Male Involvement In Family Planning Research Articles

Male involvement in family planning and its association with knowledge and spouse discussion in Ethiopia: a systematic review and meta-analysis

ObjectiveThis study aimed to estimate the pooled prevalence of male involvement in family planning (FP) and its association with knowledge and spouse discussion in Ethiopia.DesignSystematic review and meta-analysis using the...

Sperm Switch: A New Trend in Reducing Maternal Mortality

The study looked at the emerging practice of switching sperm to reduce maternal mortality in Ekiti State. Secondary data from the chosen health facilities in Ekiti State was used in the study. The major beneficiaries of family planning programs have historically been women, and men have been seen as the services' invisible partners. The study's ideas included male involvement in family planning, the effect caused by sperm switching on family planning, its difficulties, ways to use sperm switching to lower maternal death rates, and the responsibilities of midwives and the government in the process. The study's implications for nursing practice are that nurses and midwives undergoing training should be able to apply the sperm switch approach, and nurses should conduct additional research on new trends in family planning, particularly sperm switching, as well as the advantages of male involvement in family planning. The suggestion is that political commitment, priorities, effective governance, and enough financing should be given top priority. In addition, men should receive advice regarding the reversibility of the sperm switch method, and more awareness should be raised regarding the sperm switch strategy's positive effects on health when used with male contraceptives for family planning.

Family planning decision-making among young males in Southern Africa.

Male partners play a crucial role in reproductive health matters and seem to be identified as the main contributors responsible for the large proportion of poor reproductive health suffered by their female partners. Limited evidence exists, however, on effective strategies to increase male involvement in family planning. Therefore, this study aims to examine the prevalence and factors associated with male involvement in family planning decisions. Using recent data from Demographic and Health Surveys of seven countries in Southern Africa (Lesotho, Malawi, Mozambique, South Africa, Tanzania, Zambia and Zimbabwe), age, education, wealth index, religion, occupation, exposure to media, contraceptive knowledge, and sex of household head showed significant associations of male involvement in family planning, and these associations differed by country. By country, the adjusted odds ratio (AOR) showed that education (Malawi (primary) AOR: 1.12; 95% CI: 0.91-1.38; South Africa (secondary/ higher) AOR: 1.44; 95% CI: 0.95-2.19), religion (Lesotho (Muslim) AOR: 2.10; 95% CI: 0.54-8.12; Zambia (Muslim) AOR: 1.01; 95% CI: 0.69-1.49; Zambia (Traditional) AOR: 1.06; 95% CI: 0.77-1.47), marital status (Malawi (widowed) AOR: 1.06; 95% CI: 0.55- 2.05; Lesotho (divorced/separated) AOR: 1.18; 95% CI: 0.84-1.66; Mozambique (divorced/separated) AOR: 1.03; 95% CI: 0.80- 1.33), and sex of household head (South Africa (female) AOR: 1.11; 95% CI: 0.96-1.27) were significant predictors of male involvement in family planning decision-making in Southern African countries. Certain socio-economic factors such as wealth status (Malawi (middle) AOR: 1.04; 95% CI: 0.91-1.19, ρ< 0.05; South Africa (Rich) AOR: 1.06; 95% CI: 0.91-1.23), and occupational status (Mozambique (working) AOR: 1.12; 95% CI: 0.97-1.29) were found to be positively associated with males' participation in family planning decision-making in Malawi, South Africa and Mozambique. Suggested strategies include programmes targeting couples jointly and family planning education for men provided by male outreach workers, especially in communities at the grassroots level. Therefore, to encourage men's involvement and approval of family planning, community - based intervention programmes that openly target men are required to reduce stigma and misconceptions and boost consciousness of the advantages of family planning utilization.

Perception and Attitude towards Involvement of Males in Family Planning Practices in Nigeria

