Exploring the multilevel factors influencing women’s choices and utilisation of family planning services in Mufulira district, Zambia: A socio-ecological perspective

Male partner influence on Women's choices and utilisation of family planning services in Mufulira district, Zambia

“…Globally, women's decision to use contraception is heavily influenced by wider socio-ecological factors such as male partners, peers, family, and contraception knowledge and beliefs [ 30 , 37 ]. Even though the association between women's autonomy and lower fertility and greater contraception uptake has unequivocally been established [ 23 ], opposition to contraception by male partners has widely been reported in sub-Saharan Africa (SSA) [ [37] , [38] , [39] ].…”

“…Contraception side effects continue to be a widely reported barrier to contraception use and accord critical constraints to contraception use [ 38 , 40 , 44 ]. Common side effects of contraception include decreased or increased vaginal lubrication/wetness, reduced libido, and abnormal menstrual bleeding [ 17 , 30 ]. Male partner misconceptions about contraception side effects can be linked to inadequate information on contraception and the influence of cultural constructs about reproductive behaviour and gender power inequality [ 19 , 24 , 25 ].…”

“…Disapproval of contraception by a male partner can be due to a lack of trust in the efficacy of contraception [ 30 ], and undesirable side effects of contraception on women's bodies such as weight gain, and vaginal dryness which disrupt sexual pleasure [ 17 ]. In the current study, participants recounted how their male partners disapproved of their use of contraception because of the fear that they would gain weight and experience vaginal dryness.…”

“…However, recent data indicate that the fertility rate is still high in Zambia (5.5 births/woman), and the total fertility rate is about 4.7 and only about 48% of women have access to modern contraceptives [ 29 ]. Studies on contraception use in Zambia have mainly focused on factors associated with contraception use among women [ 27 , [29] , [30] , [31] ]. Given the gender and power dynamics in contraception uptake, this study aimed to explore the male partner's influence on women's choices and utilisation of family planning services in Mufulira district of Zambia.…”

“…The biggest health facility in Kawama East is Twatasha Health Centre (1st level) and Ronald Ross General hospital (2nd level). The social economic activities in the area include subsistence farming, small business enterprises, and small-scale sand mining [ 30 ].…”