Men In Family Planning Programs Research Articles

Men’s involvement in family planning programs: an exploratory study from Karachi, Pakistan

BackgroundIn Pakistan, family planning has traditionally been perceived as primarily a women’s concern, resulting in the exclusion of men from relevant initiatives. This situation is further exacerbated by cultural and social barriers that hinder men’s access to family planning services. This study addresses a significant research gap by assessing the extent of family planning service provision for men in urban areas of Karachi. It delves into the exploration of men’s involvement in family planning service delivery, identifies existing gaps in services catering to men, records men’s perceptions of accessibility and acceptability of these services, and ultimately offers recommendations to enhance men’s involvement and strengthen service provision to better meet their needs.MethodsWe employed a qualitative exploratory research design using semi-structured interviews to investigate perceptions regarding family planning service provision to men. This approach involved 25 interviews, comprising eight key informant interviews with stakeholders, eight with service providers, and nine in-depth interviews with married men.ResultsThis study highlights the limited engagement of men in family planning programs, primarily due to entrenched sociocultural norms that confine female healthcare providers to serving women, hindering men’s involvement. While national and provincial policies endorse men’s participation, they lack defined roles for male providers. Behavioral and information-sharing barriers at the community level discourage male healthcare providers from collaborating with females. Family planning programs, except for NGO-led vasectomy projects, fail to adequately address men’s needs. Despite policy recognition, implementation remains inadequate. Bridging the men’s involvement gap necessitates more male providers and improved contraceptive stigma combat training. Further research is vital to explore effective methods for involving men in community and service delivery in family planning.ConclusionThere is a need to change the perception that contraception is solely the responsibility of women, as men’s participation in family planning in Karachi is limited. Engaging men can yield positive health and non-health outcomes. Culturally sensitive services, developed with community input using a couple-centered approach, are crucial for equitable family planning. Further research is needed to explore men’s inclusion strategies in service provision and utilization.

FAMILY PLANNING COUNSELING BY VASECTOMY MOTIVATORS (CASE STUDY OF VASECTOMY COUNSELING COMMUNICATION BY MOTIVATORS IN SIATAS BARITA SUBDISTRICT, NORTH TAPANULI REGENCY)

This study aims to analyze counseling communication, obstacles faced, and efforts made by vasectomy motivators to prospective acceptors in Siatas Barita District, North Tapanuli Regency, Indonesia. The researcher used several data collection techniques to conduct this study, namely in-depth interviews and observations. The results of this study show that the motivators in the district have met the requirements as effective communicators in counseling. The motivational approach proposed by motivators shows the need for greater encouragement for men to take an active role in Family Planning (KB) programs. Efforts to increase promotion and information related to male family planning through social media, newspapers, and other information sources are important steps that are expected to increase the acceptance and participation of men in family planning programs, so that families can choose the family planning method that best suits their needs.

Men's involvement in family planning programs and associated factors from the perspective of women in Afghanistan; a case study

ObjectivesFamily planning is a cornerstone to the achievement of Sustainable Development Goals. However, men's involvement in family planning has been a challenge in many countries. This study aimed to investigate the participation of men in the family planning programs and related factors from the perspective of women referring to family planning organizations in Herat, Afghanistan 2021. MethodsThe study had a cross-sectional design. The participants of the study consisted of 544 married women aged 15-49 years selected by simple random sampling. The data collection tool was a valid and reliable questionnaire to assess the participation of men in family planning programs. To analyze the data, descriptive statistics and analytical methods including Mann-Whitney and Pearson Chi-Square tests were applied in SPSS 21. The answers to the open-end questions were analyzed, coded and classified in two main categories. ResultsThe average age of study participants was 28(±10) years and a significant proportion of them were illiterate (48.5%). Most of the participants were housewives (83.6%) and their husbands were non-professional workers (39.9%). The husbands participated in family planning programs by choosing the type of contraception (29.2%), provision of contraceptives (29.6%) and supporting their wives using them (49.3%). There were statistically significant relationships between women's and their husband's education level, and husband's employment status with the type of participation in family planning. The main incentives for Afghan men to participate family planning were the increased attention of families to the education and needs of children and the health and welfare of the wives. However, cultural norms supporting larger families, the desire for having boy children, the fear of contraception's side effects and religious prohibitions discourage them in using family planning methods. ConclusionA large number of the respondents stated that their spouse participated in family planning programs. It shows the importance and success of family planning centers in promoting sexual and reproductive health and family planning. Study showed that various factors affected men's participation in family planning programs. Recognition of these factors can help policy makers in designing behavioral interventions based on social marketing, and enhancing the effectiveness of these programs.

