire for fewer than four children were 49% more likely to use modern contraceptives than those where either spouse was undecided about family size. Conclusion: The study underscores the vital role of men's fertility intentions and preferences within couples to fully grasp fertility and family planning in Ethiopia. Emphasizing men's involvement in shared decision-making about fertility and family planning within families is crucial. Encouraging open communication between spouses regarding family size can help bridge gaps in fertility goals.