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Page 1: Mumbai Poster presentation

AN INTROSPECTIVE STUDY ON INTER-

SPOUSAL COMMUNICATION MANAGEMENT IN

REPRODUCTIVE HEALTH IN TAMILNADU AND

ORISSA, INDIA

A Poster Presentation at International Conference

Mumbai

Yade Lal Tekhre, Nisha Rani,

V. Bhattacharya and S. Rath

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National Institute of Health and Family Welfare,

Munirka, New Delhi-110 067

Objectives

To examine the nature and extent of inter-spousal

communication on various aspects of Reproductive and

Child Health

To find out the attitude and decisions about contraceptive

method and family size among spouses

To explore the variation among the diverse segment of

population/state on the subject of inter-spousal

Communication and reproductive health issues

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Statement of problem

The right to reproductive health is a key component of

women’s and men’s reproductive and sexual rights.

Moreover, the achievement of reproductive health is

inextricably linked to women’s and men’s ability to exercise

reproductive and sexual rights i.e.

reproductive decision making

equality and equity for men and women, and

Sexual and reproductive security

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The catalyst to these rights, to which we generally ignore, is inter-

spousal communication which is important for sustainable family

well-being. Such communication especially has immense

significance in seeking overall health and reproductive health care

in general and family planning services in particular.

The present study reveals data from both the spouses about couple

communication, negotiation and the degree of men’s influence on

fertility or contraceptive usage. Further more, family size,

conception, pregnancy, spacing and choice of contraception are

directly linked with the inter-spousal communication.

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Methodology

Study Area and Population

Two states in India were taken for study: Tamilnadu &

Orissa on the basis of a well performing state and

comparatively a poor performing state respectively in a large

reproductive health issues correspondingly. Further, four

segment of population were considered explicitly urban, rural,

slum and tribal in each state.

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Sampling Design and Sample Size

Four different purposive samples were selected representing urban,

rural, slum and tribal populations from each state. For each group of

sample 300 male respondents were randomly selected with specific

criteria that the respondent should be married, whose wife was in the

reproductive age group (i.e., 15-45 years of age), had spent at least one

year of married life and preferably had at least one child in the family.

Tools and Techniques

The data were collected through semi-structured and pre-

tested interview schedule. Focus Group Discussion (FGD)

among males were conducted to gather qualitative data.

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CONCLUSION

Irrespective of place of residence, a significant percentage of

respondents (50% to 98%) reported that they discussed with their wives

regarding the number of children they would like to have in the family.

However, only 28% of tribal spouses of Orissa discussed the number of

children they would like to have in the family.

About 1/3 of the respondents in Tamilnadu did not discuss with their

wives regarding number of children. More than 1/4 of respondents in

both the states irrespective of their place of residence except tribals,

discussed immediately after marriage and rest respondents after first

child, second or third child was born. While more than 50% of urban

respondents of Orissa and slum respondents of Tamilnadu discussed

immediately after marriage, only a few tribal respondents of Orissa ever

discussed with their wives.

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The respondents of TN as a progressive State reported that 65% of the

last pregnancies were unplanned; whereas, in Orissa, which is

comparatively backward State, 43% of the last pregnancies were

unplanned. The major reason in both the states (96% in TN and 93.8 in

Orissa) what respondents reported was no use of any contraceptive

methods. The last pregnancy in majority of cases was planned by the

couple in both the states.

The results of the FGD’s also reported that unplanned pregnancies could

have been avoided; communication among the couple were found

minimum on this issue, whose consequences were born by the

respective women.

The FGDs conducted showed that there was a huge gap between the

knowledge and awareness regarding different contraceptive methods and

their actual use or practice among the respondents of both the states

irrespective of their place of residence. Awareness about the contraceptive

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methods was also very low among tribals of Orissa. Only 3 NSV cases were

found out of 2398 respondents in both the states.

National population policy statement emphasis on the importance of

choice, this change in approach has not occurred at the programme level.

Since clients have limited knowledge of reversible methods, female

sterilization remains the dominant method in the programme. This fact can

be supported by the data related to the reasons of not using any

contraceptive method by the respondents.

The data clearly reveals male dominance and inferior status occupied by

majority of women in the family leads to lesser or no inter-spousal

communication in many aspects of reproductive health. Approximately

all decisions related to reproductive health issues were likely to be

influenced by dominant males. At the same time there was adequate

disparity among the different segment of population in relation to

spousal communication within the groups and as compared to other in

both the states.

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RECOMMENDATIONS

Special efforts should be made to emphasize men’s shared

responsibility and promote their active involvement in responsible

parenthood, sexual and reproductive behaviour, including family

planning.

Emphasis should also be given on family counseling, IEC

activities, community mobilization and active /participation of

males in the entire process of RCH programme.

Finally, the appropriate strategy has to be introduced with

systematic approach during routine field visits, public contacts and

home visits of the deputed health personnel to encourage inter-

spousal communication.