Couples Counseling in Reproductive Health: A Review of the Literature

A systematic review of peer-reviewed publications and grey literature from 1990 to 2016 identified 41 couples counseling interventions that met specific criteria. These interventions were conducted in high, middle, and low-income countries and addressed a range of reproductive health topics, including HIV, family planning, maternal and child health, and post-abortion care. The majority of interventions were conducted in health facilities, while others involved community outreach activities, home-based counseling, or workplace engagement. The included interventions highlighted the diversity of couples counseling approaches, varying from couples-based (couples counseled together) to couples-focused (partners counseled separately) approaches. Improved family planning outcomes as a result of couples counseling include increased adoption and continuation of contraception, including post-partum, as well as increased birth spacing. Reduced pregnancy incidence was also reported by one of the papers. Additionally, couples counseling was found to improve couple communication and partner support for family planning, increase knowledge about fertility and family planning, and increase male outreach and participation in counseling services. The literature review results highlight three programmatic implications. Firstly, a diversity of couples counseling definitions and approaches exists, and operationalizing a common definition and framework is needed. Secondly, effective couples counseling approaches vary greatly in the intensity and depth in which they address gender and power dynamics, couple communication, and intimacy. Identifying most effective elements for addressing gender should be a next step. Thirdly, few studies describe outreach strategies to increase access to couples counseling services, particularly in low-resource settings. The review also found that couples counseling interventions were more effective when they addressed multiple reproductive health topics, such as HIV and family planning. Furthermore, interventions that involved community outreach and home-based counseling were more effective than those conducted solely in health facilities. The review highlights the need for further research on the effectiveness of couples counseling interventions, particularly in low-resource settings. In terms of implementation, the review suggests that couples counseling interventions should be tailored to the specific needs and contexts of the target population. This may involve adapting the intervention to address local cultural and social norms, as well as incorporating community-based outreach and education. Additionally, the review highlights the need for further research on the role of male involvement in reproductive health, particularly in the context of couples counseling. Overall, the review provides valuable insights into the effectiveness of couples counseling interventions in improving reproductive health outcomes. The findings highlight the need for further research and development of effective couples counseling approaches, particularly in low-resource settings.