title: Agreement and concordance regarding reproductive intentions and contraception between husbands and wives in rural ballabgarh, India.
abstract: BACKGROUND
  Traditionally, women have been the chief respondents in most demographic and health surveys focusing on family planning; the role of men has been limited. However, in recent years there has been realization of the importance of men's role in family planning.
  
  
  OBJECTIVE
  To assess the levels of agreement and concordance between husbands and wives regarding reproductive intentions and contraception.
  
  
  METHODS
  A cross-sectional survey was carried out in 200 randomly selected married couples (in the age range of 15-44 years) in village Dayalpur, Haryana. Data pertaining to reproductive intentions and contraception was collected and the level of agreement (kappa statistics) between husbands and wives was calculated.
  
  
  RESULTS
  The observed concordance was 67.5% for ideal family size, 84.5% for contraceptive attitude, 88.5% for fertility desire, 93.5% for unmet need, and 97% for report of number of currently living children. The adjusted kappa statistic varied from a low of 0.43 (P </= 0.001) (ideal family size) to a high of 0.96 (P </= 0.001) (number of living children) with contraceptive attitude (0.7) (P </= 0.001), unmet need (0.88) (P </= 0.001), and current use of contraception (0.93) (P </= 0.001) having kappa values in between. Overall, a greater degree of agreement was observed for reproductive health events as compared to family planning attitudes and intentions. An in-depth analysis of the responses in the current study provides further evidence of male domination in decision making.
  
  
  CONCLUSIONS
  In surveys pertaining to reproductive health events, the wife's response can be taken as proxy for the couple's response, but for assessing family planning attitudes and intentions, there is a need to collect information from husbands and wives separately.
authors.affiliation: Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Kapil
authors.initials: K
authors.lastname: Yadav
authors.forename: Bir
authors.initials: B
authors.lastname: Singh
authors.forename: Kiran
authors.initials: K
authors.lastname: Goswami