Family Planning from a Male Perspective: Observations from a Community-Based Cross-sectional Study in Chennai, Tamil Nadu

Traditionally, family planning has been considered in the context of maternal and child health, although men play a dominant role in all matters related to reproductive decision-making. This study is carried out to assess the attitude and participation in family planning among currently married males and identify factors influencing the acceptance of male contraception. A cross-sectional study was conducted in Chennai in October 2018, which included 180 currently married men by systematic random sampling of eligible couples in the field practice area of Sanjeevarayanpet Primary Health Center (UPHC). Data was collected through a self-administered questionnaire in the local language and analyzed using SPSS version 16. Absolute and relative frequencies were estimated for descriptive data while correlates were tested for statistical significance using Pearson or Trend Chi-square tests. Study participants considered two children (82%) and spacing of at least 2 years (95%) as ideal, with spousal communication regarding family planning considered essential by a two-thirds majority. Among the 117 men who reported ever using contraception as a couple, 69% had used a condom vs. 42% and 30% for female spacing methods and tubectomy, respectively. Vasectomy, with nil acceptors, was considered acceptable by only 21% of men. Education, per-capita income, and spousal communication were seen to positively influence male contraceptive use. While married men show considerable commitment to family planning decision-making and practice, the stigma and misconceptions surrounding vasectomy have become ever more prominent. There is a need for the community and the health care system to work together to promote gender equity in family planning.

Barriers to male partner accompaniment and participation in maternal and child health care in Thika and Kiambu Level Five Hospital, Kenya

Introduction

the 1994 International Conference on Population and Development (ICPD) recommended that men should share responsibility and be actively involved in responsible parenthood, sexual and reproductive health. The level of male involvement in Kenya remains low despite growing evidence showing its benefits in maternal and newborn health. This study sought to determine factors influencing male partner involvement in maternal and child health with focus on accompaniment to maternal and child health (MCH) department.

Methods

a qualitative study utilizing exploratory design was used to gather the views of men and nurse-midwives working in the MCH department of Thika and Kiambu County Teaching and Referral hospitals in January 2022. Qualitative data were collected from focused group discussions from nurses and men respectively. The number of participants per Focused Group Discussion (FGD) ranged between six to eight. The principal author moderated the FGD that were audio recorded and lasted between 60-90 minutes. Content analysis was used to analyse data following the five steps to yield themes using MAXQDA 2022 software.

Results

five categories emerged as factors influencing male accompanying their spouses to MCH clinic: traditional gender norms, roles and beliefs, unfavorable MCH environment, work commitment, fear of HIV testing and men's work commitment.

Conclusion

traditional gender roles and norms, work commitment by men and unfavourable MCH set-up were key barriers identified that hinder men from accompanying their spouses to MCH clinic. There is need to develop an effective, feasible and sustainable intervention that will encourage male partners to accompany their spouses and participate in MCH services.

Promoting male participation in maternal healthcare in the Jaman North District in Ghana: Strategies and implementation challenges

Promoting male participation in maternal healthcare is essential for improved maternal health outcomes. This study explored existing strategies to promote male participation in maternal healthcare and assessed their implementation challenges within healthcare facilities in the Jaman North District in Ghana. A qualitative approach was implemented in April 2020. Interviews were administered to a stratified purposive sample of 18 respondents comprising six midwives and 12 male partners of postnatal mothers. All interviews were audio-recorded, transcribed, and manually analysed using thematic analysis. The findings revealed early service, male partner invitation, male partner incentivisation, public sensitization, and male informed education, as strategies to promote male participation in the district. The implementation of these strategies has been constrained by socio-cultural and health system factors, namely, perception of pregnancy as non-illness, perceived experiences gained by women during previous births, cultural stereotypes, unconducive environment of healthcare facilities, inappropriate timing of facility attendance and unexpected costs associated with male participation. Promoting male participation, therefore, requires dedicated policy attention to the existing socio-cultural and health system constraints. The Ghana Health Service and other stakeholders should consider both community-level and targeted sensitization on the benefits of male participation in maternal healthcare and a general improvement in maternal healthcare infrastructure.

Male participation in reproductive health care of women and factors associated with interpersonal relationship: A cross-sectional study in a rural community of Ambala District in Haryana

Background

Male participation plays an important role in affecting reproductive health outcomes. Communication between a wife and husband regarding reproductive matters is well recognized as a factor influencing good interpersonal relationships.

Objectives

The objectives of this study were to assess male participation in reproductive health care of women and spousal communications and also to identify factors associated with interpersonal relationship.

Methods

The present descriptive study was conducted among 104 married women aged 18-49 years in a rural community of Haryana during the months of June and July 2019. Study variables included sociodemographic characteristics, reproductive health characteristics, male participation in reproductive health care of women, and interpersonal communication.

