Background : Family planning services have been free of charge and available in all the health facilities in the Gambia since 1975 yet contraceptive prevalence is only 17.5% and even 6% in some areas. Since the last census in 2003, there existed no available data on married couples’ contraception status. Objectives :To explore married couples’ family planning knowledge, attitudes, and practices in rural and urban Gambia and to analyze what factors may affect such knowledge, attitudes and practices. Methods : Quantitative cross-sectional study design was used. Through convenience sampling, 176 men and 235 women representing a total of 176 couples participated. A structured questionnaire was used for data collection. Results : The mean scores of the married couples family planning knowledge, attitudes, and practices were 19.00±6.11(ranging from 0 to 64), 6.90±3.08 (0 to 14) and 4.69±3.3 (0 to 19) respectively. Urban residents had higher scores on family planning practice than rural residents (p<.05). Attitude is the strongest predictor of practice (accounted for 34.6% of variance). Conclusions : These findings offer a descriptive answer to “what are married couples’ family planning knowledge, attitude and practice in Gambia”, as well as suggesting broader health intervention programs in health education and promotion.

Key Words : Family planning, knowledge, attitude, practice, married couples, The Gambia