e use about twice as often as did their wives in Benin, Burkina Faso, the Central African Republic, and Mali. The condom and periodic abstinence were the main methods reported by men whose wives reported no contraceptive use. In cases where a direct comparison was possible, the likelihood that the man would report use when the woman did not was everywhere greater than the probability that the woman would report use when the man did not. Lack of concurrence was greater among polygamous couples than among monogamous couples, as well as among those couples in which one or both spouses reported extramarital sexual partners.

The authors suggested a number of reasons why husbands and wives might not concur on their method of contraception. Women's secret practice of female contraceptive methods could account for a sizable proportion of women's sole reports, but husbands had many more sole reports. The possibility also exists that respondents give what they consider to be a socially desirable response rather than a valid one. Women, for example, may sometimes be embarrassed to report the use of coitus-dependent methods such as condoms.

On the other hand, husbands might tend to overreport contraceptive use if they want to project a modern image to interviewers, who typically are urban residents and more educated than the respondents. In eight of eighteen countries, among wives reporting they practiced periodic abstinence, fewer than 50 percent could give an accurate answer about the time of ovulation. Validity was high, however, for wives who reported using the pill. In 17 of 21 countries, among women who reported using oral contraceptives, three-fourths or more were able to produce the pill packet.

The authors state that they lean toward putting more credence into what a woman says about birth control than what her husband says. As Becker notes, "Biologically, women have more at stake in terms of the risks of pregnancy and so they are more like
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Contact: Tim Parsons or Ming Tai
paffairs@jhsph.edu
410-955-6878
Johns Hopkins University Bloomberg School of Public Health
16-Jul-2001

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