1. 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.