Aim: The study is designed to assess the perception and attitude towards the involvement of males in family planning practices in Nigeria.&#x0D; Methodology: This study design was a descriptive cross-sectional design, whose population were males (15-55 years), and selected via the convenience sampling technique. The research instrument was a semi-structured questionnaire on male involvement in family planning and was subjected to face and content validity (Cronbach Alpha = 0.673). The study data (responses) were analysed using simple frequency, percentages, and means, with the Statistical Packages for Social Sciences (SPSS) V 21.&#x0D; Results: Most of the men (n=267; 96.4%) have good knowledge of family planning, and there is a medium level of men’s involvement (n=141; 50.9%) towards family planning practices. Furthermore, regarding their behaviours towards family planning methods involvement, 208 (75.1%) men disagreed that family planning is meant for only females and that contraceptives are not working for males, while all the men (n=277; 100 %) disagreed that family planning is meant for the literate only. More so, half of the men (n=147; 53.1%) rejected that family planning delay pregnancy, while 208 (75.1%) men accepted that it prevents pregnancies. These results proved that the men do not believe only the literate utilize family planning methods.&#x0D; Conclusion: Most males are knowledgeable about family planning and many adopted condoms as their methods of family planning, which implies that men could be effectively involved in family planning with proper and effective education.

Factors that Influence Reproductive Health Decisions Among Low-Income Males Enrolled in an Anti-poverty Government Initiative in an Urban Community: A Qualitative Study Based on Thematic Analyses of Focus Group Discussions in Pasig, Philippines

Poor family planning greatly impacts both maternal and child health outcomes. While legislation of the 2012 Responsible Parenthood and Reproductive Health Law increased the access and use of contraceptives, there is still an unmet need for family planning in terms of limiting and spacing of births especially in the lower economic quintiles within densely populated urban communities. Meanwhile, while other studies have shown that male involvement in family planning yields beneficial reproductive health outcomes, local reproductive health policies by the government targeting men have remained very minimal. Therefore, this qualitative study explored the factors that influence the reproductive health decisions among low-income males which may augment the local government in creating reproductive health policies that extend to these demographics. Using a modified qualitative knowledge, attitudes and practices framework, low-income 18-45 year-old males enrolled in an anti-poverty government initiative, the Pantawid Pamilyang Pilipino Program (4Ps), in Barangay, Pinagbuhatan Pasig City were included in this study. Four FGDs with 3-5 members recruited through purposive sampling were conducted between June 1-July 31, 2019. Thematic analysis was done using NVIVO software (ver. 11) and five themes emerged as the key factors that influence reproductive health decisions. Men enrolled in the 4Ps in Barangay Pinagbuhatan, Pasig City decide the contraceptives to use while their female partners use these contraceptives. (1) Safety issues and (2) compatibility on a contraceptive, (3) control over sex, (4) possible infidelity in marital dynamics, and (5) hegemonic masculinity are the five factors that influence their choice of family planning methods.

Male engagement in family planning: the role of faith leaders in urban West Africa.

Sustainable Development Goal 3 aims to improve access to modern contraceptives and inform and educate people on family planning (FP). However, contraceptive use among women of reproductive age in West Africa is low at approximately 20%. One related factor is the limited engagement of males in FP decision-making. Addressing this issue requires a multiplicity of approaches, including the engagement of faith leaders. Faith leaders are often trusted by their congregants and could be an avenue to promoting male involvement in FP. In this report, we discuss the role of faith leaders in two West African countries, Nigeria and Ghana. We conducted 11 in-depth interviews with faith leaders in Nigeria and Ghana. Our exploratory findings indicate that faith leaders seem to have adequate knowledge and a positive perspective on male engagement and FP. In addition, the relationship of trust faith leaders maintain with their congregants is valuable in educating or counselling congregants on male engagement and FP.

Qualitative Analysis of Men's Involvement in Family Planning in The Philippines: An Ecological Assessment.

While family planning (FP) programs have the capacity to empower women, support gender equality, and reduce poverty, male involvement is an influential factor for the uptake of FP that has been lacking. In the past decade, there have been more progressive FP policies and growing attention on male involvement in FP in the Philippines, providing an opportunity to develop evidence-based interventions to better integrate men into FP services by approaching care delivery from a family-focused perspective. This paper sought to understand the current role of men in FP services and explore how to strengthen facilitators and overcome barriers to optimize men's involvement in FP in the Philippines. Using the Ecological Model for Health Promotion, this qualitative study used convenience sampling to collect data through in-depth interviews and focus group discussions at all levels of the ecosystem. All data were collected in the Albay area, with the exception of some policy data collected in Manila. Qualitative analysis was guided by content analysis. The final sample included 66 participants across the ecosystem. Two primary themes emerged: (1) Resources and health care systems structure impact on male involvement in FP and (2) Education and training that support male involvement in FP. The findings of our qualitative study suggest that while men in the Philippines and their ecosystems support men's FP involvement, the inconsistent health care systems and protocols are not yet reaching men with information and education they need to help them make informed FP decisions with their female partners.

