Dynamic interplay of female and male attitudes and their mutual influence on fertility and contraceptive use decision-making: Evidence from Malawi and Nigeria

Objectives. To understand the mutual influence men and women have on fertility and contraceptive use decision-making. With the shifting paradigms in reproductive health, understanding male influence on female reproductive behavior is a high priority. Malawian and Nigerian women continue to have more children than they desire. Unmet need for contraceptives remains high (26% in Malawi, 20% in Nigeria), although, the two countries reflect very different contraceptive use patterns.
Methods. Data was collected using qualitative methods. A total of 47 focus group discussions and 32 in-depth interviews, were conducted across the countries. Thematic analysis was utilized to identify patterns.
Results. Women and men influence each other’s fertility preferences and contraceptive decision-making in complex ways. While men might feel dominant in marital relationships, they too feel constrained in their normative environment. Women are far from silent bystanders; they strategize to accomplish their fertility goals.
Conclusion. Women and men influence each other’s fertility and contraceptive behaviors in complex ways. Contextual realities have an important influence in determining patterns of dependence and influence between spouses. Knowledge of relationship dynamics and context can be useful to achieve couple fertility desires.