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Aims and objectives To examine couple interactions to predict wives' contraceptive use as well as that of their husbands in rural Ethiopia. Background Previous studies stated that men's power and their preferences regarding family planning have a significant role in the adoption of contraception, as well as women's general reproductive health. Spousal communication on reproductive matters helped couples to be aware of each other's perspectives and enhanced the usage of family planning through shared decision-making. Design A cross-sectional descriptive design was used to analyse the Actor and Partner effects within the marital dyad. The study sample included 389 married couples who were recruited from households in seven enumeration areas randomly selected from Hetosa Woreda in Ethiopia. Methods We used a face-to-face interview survey. Data were collected between 22 October and 21 November 2010 and analysed using descriptive statistics, chi-squared test, t-test, Pearson's correlation and the Actor-Partner interdependence model. Results There were significant differences in perceptions about family planning, contraceptive knowledge and contraceptive use between wives and husbands. Wives' perceptions about family planning affected theirs as well as that of their husbands' knowledge and use of contraceptive methods. However, husbands' perceptions about family planning did not affect their knowledge and use of contraceptive methods, but did influence their wives'. Conclusions The application of couple data enhanced our understanding of the complex interactions between wives and husbands, which may lead to novel dyadic-based interventions to improve family planning practice. Relevance to clinical practice Couples must be educated and informed not only about the adoption of contraception, but also about reproductive rights and responsibilities through changes in educational and motivational strategies. [ABSTRACT FROM AUTHOR]