Whose ‘unmet need’?—Issues of dis/agreement
Reproductive decision-making is a complex process, differing from one couple to the next, as the ensuing analysis illustrates. Generally, even though the large scale surveys that have interviewed both husbands and wives can be used to assess differences in preferences for children and attitudes to family planning, the underlying processes, and often the real preferences, are lost. In this section I focus on husbands’ and wives’ responses to a question on the ‘wantedness’ of their last child to show the discrepancies that can emerge between a survey and an interview. This is not to suggest that surveys are unreliable, but to indicate that a question as sensitive as one dealing with feelings about past childbearing (i. e. a living and breathing person and not an abstract idea) is often so political, and so tied up with personal and gendered identities that a survey item (alone) may not be the best way of capturing the phenomenon.
The data from my survey allow us to identify 8 childbearing preferences[97] related to the last child. These can further be divided into two categories—couples who were in agreement, and those who were in disagreement about wanting the child:
Agreement:
Both partners wanted the child then (Both then)
Both did not want then (Both wait)
Both want no more (Both stop)
Disagreement:
Wife wanted then/Husband not then (Wife then-husband wait)
Wife no more /Husband not then (Wife stop-husband wait)
Wife wanted then/Husband no more (Wife then-husband stop)
Wife not then/Husband wanted then (Wife wait-husband then)
Wife no more /Husband wanted then (Wife stop-husband then)
Among the 107 eligible survey respondents (i. e. excluding three couples where one or both partners have not had a child) almost 78 per cent indicate they were in agreement about wanting or not wanting the last child at the time s/he was born, with most (66.4 per cent) agreeing that they both wanted the child and 10.3 per cent revealing the existence of a joint ‘unmet need’ (Table 1). The bottom half of the table describes the couples in which one partner had an ‘unmet need’. In over 20 per cent of cases one partner had an ‘unmet need’ for spacing or limiting (combined ‘unmet need’ for spacing and stopping for husbands is 8.3 per cent while it is 13.9 per cent for wives).
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Arnfred Page 125 Wednesday, March 3, 2004 2:38 PM
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Whose ‘Unmet Need’ Dis/Agreement about Childbearing among Ghanaian Couples
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Table 1. Wantedness of last child among couples (couples N=107*)
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Couple (joint desire)
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%
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No.
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1. Both wanted then
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66.4
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(71)
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2. Both did not want then (wait)
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0.9
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(1)
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3. Both want no more (stop)
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10.3
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(11)
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4. Wife then—husban wait
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1.8
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(2)
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5. Wife stop—husban wait
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1.8
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(2)
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6. Wife then—husband stop
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4.7
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(5)
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7. Wife wait—husband then
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1.8
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(2)
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8. Wife stop—husband then
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10.3
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(11)
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Wife no reply—husband then
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1.8
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(2)
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* While there were 110 couples in the overall sample, three couples where one or both partners have never had a child are excluded from the analysis.
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A comparison of the responses to both survey and interview questions among the re-interviewed couples allow us to tease out some of the nuances involved in ‘unmet need’. Among the 11 couples I interviewed interesting discrepancies emerge between the survey and interview responses. What is even more interesting is the analysis of which couples fall into the respective categories. When we remove one couple where the wife had a child prior to the marriage and the couple have no children together (yet), out of the remaining ten couples only four maintained the joint positions they had offered in the survey when they were interviewed. In two cases husbands and wives reversed their positions from ‘wife then and husband wait’ and ‘wife wait and husband then’. In one case where both indicated ‘stop’ in the survey this changed to ‘both then’ in the interview. And in three cases it would appear that during the survey one partner gave a response that matched what he or she believed the other’s position to be; this was borne out in the interviews. In the first of these three both indicated ‘stop’ in the survey, but the wife said ‘then’ in the interview while her husband maintained ‘stop’; in the second both said ‘then’ in the survey but in the interviews the wife said ‘stop’ while her husband said ‘then’. In both these cases it would appear that the wife did not reveal her ‘real’ preference until the interview. In the third case both also said ‘then’ during the survey but during the interview while the wife still said ‘then’ her husband said ‘stop’.
How can we explain these discrepancies? Firstly we should note that these are stated preferences. Individuals may be presenting what they believe to be the socially acceptable responses on the survey. More importantly, some respondents may be reflecting the extent to which individuals who ‘lost’ out in a disagreement present the preferences of their spouses who ‘won’ in a survey where no attempt is made to explore processes. In such cases levels of disagreement about reproductive decision-making are understated and decision-making dynamics are masked. For other couples it is possible that a stated preference may be accurate at the time of the survey but may be revised later; some of the wives’ and hus-
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Arnfred Page 126 Wednesday, March 3, 2004 2:38 PM
