Couple’s reports of household decision-making, unmet need for contraception, and unintended pregnancy in Bangladesh

Introduction: Previous researches emphasize the role of wife’s sole contribution in household decision-makings as predictor of family planning and reproductive health behaviors in many developing countries. These studies tend to overlook how couple’s joint decision-making may promote better reproductive health outcomes than any partner’s sole decision-makings which lack input or agreement from other partner in a marital relationship. Using married couple’s matched responses in decision-making questions; this study examines the association between couples’ concordant and discordant decision-makings, and wife’s unmet need for contraception and unintended pregnancy in Bangladesh. Methods: This study used couple’s dataset (n= 3336) of Bangladesh Demographic and Health Survey of 2007. Multivariate logistic regression was used to examine the likelihood of unmet need for contraception, and unintended pregnancy among married women of reproductive age. Findings: Study findings reveal that there are substantial levels of both concordance and discordance in responses to household decision-making items. Results from logistic regression analyses suggest that compared to couple’s joint decision making, husband-only or wife-only decision-making is associated with higher risk for women in having both unmet need for contraception and unintended pregnancy. Regression results also indicate that unmet need for contraception and unintended pregnancy are lower among women with lower parity, women from relatively richer households, and women heard family planning messages on television. Conclusion: As couple’s joint decision-making is significantly associated with better reproductive outcomes, policy makers may promote community based outreach programs, and communication campaigns for family planning focusing on egalitarian gender role approach.