Covert Contraceptive Use and Discordant Fertility Preferences among Ethiopian Couples

Biruk T. Tessema, Addis Ababa Mortality Surveillance Program
Michelle J. Hindin, Johns Hopkins Bloomberg School of Public Health

In some settings, women use contraceptives without the knowledge of their partners. In this study we use couple data from the 2005 Ethiopian DHS (EDHS) to estimate covert contraceptive use and to identify discordant fertility preferences. We estimated covert use from women’s responses about their husband’s knowledge of contraceptive use and from couples’ discordant responses on use and type of method. We found that 7.9% of women use contraceptives secretly, but based on discordant responses, 27% of women used contraception without full knowledge of their partners. Women who have a want fewer children than their partners reported more secret use and couples who have the lowest agreement on fertility preference were the most likely to report secret use. In settings, like Ethiopia, where modern contraceptive use is relatively low, addressing couple communication is needed to both increase male involvement and promote the use of contraception to avoid unintended pregnancies.