Spousal Communication, Child Marriage, and Modern Contraceptive Use Among Married Women in Mali

Spousal communication is associated with modern contraceptive use, but minimal attention has been paid to understanding how spousal communication quality shapes individuals’ ability to negotiate sexual and reproductive health needs. This study conducted a secondary analysis of survey responses from 859 married women of reproductive age in Mali who participated in the Born on Time Study. Bivariate and multiple logistic regression models assessed associations between spousal communication about family planning (FP), its quality, and modern contraceptive use, stratified by child marriage. Among married women participating in the Born on Time Study, 26.7% reported using modern contraception. Among those using a modern method, 63.8% reported high communication about FP, and over three-quarters reported a high agreement with feeling their opinion was shared and valued when talking with spouses. Those who communicated about FP and felt their opinions were valued had increased odds of currently using a modern method compared to their counterparts. This trend was similar for those married before or after age 18. Encouragement of spousal communication is important for interventions aiming to increase access to and utilization of modern contraception. More research is needed to elucidate the importance of spousal communication quality in relation to FP.