Consensus, power and trust in the use of family planning and condoms by couples in Eastern and Southern Africa

Thomas W. Pullum, University of Texas at Austin
John G. Cleland, London School of Hygiene and Tropical Medicine
Iqbal H. Shah, World Health Organization (WHO)

This paper uses data on family planning and condom use by married or cohabiting couples in Kenya, South Africa, Tanzania, Uganda, Zambia and (to a lesser extent) Zimbabwe collected by the World Health Organization (WHO) in 1999-2000 as part of a major research initiative. We find that the use of family planning has strong and approximately equal influences from the man’s and the woman’s desire to limit fertility. It also depends crucially on the woman’s (but not the man’s) favourable attitude toward family planning. Condom use has a crucial dependence on the woman’s (but not the man’s) subjective sense of HIV risk. It is strongly and approximately equally influenced by the man’s and the woman’s attitudes toward condoms. The results suggest a more important role for women in family planning and condom use than is implied by much of the literature and by focus group discussions within the same project.