Male attitudes towards family planning in the Limpopo province of South Africa.

Women often do not receive support from their partners with regards to family planning (FP), which can lead to hesitancy and inconsistent use. This study sought to understand the male attitudes that contribute to this. A qualitative descriptive study was conducted in 2019 using focus group discussions (FGDs) with purposively selected men aged ≥ 25 years and in a relationship with a woman of childbearing age. An open-ended question guide was used to explore men's perceptions regarding FP. The discussions were recorded, translated and transcribed verbatim, whereafter transcripts were coded and analysed thematically. Three major themes were identified, namely: (1) the advantages of FP, including financial benefits and the prevention of sexually transmitted infections and unwanted pregnancy; (2) the disadvantages of FP, including perceived adverse effects on men and women, as well as marital difficulties; and (3) the exclusion of men from FP by health workers and their partners. Men felt ambivalent towards FP. They were aware of the benefits thereof, but were hesitant to allow their female partners to use contraceptives, because of several misconceptions about the adverse effects. This underscores the need to involve men in FP programmes.

Partner support and women's contraceptive use: insight from urban poor communities in Accra, Ghana

BackgroundDespite the benefits associated with contraceptive use, there is a low prevalence of contraceptive use in sub-Saharan Africa and Ghana. Previous studies have partly and consistently attributed the low prevalence of contraceptive use to partner opposition. However, little is known about the influence of men in contraceptive related choices of their partners, particularly within the context of urban poverty. This study examines the influences of partners on women’s contraceptive choices.MethodsThe study utilized a cross-sectional household survey data of 1578 currently married women and women in a union of reproductive ages 16–44 years. Women who were pregnant and those trying to be pregnant were excluded from the analysis. The dependent variables for the study were current use of any contraceptive method, types of contraceptive methods and types of modern contraceptive methods. The independent variable for the study was a woman’s report of partner support in contraceptive related choices. A binary logistic regression model was used to examine the associations between partner support in contraceptive related choices and contraceptive use of women.ResultsThe results of the study show that partner support of contraceptive related choices has a significant influence on contraceptive use of women. Women who indicated support from their partners were more likely to be current users of any contraceptive method, yet were less likely to use modern contraceptive methods.ConclusionThe study highlights the need to involve men in family planning programs and research, as well as educating them on the various contraceptive modern methods and the side effects.

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.

Penurunan Kualitas dan Kuantitas Spermatozoa Mencit (Mus musculus L.) Setelah Pemberian Ekstrak Rimpang Rumput Teki ( Cyperus rotundus L.)

The lack of participation of men in family planning programs is due to the limited choice of male contraceptive. Traditional medicinal plants are one of ideal alternative types of male contraception. This study aimed to study the effect of Cyperus rotundus L. rhizome on the quality and quantity of spermatozoa in male mice (Mus musculus L.). Twenty male mice were divided into four treatment groups, namely control group (C0), the dose of teki grass rhizome extract 4.5 mg/40 g BW (C1), the dose of teki grass rhizome extract 45 mg/40 g BW (C2), and the dose of teki grass rhizome extract 135 mg/40 g BW (C3) for 35 days. Parameters measured were the motility, viability, morphology, and concentration of spermatozoa. The data were analyzed for diversity and then further tested using the LSD test with a 5% significance level. The results of the analysis showed that giving teki grass rhizome extract had a significant effect on the motility, viability, morphology, and concentration of spermatozoa. It can be concluded that teki grass rhizome can be used as an alternative male contraception because it can reduce motility, viability, morphology, and spermatozoa concentration.

