Development (ICPD) shifted global thinking on reproductive health from a population-based approach to a rights-based approach. With this shift came a heightened awareness of how gender relations and equality can influence sexual and reproductive rights. The ICPD program of action declared that "human sexuality and gender relations are closely interrelated and together affect the ability of men and women to achieve and maintain sexual health and manage their reproductive lives." 1(p. 48) Promoting and achieving respectful and equitable gender relations through harmonious partnerships were key elements in several of the program's objectives. To fulfill the ICPD commitments, a better understanding of how partners relate to one another, how to assess relationship quality, and how partners' relations promote or inhibit sexual and reproductive desires and decisions is needed. These topics have received little research attention in Sub-Saharan Africa. In response to this gap in research, we designed this study to improve our understanding of how various dimensions of relationship quality of married or cohabiting partners in Kumasi, Ghana, are related to contraceptive use. We focus on five dimensions of relationship qualitycommitment, trust, constructive communication, destructive communication and satisfaction. Relationship Quality and Contraceptive UseAccording to the Guttmacher Institute and the United Nations Population Fund, 222 million women in developing countries had an unmet need for family planning in 2012; these women wanted to space or limit childbearing but were not using a modern contraceptive method.2 While rates of contraceptive use are increasing in some regions, West Africa has mainly experienced stagnant and in some cases decreased use of contraceptives. Extensive research has been conducted to identify characteristics associated with women's contraceptive use and nonuse throughout the world, including Sub-Saharan Africa. Over the last two decades, research has increasingly focused on how contraceptive use may be related to couple characteristics and relationship dynamics. 3-9Nearly all sexual and reproductive decisions made within intimate relationships affect both partners, even when only one partner is making the decision. Women's lack of power and autonomy in intimate relationships has been recognized as a reality for many women in Sub-Saharan Africa, and the detrimental effects on their health and livelihood have been assessed. 6,10,11