(480) Whose Responsibility Is It: Examining Internet Trends to Assess Vasectomy Interest Following the Texas Heartbeat Abortion Ban

Abstract Introduction There have been record-high numbers of anti-abortion laws being pushed in the United States, and Texas has been one of the few states not to have such laws struck down. In May 2021, Texas passed the “heartbeat abortion ban” law making abortions after detection of a fetal heartbeat illegal and liable to be sued in court. The bill was enacted on September 1st of the same year. Many have investigated its effect on women, abortion clinic services, and abortion providers, yet very few have examined its impact on men. Objective To examine the impact of Texas’s 6-week “Heartbeat Abortion Ban” on people’s interest in vasectomies through internet searches. Methods Relative search volumes (RSVs) of male family planning terms – “vasectomy”, “vasectomy cost”, “vasectomy near me”, “urologist near me”, and “how to get a vasectomy”-- in Texas and the United States between 2020 and 2021 were pulled from Google Trends Analytics. The scores were populated into Excel and t-tests were run between parallel dates in 2020 and in 2021. The terms “vasectomy” and “vasectomy cost” were coded as showing general interest, and the terms “vasectomy near me”, “urologist near me”, and “how to get a vasectomy” were coded as indicative of planning and a higher degree of motivation to carry out a vasectomy. Results The weekly RSV average score for the term “vasectomy” and “vasectomy cost” significantly increased from 2020 to 2021 in the United States and specifically in Texas (p&amp;lt;0.01). In 2021, the peak weekly relative search interest for “vasectomy” was from Sept 5th to 11th, almost one week after the bill was enacted. Additionally, average relative search term scores for terms indicative of carrying out a vasectomy such as “vasectomy near me”, “urologist near me”, and “how to get a vasectomy” were almost all significantly higher in 2021 than in 2020, except for “urologist near me” in Texas (p = 0.42) and “how to get a vasectomy” in the United States (p=0.13). However, none of the search terms related to carrying out a vasectomy significantly peaked within 2021 nor peaked specifically around the passing or enacting of the Texas “Heartbeat Abortion Ban” in Texas. Conclusions While general search trends about male family planning increased between 2020 and 2021, there was no increase in searches indicative of carrying out vasectomies surrounding the Texas abortion ban in Texas. These results paint a general stagnation and possible decline of people interested in following through with a vasectomy after Texas’s restrictive abortion law was passed and enacted. This could allude to the notion that society views contraception and family planning as a woman’s responsibility. Future studies looking at trends in vasectomy rates in regions with limitations on abortions can also be useful in understanding male involvement in family planning. Similar studies have not been conducted in the past. Disclosure No

Reassessing the level and implications of male involvement in family planning in Indonesia

BackgroundAlthough there is global recognition of the importance of involving men in family planning and reproductive health matters, this issue has received insufficient attention in many countries. The present study sought to characterize married Indonesian males as to their level of involvement in family planning, identify the correlates thereof and assess the implications of male involvement for unmet need for family planning.MethodsA mixed methods research design was used. The main source of quantitative data was 2017 Indonesian Demographic Health Survey (IDHS) data from 8,380 married couples. The underlying “dimensions” of male involvement were identified via factor analysis. The correlates of male involvement were assessed via comparisons across the four dimensions of male involvement identified in the factor analysis. Outcomes were assessed by comparing women’s and couple’s unmet need for family planning for the four underlying dimensions of male involvement. Qualitative data were collected via focus group discussions with four groups of key informants.ResultsIndonesian male involvement as family planning clients remains limited, with only 8% of men using a contraceptive method at the time of the 2017 IDHS. However, factor analyses revealed three other independent “dimensions” of male involvement, two of which (along with male contraceptive use) were associated with significantly lower odds of female unmet need for family planning. Male involvement as clients and passive male approval of family planning, which in Indonesia empowers females take action to avoid unwanted pregnancies, were associated with 23% and 35% reductions in female unmet need, respectively. The analyses suggest that age, education, geographic residence, knowledge of contraceptive methods, and media exposure distinguish men with higher levels of involvement. Socially mandated gender roles concerning family planning and perceived limited programmatic attention to males highlight the quantitative findings.ConclusionsIndonesian males are involved in family planning in several ways, although women continue to bear most of the responsibility for realizing couple reproductive aspirations. Gender transformative programming that addresses broader gender issues and targets priority sub-groups of men as well as health service providers, community and religious leaders would seem to be the way forward.