&lt;p&gt;Use of Modern Contraceptive Methods in Burkina Faso: What are the Obstacles to Male Involvement in Improving Indicators in the Centre-East and Centre-North Regions?&lt;/p&gt;

IntroductionIn Burkina Faso, despite several efforts to improve contraceptive uptake, contraceptive prevalence remains low. Studies suggest that the low levels of family planning (FP) practices can be partially attributed to the low participation of men in reproductive health programmes. Involving men in FP programmes in Burkina Faso is thus imperative, but the obstacles to this are poorly documented. This study has two objectives to explore the perspectives of men and women on barriers to contraceptive use and to identify the strategies to increase male involvement in family planning.MethodsIt is a qualitative study using 20 focus groups and 52 in-depth individual interviews in two regions (North Central Region and Central East Region) with a sample of 29 adult men and 23 women who were married and had children or not. Interviews were conducted in Moore (the national language commonly spoken in both regions). All interviews were recorded and transcribed into French using Microsoft Word. Then, content analysis was carried out using the constant comparison method to identify the major themes.ResultsThe results show that men’s attitudes are still a significant barrier to women’s use of modern contraceptives. The reasons women do not use contraception and men do not adhere to FP programmes include lack of method knowledge, negative beliefs and perceptions about modern contraceptive methods, and the side effects of contraceptives. Cultural norms and preferences for large families are also common barriers to FP. However, the results showed that men’s awareness of FP, communication between spouses, and access to FP services can promote men’s adherence to FP programmes in the Centre-East and Centre-North regions of Burkina Faso.ConclusionEfforts should be made to improve educational standards, especially for men, and reorient FP services to make them more accessible to men.

Contextual and Social Factors Influencing Male Fertility in Nigeria.

Objectives Fertility level remains relatively high in Nigeria. Currently, it peaks at about six children per woman. Many studies have suggested targeting men in family planning programs to reduce fertility levels, particularly in patriarchal societies. Nigeria, being a patriarchal and multiethnic society, males’ influence on fertility behavior remains indisputable. Thus, this study explores contextual factors, such as sociocultural norms, beliefs, preferences, and perceptions, that influence male fertility behavior across different ethnic groups in Nigeria. Design The study uses qualitative data that involved focus group discussion (FGD) and in-depth interview (IDI) from three geopolitical zones in Nigeria, with each zone representing the three major ethnic groups in Nigeria. Six IDIs and four FGDs were conducted in each of the three selected regions among men making a total of 18 IDIs and 12 FGDs, respectively. The data were transcribed and exported to Atlas.ti software for analyses. Results Some of the beliefs and perceptions mentioned include influence of religion, polygamy, socioeconomic status, government policy, peer pressure, culture, and sex preference. These factors were found to vary considerably across tribes/ethnic groups. Conclusions Findings from this article show that there are other factors beyond individual factors that affect fertility behavior among men. Thus, there is a need to take into consideration the unique community structures in subsequent population-oriented social policy reviews and implementation to tackle high fertility behavior in Nigeria.

Male involvement in family planning; an often neglected determinant of contraceptive prevalence in Sub-Saharan Africa

&lt;p class="abstract"&gt;For more than two decades, there have been efforts to include men in family planning programmes. Male involvement was first echoed on a global scale at the International Conference on Population and Development (ICPD) plan of action, Cairo 1994.&lt;strong&gt; &lt;/strong&gt;This article is aimed at highlighting the importance of male involvement in increasing contraceptive prevalence in Sub-Saharan Africa.&lt;strong&gt; &lt;/strong&gt;A literature search using Google, Google scholar, PubMed, Hinary, Medical textbooks and related journals. Relevant articles were extracted and used for this review.&lt;strong&gt; &lt;/strong&gt;Majority of the literature assessed showed alienation of men in family planning and other reproductive health services despite the declaration made at the International Conference on Population and Development in Cairo, 1994. Findings also showed significant level of awareness of modern family planning methods amongst men but very low support for its use by themselves and/or their spouses or partners. Some of the reasons for such apathy include fears of side effects, non-availability, high cost and ignorance. The importance of involving men in family planning services cannot be over stressed. There are overwhelming evidence that with male support, there would be greater uptake and sustained use of family planning. This will lead to improved maternal and child health indices especially in our setting where the burden of the morbidity and mortality of maternal and child health is greatest.&lt;/p&gt;

