Background: Few studies have used couple data to identify individual- and relationship-level characteristics that affect contraceptive use in urban areas. Using matched couple data from urban Kenya collected in 2010, this study determines the association between relationship-level characteristics (desire for another child, communication about desired number of children and FP use) and contraceptive use and intention to use among non-users.

Methods: Data were collected from three Kenyan cities: Nairobi, Mombasa and Kisumu. Baseline population-based survey data from the Measurement, Learning & Evaluation Project were used to identify 883couples (weighted value=840). Multivariate regressions used the couple as the unit of analysis.

Results: Almost two-thirds of couples currently used contraception. Adjusting for individual- and environmental-level characteristics, couples who desired another child were less likely to use contraception than couples wanting more children. In addition, couples where both partners reported communicating with each other regarding desired number of children and FP use were more likely to use contraception compared to couples that did not communicate. Analyses testing the association of relationship-level characteristics and intention to use contraception, among non-users, resembled those of current contraceptive users.

Conclusion: Couple-level characteristics are associated with current contraceptive use and future intent to use. Couples that discussed their desired number of children and FP use were more likely to use contraception than couples that did not communicate with each other. FP programs should identify strategies to improve communication in FP among couples and to ensure better cooperation between partners.