Men, The Missing Link In Gender-equitable Family Planning: A Scoping Review

Abstract

Background: Across societies, gender norms often allow men to hold key decision-making power within relationships, households and communities. This extends to almost all domains, consisting of family planning (FP) as well. FP programs have largely engaged men as clients and rarely as equal partners or influencers although across lower- and middle-income countries (LMICs), and especially in South Asia, men hold key decision-making power on the domain of family planning. The objective of this article is to explore couple dynamics through the lens of spousal communication and decision-making and unpack male engagement and spousal dynamics in family planning. Methods: This review presents a synthesis of evidence from two peer-reviewed databases, PubMed and Jstor, and and insights from programmatic documents to shed light on gender equitable engagement of young married men in family planning. Inclusion and exclusion criteria for both these databases was set and search strategies were finalized. This was followed by title and abstract screening, data extraction, synthesis and analysis. Results: Study participants included unmarried men (16%, n=8), married men (19%, n=9), married women (19%, n=9), married couples (25%, n=12) or more than two respondent categories (21%, n=10). Almost three quarters (71%, n=34) of the studies selected had FP as the primary area of inquiry. Other prominent thematics on which the studies reported were around norms (n=9, 16%), couple dynamics and intimacy (n=12, 22%). Conclusions: The evidence presented provides sufficient impetus to expand on gender-equitable male engagement, viewing men as equal and supportive partners for informed, equitable and collaborative contraceptive uptake and FP choices by couples.

Misconceptions and Spousal Communication about Family Planning among Women of a Rural Community in Ekiti State, Nigeria

“…Education has been significantly associated with increase in contraceptive prevalence rate. [16] Prevalence of ever use of contraceptive was 23.7% in this study which is far less than what was found 56.2% in another rural community in Lagos State within the same Southwester region. [17] Contraceptive prevalence rate is still very low and still quite substantial number of women still experience unmet need.…”

“…In the town/city means of livelihood is more expensive so couples need to plan and regulate the number of children and when they would like to have the children. [16,19] Couples that discuss family planning had been found to used modern methods of family planning. [24] This study revealed that majority of those that discussed their husbands approved the use of family planning and 38% of them eventually used compared to 15% that used among those that didn't discuss with their husbands.…”

“…A similar pattern was documented by Sisay et al in Ethiopia. [25] Some of the factors that hinder communication between spouses on family planning are lack of knowledge on the part of the husband and the influence of the mother-in-law [16,24]. Family planning majorly is seen as woman issue so program and health workers concentrate on women alone and the men are left out.…”

“…Behavioural change communication through the mass media can change the narratives [11,26] Family planning service provider should endeavor to target the couple rather than just the woman because some men may allow their wives to use modern family planning methods if they are educated by health workers rather than their wives due to their ego. [16] Sometimes engaging the male in meaningful communication by the wife can be difficult because the cultural believe that man is not interested in the discussion or is the man that should decide the number of children since he is the sole prover for the family especially in the rural. [19] The discordant in the number of children desire by the husband and the wife can also be a barrier.…”