Knowledge and Attitude of Men on Contraception Methods

Family planning refers to a conscious effort by a couple to limit or space the number of children they have through the use of contraceptive methods. Family planning in the global health field often revolves around women and girls. It is often regarded as the woman's responsibility, but there is growing recognition of the need to involve men in family planning programs.&#x0D; One of the most serious problems of developing countries still have to solve is their rapid and uncontrolled increase in population. It is well documented that men’s general knowledge and attitudes concerning the ideal family size, gender preference of children, ideal spacing between child births, and contraceptive method use greatly influence women’s preferences and opinions. Family planning has traditionally been viewed as the woman's responsibility, but there has been a growing recognition of the need to involve men in family planning programs as a means of achieving reproductive health objectives, as well as attaining greater gender equity.

Engaging Men in Family Planning: Perspectives From Married Men in Lomé, Togo.

Family planning programs have made vast progress in many regions of sub-Saharan Africa in the last decade, but francophone West Africa is still lagging behind. More emphasis on male engagement might result in better outcomes, especially in countries with strong patriarchal societies. Few studies in francophone West Africa have examined attitudes of male involvement in family planning from the perspective of men themselves, yet this evidence is necessary for development of successful family planning projects that include men. This qualitative study, conducted in 2016, explored attitudes of 72 married men ages 18-54 through 6 focus groups in the capital of Togo, Lomé. Participants included professional workers as well as skilled and unskilled workers. Results indicate that men have specific views on family planning based on their knowledge and understanding of how and why women might use contraception. While some men did have reservations, both founded and not, there was an overwhelmingly positive response to discussing family planning and being engaged with related decisions and services. Four key findings from the analyses of focus group responses were: (1) socioeconomic motivations drive men's interest in family planning; (2) men strongly disapprove of unilateral decisions by women to use family planning; (3) misconceptions surrounding modern methods can hinder support for family planning; and (4) limited method choice for men, insufficient venues to receive services, and few messages that target men create barriers for male engagement in family planning. Future attempts to engage men in family planning programs should pay specific attention to men's concerns, misconceptions, and their roles in family decision making. Interventions should educate men on the socioeconomic and health benefits of family planning while explaining the possible side effects and dispelling myths. To help build trust and facilitate open communication, family planning programs that encourage counseling of husbands and wives in their homes by community health workers, trusted men, or couples who have successfully used or are currently using family planning to achieve their desired family size will be important.

Men’s perceptions of child-bearing and fertility control in Pakistan: insights from a PEER project

Notions of masculinity, which promote the role of men as providers and decision-makers, alongside men’s opposition to modern forms of contraception, have long been assumed to be a barrier to women’s use of contraception in Pakistan. There has been little in-depth exploration of varieties of masculinity and how these may influence men’s views of child-bearing or fertility preferences. This study used Participatory Ethnographic and Evaluation Research to explore married men’s (aged 18 to 45 years) perceptions of marriage, child-bearing and fertility control. A total of 31 men were recruited as researchers in two provinces (Punjab and Khyber Pakhtunkhwa), who, in turn, each interviewed two male friends. Men overall supported a ‘smaller’ family size and use of contraceptive methods. Drivers of this preference included perceived economic constraints, the desire to invest in children’s education, and wider acceptability of contraceptive use. Limiting family size was associated with both the value of competent male providers taking care of their children, as well as being poor. Men wanted to have better access to information through a range of channels. Understanding the sociocultural contexts in which masculinities are constructed is essential before involving men in family planning programmes, so that gender inequalities are not reinforced.

