Abstract
BackgroundInvolving male partners in family planning (FP) education and counseling may improve FP utilization and help meet couples’ reproductive health needs in the postpartum period. We aimed to explore Kenyan men’s and women’s perspectives on an interactive short message service (SMS) approach to support postpartum FP decision-making, and inform intervention content for a randomized controlled trial (RCT).MethodsWe conducted four focus group discussions (FGD) among men (n = 35) and two among pregnant/postpartum women (n = 15) in western Kenya. Female participants were recruited at antenatal clinics; male participants were referred by antenatal attendees. FGDs included participant critique of pilot theory-based SMS messages. FGD transcripts were coded by two investigators and analyzed using an iterative, modified grounded theory approach. These data informed the intervention and RCT design, in which women had the option to refer male partners for trial enrollment.ResultsMen strongly desired inclusion in FP programs, and frequently discussed negative relationship consequences of women’s covert contraceptive use. Female and male participants voiced a variety of concerns about contraceptive side effects and potential harms, which were central to narratives of community influence on personal contraceptive choices. Most participants felt that receiving FP-focused SMS and including men would be beneficial. They perceived that SMS dialogue with a nurse about FP could reduce misperceptions and may stimulate communication within couples, thereby improving contraceptive access and continuation. Shared decision-making around FP within couple relationships, in consultation with clinicians, was highly valued.ConclusionsHealth concerns about FP and limited couple communication are perceived contributors to postpartum unmet contraceptive need. With women’s consent, the inclusion of male partners in FP services, and specifically in an mHealth SMS intervention, is acceptable and desired. Receiving SMS may trigger communication about postpartum FP within couples. SMS content should address contraceptive knowledge gaps, anticipated side effects and FP misperceptions, and allow for real-time method choice assistance.
Highlights
Involving male partners in family planning (FP) education and counseling may improve FP utilization and help meet couples’ reproductive health needs in the postpartum period
The purpose of this study was to understand Kenyan men’s and women’s views on the use of two-way short message service (SMS) with a health provider to support postpartum contraceptive use, which would inform an Mobile health (mHealth) intervention tailored for couples
Men and women perceived that engaging couples in FP counseling via SMS would help overcome barriers to postpartum contraceptive use: by reducing misperceptions about contraceptive harms, providing information about potential side effects, and encouraging communication within couples
Summary
Involving male partners in family planning (FP) education and counseling may improve FP utilization and help meet couples’ reproductive health needs in the postpartum period. Multiple health systems and socio-cultural barriers to postpartum FP use have been described, from concerns about side effects and safety of modern FP methods [7, 8], low risk perception of pregnancy due to lactation and lack of menses [3, 9], concern for partner disapproval [10], and poor postpartum visit attendance with inadequate counseling in the clinical setting [11, 12]. Findings from qualitative work in Kenya show that many men and women desire male inclusion in FP education and decision-making, and that FP-related stigma, men’s concerns about side effects, and shifting gender relations contribute to male resistance [18, 19]. Best practices in harnessing male involvement have not been demonstrated
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