A Comparative Qualitative Survey of Male Involvement in Family Planning in Urban and Rural Communities of Sokoto State, Nigeria

Background: Nigeria's total fertility rate has remained high despite decades of family planning (FP) programmes. Studies have identified men as barriers to the use of contraceptives by women. The study aimed to explore and compare the knowledge of FP, perception of FP, male involvement (MI) in FP, barriers and facilitators to MI in FP among men in urban and rural communities of Sokoto State.&#x0D; Methods: A comparative qualitative study was done among married men in urban and rural areas of Sokoto State in April 2019. Eight focus group discussions were conducted among 55 married men purposively selected and grouped based on educational status and age. Data were transcribed verbatim and content analysis on emerging themes was done.&#x0D; Results: The participants said that FP is beneficial to the mother, the child and the father. Almost all the participants expressed unwillingness to use or allow their wives to use the permanent methods of FP. Almost all the participants in the urban and rural groups said that men should be involved in FP. Religion and ignorance were the most common barriers mentioned in the urban and rural groups. Increasing awareness of FP, religious leaders and traditional rulers championing the issue of FP and increase commitment by the government were the facilitating factors of MI in FP.&#x0D; Conclusion: The participants said that FP is beneficial and that men should be involved in it. Sokoto State government should increase commitment to FP by carrying out state-wide campaigns and outreaches at regular intervals

Knowledge, Attitude and Male Involvement in Family Planning as Predictors to Contraceptive use in Kalabari Communities in Rivers State, Nigeria

This study focused on Knowledge, Attitude and Male involvement in family planning as predictors to contraceptive use in Kalabari communities of Rivers State. The descriptive cross-sectional survey design was adopted for the study. A 2-staged sampling technique was used to select four hundred and forty participants. Data was collected using a semi-structured questionnaire with a reliability coefficient of 0.70. Analysis was done using simple percentage, mean and standard deviation, and binary logistic regression. The finding of this study showed that overall 48.6% are knowledgeable about contraceptives while more than half (51.1%) were not knowledgeable; majority (92.7%) had positive attitude towards contraceptive use while 7.3% had negative attitude towards contraceptive use; and 2.2% were highly involved in family planning while 97.8% had low involvement. The finding of this study on contraceptive utilization showed that 68.6% have ever used contraceptive while 61.2% currently use contraceptives and methods currently used include daily pills (35.2%), condom (22.5%), withdrawal (16.5%), postinor (13.1%), diaphragm (4.7%), implants (4.5%) and injectable (3.2%). The tested hypotheses showed a significant relationship between knowledge of family planning and the use of contraceptives and respondents who had knowledge were 2.63 times less likely to use contraceptive compared to those who were not knowledgeable (OR=0.38, 95%CI: 0.24-0.61). A significant relationship was also found between male involvement in family planning and the use of contraceptives and those who were involved in family planning were 1.98 times less likely to use contraceptive compared to those who were not involved (OR=0.505, 95%CI: 0.000). However, attitude towards family planning was not found to be significantly related to contraceptive use ( = 3.11, df = 1, p-value = 0.076). It was concluded that knowledge of contraceptives was not universal, male involvement in family planning is very low and the attitude individuals have in most cases does not translate to practice. There is therefore the need for public health practitioners and other Non-governmental Organizations to sustain efforts to raise awareness and motivation for proper contraceptive use.

Modern contraceptive utilisation and its associated factors among reproductive age women in high fertility regions of Ethiopia: a multilevel analysis of Ethiopia Demographic and Health Survey

ObjectiveThis study is aimed to assess the magnitude of modern contraceptives utilisation and associated factors among reproductive age women in high fertility regions of Ethiopia.DesignCross-sectional study.SettingHigh fertility regions of Ethiopian.ParticipantsA...