English

If policies for the promotion of gender equality are to be realizable their goals must include equitable distribution of health related resources in line with MDG goals 3 and 5 which focus on promoting gender equality, empowerment of women and family planning. This requires careful identification of the similarities and differences in the use of family planning as a component of reproductive health. It also necessitates an analysis of the gendered obstacles that currently prevent men and women from participating or using family planning. Reasons for inequalities in the use of family planning include patriarchal culture, religious beliefs and sex preference manifested in discrimination against female children in health and general care. This paper examines gender inequality in family planning practice and sustainable development in Nigeria, using Patriarchal theory as the framework. The paper strongly argued that socio-cultural factors as well as gender roles influence the use of family planning and affect health and sustainable development in Nigeria. It outlines some measures for change which include policies to ensure universal access to reproductive health care, to reduce gender inequalities in access to resources and to relax the constraints of rigidly defined gender roles. The paper recommends that strategies to improve true sustainable development will depend on the empowerment of women in Nigerian through education and access to socio economic opportunities. The paper further recommends policy initiatives to include men in family planning programmes in Nigeria to engender equity in health and sustainable development. Key words: Gender equity, family planning, patriarchy, sustainable development.

Spousal discordance on fertility preference and its effect on contraceptive practice among married couples in Jimma zone, Ethiopia

ObjectivesTo assess spousal agreement levels regarding fertility preference and spousal communication, and to look at how it affects contraceptive use by couples.MethodsWe conducted a cross-sectional study to collect quantitative data from March to May 2010 in Jimma zone, Ethiopia, using a multistage sampling design covering six districts. In each of the 811 couples included in the survey, both spouses were interviewed. Concordance between the husband and wife was assessed using different statistics and tests including concordance rates, ANOVA, Cohen’s Κ and McNemar’s test for paired samples. Multivariate analysis was computed to ascertain factors associated with contraceptive use.ResultsOver half of the couples wanted more children and 27.8% of the spouses differed about the desire for more children. In terms of sex preference, there was a 48.7% discord in couples who wanted to have more children. At large, spousal concordance on the importance of family planning was positive. However, it was the husband’s favourable attitude towards family planning that determined a couple’s use of contraception. Overall, contraceptive prevalence was 42.9%. Among the groups with the highest level of contraceptive users, were couples where the husband does not want any more children. Spousal communication about the decision to use contraception showed a positive association with a couple’s contraceptive prevalence.ConclusionsFamily planning programs aiming to increase contraceptive uptake could benefit from findings on spousal agreement regarding fertility desire, because the characteristics of each spouse influences the couple’s fertility level. Disparities between husband and wife about the desire for more children sustain the need for male consideration while analysing the unmet need for contraception. Moreover, men play a significant role in the decision making concerning contraceptive use. Accordingly, involving men in family planning programs could increase a couple’s contraceptive practice in the future.

Engaging Men in Family Planning Services Delivery: Experiences Introducing the Standard Days Method® in Four Countries

Family planning is often regarded as the woman's responsibility, but there is growing recognition of the need to involve men in family planning programs. Since 2001, the fertility-awareness-based Standard Days Method® (SDM) has been introduced in more than 30 countries, providing a natural, effective birth control option. SDM requires the cooperation of the male partner, and its introduction created an opportunity to test innovative strategies to engage couples in family planning. Such strategies included couple counselling, outreach activities that encouraged men to participate in family planning and integration of family planning into traditionally male programs. Due to the SDM's intrinsic characteristics as a couple method, SDM providers are sensitized to the importance of exploring other critical sexual and reproductive health topics, including intimate partner violence, HIV, sexuality and partner communication. This paper presents several case studies describing how men were engaged in SDM introduction activities in four countries.

