Association of Husband/Partner's Influence in Health Care Decision Making with Woman's Intent-to-Use Contraception in Mozambique: Results from a 2011 Nationally Representative Sample

Background: The role of a husband/partner making health care decision for a woman as a factor for her future intent-to-use contraceptives has not been studied in Mozambique. This study assessed this relationship using data from 2011 Mozambique Demographic Health Survey (DHS), which included a nationally representative sample of 7,022 women aged 15-49 years.

Methods: The primary outcome of interest was a woman’s future intent-to-use contraceptives. The primary exposure of interest was the person making health care decision for a woman and dichotomized as the husband/partner alone vs.the woman alone or the respondant and husband/partner jointly. Several potential socio-demographic confounders were adjusted for in multivariable logistic regression analysis. Adjusted odds ratio (aOR) and 95% confidence interval (CI) are reported.

Results:  The mean age of the sample was 30.4 (95%CI 30.1-30.7). Overall, a woman who reported her husband/partner usually made the decisions about her health care were 19% less likely to report future intent-to-use contraceptives than women reporting they themselves or jointly made the decision (aOR=0.81, 95%CI 0.71- 0.92). In stratified analyses, this association remained statistically significant among rural women (aOR=0.75, 0.65-0.87); among women who knew about modern contraceptive methods (aOR=0.83, 0.73-0.95); and among women with three or more (aOR=0.81, 0.68-0.97) and two or fewer children (aOR=0.79, 0.65-0.96) living children.

Conclusion/Policy Implications: A husband/partner’s influence in health care decision making was a predictor of Mozambican woman’s future intention-to-use contraceptives. Family planning programs aimed at improving contraceptives uptake among women in Mozambique should consider the role of husband/partner to ensure program success.