Determinants of Male Involvement in Family Planning Decision making in a Rural Community in Northern Nigeria

Background: Male involvement in family planning (FP) is most often associated with better health outcomes for the family. This study assessed male involvement in FP at Fadan Kamantan, a rural community in Zango Kataf Local Government Area of Kaduna State, North Western Nigeria.&#x0D; Methods: This was a community-based descriptive cross-sectional study conducted among 166 married men selected using multi-staged sampling technique. A set of structured, interviewer-administered questionnaires were used to obtain information from the respondents. Data was analyzed with IBM SPSS version 23.0 and STATA/SE 12. The level of statistical significance was set at p&lt;0.05.&#x0D; Results: The mean age of respondents was 38 ±10.7 years. Current use of FP method by the respondents’ spouses was 80 (51%). One hundred and twenty-two (77.7%) of the men gave consent for their wives to attend the FP clinics, 60 (38.2%) ever followed wives to the FP clinics, 122 (77.7%) ever initiated FP discussion with their spouses, 14 (8.9%) initiated FP discussions all the time, husbands predominantly took FP decisions 89 (56.7%). Only 97 (58.4%) had good overall scores for male involvement in FP decision making. The odds for good male involvement in FP was 27 times higher for those who had tertiary education (AOR=27.00, 95%CI=2.95-247.44) compared to those with no formal education.&#x0D; Conclusion: The study showed that male involvement in FP was determined by educational status. The Local Government Authority should engage in health education on FP services targeted at men with lower educational status in this community.

Knowledge, Attitude and Level of Involvement of Married Males in Family Planning

Background There is an age-old notion that family planning is women’s responsibility disregarding the fact that men have equal responsibility in fertility regulation. Although male involvement is getting more recognition, studies on men’s role in family planning are very few in the number in this part of the world.&#x0D; Objective To assess the knowledge, attitude and level of male involvement in family planning and to find out the factors associated with male involvement by contraceptive usage.&#x0D; Method A community based cross-sectional study was done from May to July 2021 among 165 currently married male, who had at least one child, living in Singur district of West Bengal. Cluster sampling method was done to select study participants and data were collected by pre-designed pretested questionnaire. Descriptive statistics, multivariable logistic regression was applied and data were analysed applying SPSS software.&#x0D; Result Only 36.4% participants were directly involved in family planning either by using condom or by withdrawal method but 65.5% participants were indirectly involved in family planning through spousal communication either by approving contraceptive use to their spouse or by decision making regarding family planning. Moreover, barrier of contraceptives usage were side effect (27%) and fear of impotence (25.5%). Male involvement was significantly associated with participant’s education [AOR (95% CI= 3.63 (1.45-9.05)], caste [AOR (95% CI= 7.06 (2.55-19.51)], number of living children [AOR (95%CI= 5.01(1.95-12.87)], desire for more child [AOR (95% CI=0.34 (.13-.87)] and attitude on family planning [AOR (95% CI= 3.55 (1.41-8.94)].&#x0D; Conclusion This study identified the prevailing gender norms in rural areas. Advocacy for male involvement in family planning by health personnel during counselling of eligible couples should help in increasing contraceptive coverage in the long run.

Male involvement in family planning use and associated factors among currently married men in rural Eastern Ethiopia.

Introduction/Objectives:Male involvement in family planning refers to all organizational actions focused on men as a distinct group to increase the acceptability and uptake of family planning among either sex. Despite the growing evidence of male involvement in increasing family planning uptake among couples, a little success has been achieved in Ethiopia, especially in rural areas. Hence, this study aimed to assess male involvement in family planning and its associated factors among currently married men in selected rural areas of Eastern Ethiopia.Methods:A community-based cross-sectional survey was conducted among 577 randomly selected currently married men, using a simple random sampling method in randomly selected rural districts of Eastern Ethiopia. Data were collected using a pretested interviewer-administered questionnaire. The collected data were entered into a computer using Epi-Data Version 3.1. The analysis was performed using the Statistical Package for the social sciences software version 21. Logistic regression analysis was used to analyze the association between the dependent and independent variables. Finally, adjusted odds ratio with 95% confidence intervals at P-value < 0.05 was considered to be significantly associated with the outcome variable.Results:Out of 577, a total of, 555 married men were included in the study, resulting in a response rate of 96.2%. The magnitude of male involvement in family planning use was 59.3% (95% confidence interval: 47.1, 68. 2). Ever use of family planning by a spouse (adjusted odds ratio: 2.37; 95% confidence interval: 1.59, 3.52), ever discussion of spouse on sexual and reproductive health/family planning issues (adjusted odds ratio: 2.05; 95% confidence interval: 1.40, 3.02), and the husband’s approval of family planning (adjusted odds ratio: 2.45; 95% confidence interval: 1.34, 4.96) were significantly associated with higher odds of male involvement in family planning use than their counterparts.Conclusion:The number of men involved in the family planning was low. Ever use of family planning methods by a spouse, ever discussion of spouse on sexual and reproductive health/family planning issues, and husband approval on family planning use were found to be important predictors of male involvement in family planning use. To improve modern family planning uptake among men and women, it is imperative to include men in family planning programs, such as family planning messaging, sensitizations, and services.