Five-year experience with depot medroxy progesterone acetate injectable contraception

The objective of this article is to describe the characteristics and experiences of clients who used depot medroxy progesterone acetate for contraception. A retrospective review of family planning records of clients who used depo-provera between 1992 and 1996 at the family planning clinic of University of Nigerian Teaching Hospital, Enugu. The mean age of clients was 32.7 +/- 5.2 years. Over 71% of clients had five or more children. Clients with no education (78.7%) or primary education (75.1%) were more likely to be grand-multiparous compared to women with at least secondary education (49.6%). Among clients with 1-4 living children, 81.3% used depo-provera for child spacing. Among those with 5-8 living children, 48.8% used it for child spacing. Menstrual abnormalities were the main complications but the commonest reason given for discontinuation was "husband's wish". The continuation rate at 36 months was 82.7%. Depot medroxy progesterone acetate is an acceptable and effective method of contraception. The involvement of men in family planning programmes cannot be over-emphasised as they significantly influence the decision of women regarding contraceptive use.

Knowledge of and attitudes towards family planning by male teachers in the Islamic Republic of Iran

A cross-sectional study was carried out on knowledge of and attitudes to family planning in male teachers working in the education system in Teheran. We found that 65% of the study population had acceptable knowledge regarding the issue. More than 95% of respondents reported having a favourable attitude towards the implementation of family planning programmes and about 90% believed that decision-making regarding use of contraceptives should be a joint process. To improve the planning and administration of family planning programmes, the main variables identified in this study should be further investigated in different population groups. Addressing men in family planning programmes may improve their success and lead to increased contraceptive use.

A qualitative study of clandestine contraceptive use in urban Mali.

This prospective study uses qualitative methods to examine the social and economic impact of family planning on women's lives in the district of Bamako, Mali. Fifty-five first-time users of contraceptives were interviewed in October 1996. Of particular interest is the high proportion (17/55) of those who had hidden their use of a birth-control method from their husbands. Substantial collusion is found to have occurred between sisters-in-law in assisting each other to gain and hide methods of family planning and to keep their use secret from their spouses and older marital relatives. The main reason for discontinuation among the clandestine users was menstrual disruption, which they feared would make their husbands aware of their contraceptive use. By the end of the study, women were aware that their use of contraceptives had increased their mobility and available time, enabling them to enhance the quantity and efficiency of their work activities. Contraception, therefore, appears to be a valuable resource, permitting women to improve their economic and social status. In settings where clandestine use is prevalent, at least in the short term involving men in family planning programs may not always be beneficial, nor may considering the couple as the unit of intervention and analysis always be appropriate. In the long term, however, the underlying causes of men's objections to contraceptive use need to be addressed so as to facilitate communication and joint decisionmaking about family planning.

Community Health Nurses and Family Planning Services for Men

Current concerns about sexually transmitted diseases (STDs) and acquired immunodeficiency syndrome (AIDS), as well as unintended pregnancy, have drawn increasing attention to reproductive health services for men. This report presents information about responses by 844 community health nurses (CHNs) to a self-administered mailed questionnaire that included questions about the extent of the nurses' involvement in delivering or administering family planning services to men, their knowledge and attitudes about men and family planning, and their preparation for working with men. Our sample included CHNs in practice in five states and a sample of CHNs belonging to a national organization of public health nursing, in order to gain information about CHNs in practice in the field and CHNs more likely to be in an educational or administrative position and thus able to influence or to set policy. Two thirds of the nurses surveyed work with men in their reproductive years but only 17.8% delivered or administered family planning services to men (23% of the state sample and 12.5% of the organization sample). Deficits in knowledge about male birth control methods were identified; for example, only 32% knew the use-effectiveness rate of the condom. However, 90% of the CHNs knew the condom has to be put on before any genital contact is made. The CHNs' attitudes were positive; more than 90% said they felt men had equal responsibility with their partners in preventing unwanted pregnancies, using contraception, and contraceptive decision making. Yet, only 9.6% of the CHNs felt men have as much knowledge about contraception as women do. Seventy percent of the nurses felt tha sex education in schools was directed more to female students than to male students. More than 90% said they believed that family planning providers have a responsibility to provide services to men; but two thirds felt that nurses are not as well prepared to work with male as with female clients. Increased educational preparation may improve CHNs' knowledge about men and family planning and enable them to feel professionally prepared to deliver and administer the services they feel are necessary for male as well as female clients. There are 101,430 CHNs in the United States, working in public health departments or other service agencies in almost every community across the country. These CHNs are a major resource for the family planning field.