Abstract
BackgroundFamily planning (FP) researchers and policy makers have often overlooked the importance of involving men in couples’ fertility choices and contraception, despite the fact that male involvement is a vital factor in sexual and reproductive health programming. This study aimed to assess whether men’s exposure to FP demand-generation activities is associated with their reported use of modern contraceptive methods.MethodsWe used evaluation data from the Measurement, Learning & Evaluation project for the Urban Reproductive Health Initiative (URHI) in select cities of three African countries (Kenya, Nigeria, and Senegal) collected in 2012/2013. A two-stage cluster sampling design was used to select a representative sample of men in the study sites. The sample for this study includes men aged 15–59 years who had no missing data on any of the key variables: 696 men in Kenya, 2311 in Nigeria, and 1613 in Senegal. We conducted descriptive analyses and multivariate logistic regression analyses to assess the associations of interest. All analyses were weighted to account for the study design and non-response rates using Stata version 13.ResultsThe proportion of men who reported use of modern contraceptive methods was 58 % in Kenya, 43 % in Nigeria, and 27 % in Senegal. About 80 % were exposed to at least one URHI demand-generation activity in each country. Certain URHI demand-generation activities were significantly associated with men’s reported use of modern contraception. In Kenya, those who participated in URHI-led community events had four times higher odds of reporting use of modern methods (aOR: 3.70; p < 0.05) while in Senegal, exposure to URHI-television programs (aOR: 1.40; p < 0.05) and having heard a religious leader speak favorably about FP (aOR: 1.72; p < 0.05) were associated with modern contraceptive method use. No such associations were observed in Nigeria.ConclusionStudy findings are important for informing future FP program activities that seek to engage men. Program activities should be tailored by geographic context as results from this study indicate city and country-level variations. These types of gender-comprehensive and context-specific programs are likely to be the most successful at reducing unmet need for FP.Electronic supplementary materialThe online version of this article (doi:10.1186/s12978-015-0056-1) contains supplementary material, which is available to authorized users.
Highlights
Planning (FP) researchers and policy makers have often overlooked the importance of involving men in couples’ fertility choices and contraception, despite the fact that male involvement is a vital factor in sexual and reproductive health programming
While we demonstrate some associations between program exposure and modern contraceptive method use, the main message is that Family planning (FP) programs likely need to not “include” men but target the program activities and messages to men
To conclude, FP programs need to consider the role of men in influencing contraceptive behaviors of women and couples
Summary
Planning (FP) researchers and policy makers have often overlooked the importance of involving men in couples’ fertility choices and contraception, despite the fact that male involvement is a vital factor in sexual and reproductive health programming. According to the most recent Demographic and Health Surveys (DHS) in Kenya (2014), Nigeria (2013), and Senegal (2010/11), the proportions of women in union (i.e. married or cohabiting with a male partner) using a modern contraceptive method are 53, 10, and 12 % respectively [7,8,9]. These low levels of modern contraceptive prevalence are discouraging, especially in light of the region’s high fertility and high maternal and infant mortality rates. These low proportions of unmet need for FP indicate that high fertility desires continue to persist in these countries
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