Prevalence and determinants of the involvement of married men in family planning services in Ethiopia: A systematic review and meta-analysis.

Background:Male involvement in family planning includes not only using contraceptives but also encouraging and supporting their partners’ contraception needs and choices, encouraging peers to use family planning, and influencing policy to make male-related programs more conducive. In Ethiopia, the prevalence and associated factors of male involvement in family planning were highly inconsistent across studies. As a result, the goal of this study was to use a systematic review and meta-analysis to estimate the pooled prevalence of male involvement in family planning and its associated factors in Ethiopia.Methods:Electronic literature search using PubMed, Google Scholar, EMBASE, HINAR, Scopus, and Web of Sciences were performed without time restriction to identify the primary studies. Data were extracted using a pretested standardized data extraction format and analyzed using STATA 14 statistical software. A random-effect model was used to estimate the pooled prevalence of male involvement.Results:A total of 17 studies were included to give the pooled prevalence of male involvement in family planning in Ethiopia, which was 39.66% (95% confidence interval = 29.86, 49.45). Educational status (adjusted odds ratio = 1.99, 95% confidence interval = 1.26, 3.14), discussion of family planning with wife (adjusted odds ratio = 4.15, 95% confidence interval = 2.21, 7.80), knowledge (adjusted odds ratio = 1.83, 95% confidence interval = 1.26, 2.64), positive attitude about family planning (adjusted odds ratio = 2.57, 95% confidence interval = 1.70, 3.90), and approval of contraceptive use (adjusted odds ratio = 2.57, 95% confidence interval = 1.70, 3.90) were found to be significantly associated with involvement of men in family planning service.Conclusion:The overall prevalence of male involvement in family planning in Ethiopia was significantly low. Male involvement in family planning should be made available, accessible, and advocated for by government and non-governmental organizations, service providers, program planners, and stakeholders. In addition, to increase the role of men in the use of family planning services, a conducive environment for education, behavioral change, and open discussion about reproductive health issues is required.

Male involvement in family planning in a rural area of India.

ABSTRACTIntroduction:Family planning is one of the essential health care services to promote and ensure reproductive health. Nearly 40.2 percent of men think it as a woman’s responsibility as per the National Family Health Survey 4. Not much attention has been given to the male partners in the usage of contraceptives. So, this study was conducted to assess the male participation in family planning among married males in a rural area of Chhattisgarh.Methodology:A sample of 365 married males were interviewed through a semi-structured questionnaire at a primary health care center.Results:Only 48 (13.1%) participants were using condoms or male sterilization as a method of contraception at the time of the study. Good involvement of males in family planning was found to be (10.9%) in our study. Those who were above the poverty line and educated (graduation and above) had good involvement in family planning. The chief reason cited for not opting for male sterilization by participants was fear of physical weakness followed by family opposition.Conclusion:The socio-cultural barrier in itself demotivates men from getting involved in the family planning program. This study recommends increasing health literacy regarding family planning among men by including it in the school curriculum and through awareness activities and counseling that influences them positively and motivates them to accept contraceptive services and shared decision making. Sterilization facilities should be made accessible to them to further encourage them.

Missing men in family planning: understanding the socio-spatial differentials in male sterilization and male spacing methods of contraception in India.

Male involvement in family planning results in improved reproductive health and gender outcomes for women. In India, the use of family planning methods remains largely female-dominated. Recent media reports have indicated a rapid decline in male sterilization use in the past few years. This study aimed to assess the trends in, patterns of and factors associated with the use of male sterilization and male spacing methods in India using data from four rounds of the National Family Health Survey, conducted from 1992 to 2016. Bivariate analysis was done to see the trends in, and patterns of, male sterilization and spacing methods, while multinomial logistic regression was used to understand the factors associated with male spacing methods and sterilization. The results show a marked decline in the prevalence of male sterilization from 1992-93 (3.5%) to 2015-16 (0.3%) in India. Of the 640 districts, only 21 had a more than 2% prevalence of male sterilization. Scheduled tribe couples were two times more likely to use male sterilization than other (upper/no caste) groups. Couples from the northern region were significantly more likely to use male sterilization (aOR: 1.68, 95% CI: 1.43-1.97) compared with those from the south. There was a regional disparity in male condom use, with a very small proportion of couples in the southern (1.1%), north-eastern (2.4%) and eastern (3.3%) regions using the method compared with couples from the northern region (9.7%). Couples from the northern (aOR: 8.89, 95% CI: 8.44-9.38), north-eastern (aOR: 11.37, 95% CI: 10.62-12.18), eastern (aOR: 6.96, 95% CI: 6.60-7.34), western (aOR: 4.65, 95% CI: 4.40-4.92) and central (aOR: 10.89, 95% CI: 10.35-11.46) regions were also significantly more likely to use male spacing methods than those from southern India. Therefore, a greater focus on increasing the use of male sterilization and condoms is required in India to reduce the gender disparity in the use of family planning methods.

Male Involvement in Family Planning: A Qualitative Survey of the Barriers and Facilitators amongst Married Men in Sokoto metropolis

Background: Although large families are desired in Nigeria, women tend to want fewer children than men but are often unable to limit or space childbirth due to gender dynamics within relationships. Studies have identified men as a significant barrier to the use of contraceptives by their wives. The study explored married men’s knowledge and perception on family planning (FP), involvement in FP, barriers and facilitators of male involvement (MI) in FP in Sokoto Metropolis.Methods: A qualitative study was done among married men in Sokoto Metropolis in November 2017. Four focus group discussions were conducted among thirty-two men grouped based on educational status and age. Data was transcribed verbatim and a content analysis on emerging themes was done.Results: All the participants were aware of FP and most of them said that it is beneficial to everyone in the community. Most of the participants perceived that FP is an issue for both men and women. All the participants said that men should be involved in FP. The barriers to MI in FP mentioned were lack of knowledge on FP and poverty while increasing awareness on FP, religious leaders and traditional rulers championing FP, and making FP free were the facilitators suggested.Conclusion: The participants said that FP is beneficial to everyone in the community and men should be involved in FP. Traditional and religious leaders should be made the champions of FP in their various communities to improve acceptance and utilisation.

Use of community-based interventions to promote family planning use among pastoralist women in Ethiopia: cluster randomized controlled trial

BackgroundAfar region is one of the pastoralist dominated regions in Ethiopia. The region is characterized by a low contraceptive prevalence rate (CPR) of 5.4%. Lack of awareness of contraceptive use, husband objection and religious barriers are attributed to low CPR in the region. This study assessed the effect of community-based interventions for promoting family planning (FP) use among pastoralist communities in Ethiopia.MethodsThe study design was a three-arm, parallel, clustered randomized controlled trial (CRT). The three study arms were: (1) male involvement in family planning (FP) education; (2) women’s education on FP; and (3) control. A total of 33 clusters were randomized and allocated with a one-to-one ratio. Intervention components included (1) health education on FP to married women and men by faema leaders (a traditional community-based structure that serves as a social support group); (2) video-assisted message on FP; and (3) assisting the faema leader using health workers and health extension workers (HEWs). The intervention was given for a total of nine months. FP use and intentions were measured as outcome variables. In addition, a cluster-level summary considering a cluster effect analysis was performed. The result was presented with t.test, adjusted risks and its 95% confidence interval (CI).ResultsThe proportion of FP use among the arms was 34% in the male involvement in FP education, 17.5% in women’s education on FP and 4.3% in the control. There was a positive change in the proportion of FP use in the male involvement in FP education and women’s education on FP arms with absolute risk (AR) of 0.29 (95% CI, 0.23,0.34) and 0.13 (95% CI,0.08,0.17), respectively, as compared to the control arm. Similarly, married women in the male involvement in FP education and women’s education on FP arms had 3.4 (2.48, 4.91) and 2.1 (1.50, 2.95) higher intention to use FP, respectively, as compared with the control arm.ConclusionThe present study suggests that in such male-dominated pastoralist communities with more considerable religious barriers, the community-based health education mainly targeting males appears to be a promising strategy for improving FP use and intention to use FP.Trial registrationClinicalTrials.gov, NCT03450564, March, 2018.