Results

Male participation was reported by 72 (69.2%) women with an overall involvement of spouses in antenatal care by 71 (68.3%) women. Joint decisions concerning desired number of children, use of contraceptive, and choice of contraceptive use were reported by 47 (45.2%), 48 (46.2%), and 55 (52.9%) women, respectively. Good interpersonal relationship was reported by 80 (76.9%) women and 67 (64.4%) felt their expectations were fulfilled. Male partners played dominant roles in decisions concerning contraceptive use and place of delivery only. Low socioeconomic status came out to be a significant risk factor of not having good interpersonal relationships (P = 0.02).

Conclusion

Male participation in reproductive health care of women was reasonably high. Spouses were having good interpersonal relationships meeting expectations of women. Efforts should be made for increasing male involvement and encouraging better interpersonal communications for attaining desired reproductive health outcomes for women.

Under-the-Mango-Tree: a theatre-based male EMTCT engagement intervention in post-conflict northern Uganda

Male involvement in human immunodeficiency virus (HIV) care cascades is identified as a critical prerequisite for the successful elimination of mother-to-child transfer of HIV. Scant evidence exists on efficacious culturally appropriate and male-inclusive elimination of mother-to-child transfer interventions. This reflection-in-action paper highlights field notes and observations of the development of Under-the- Mango-Tree, a theatre-based male-inclusive intervention pilot tested in northern Uganda. The intervention included: (a) traditional drama, dances and songs and (b) expert testimonies and group dialogue. Observations in this pilot showed that a theatre-based intervention was suitable for social persuasion; role modelling and moderating mastery of experience through effectively combining simple songs, dances and drama; testimonies of successful adherence by expert clients; and through reflective group discussions. These observations have implications for male-inclusive elimination of mother-to-child transfer intervention development.

Male Perception and Participation in Family Planning Among Tribal Communities of Maharashtra, India: A Mixed-Method Study

This study examined male perceptions and awareness about family planning. The study also investigated male involvement in family planning and contraceptive use decision-making. Furthermore, in this study, we assessed men’s awareness, attitude, and practice of modern contraceptive methods and determined the level of spousal communication. In this study, a field survey was conducted among the tribal population of Maharashtra. Both qualitative and quantitative methods were used for data collection. A sample of 385 men whose wives had given birth in the last 2 years were interviewed. Almost two thirds of the surveyed men (64%) had heard about modern family planning. The main source of information for family planning was the multipurpose worker in the village for 48% of men, followed by friends 16% and the auxiliary nurse midwife and accredited social health activist for 11% and 10%, respectively. Results show that the current use of any modern family planning method, including male and female methods, was 18.4%. Among the currently used modern methods, the major modern family planning method was male sterilization (67%), followed by oral pills (11%) and male condom use (10%). This study indicated that the acceptance of male modern family planning methods is very high.

Factors influencing male participation in reproductive health: a qualitative study

INTRODUCTION

Male involvement in reproductive health is an essential component in promoting maternal and family health. In Nepal, men are not actively engaged in most maternal and child health (MCH) services nor in other reproductive health programs. There is a need to know about the understanding of key professionals in such practices. This study explores gendered perspectives among teachers and health professionals to understand the factors contributing to male involvement in reproductive health.

METHODS

The data were collected through two focus group discussions (FGDs) and seven key informant interviews (KIIs). FGDs were held among male teachers of selected schools, and KIIs were conducted with health professionals of the health post of Bungamati, Lalitpur. An unstructured interview guide was used to explore their experiences and perceptions. All KIIs and FGDs were recorded, translated and transcribed verbatim.

RESULTS

Findings show limited male involvement in reproductive health. Participants reported several hindering and challenging factors such as sociocultural and psychological norms, lack of education, and misinformation and dominance of female as health care providers in many MCH clinics. Perceived motivating factors included positive attitude in men, literacy and awareness, inclusion of reproductive health in school curriculum and certain incentives. Participants also recommended a range of strategies for increasing men's involvement in reproductive health in Nepal.

CONCLUSION

Men's education and attitude, knowledge and awareness, sociocultural factors, psychological factors, health system factors, and policies play important roles in male involvement in reproductive health. Programs on effective implementation of men involvement in reproductive health initiatives should address the barriers and challenges to men's supportive activities. This study also suggests increasing literacy of reproductive health among men that enhances their positivity and motivates them to participate in reproductive health services.

Unmet need for family planning among married women of reproductive age group in urban Tamil Nadu

Context:

Unmet need for family planning (FP), which refers to the condition in which there is the desire to avoid or post-pone child bearing, without the use of any means of contraception, has been a core concept in the field of international population for more than three decades.

Objectives:

The very objective of this study is to determine the prevalence of “unmet need for FP” and its socio-demographic determinants among married reproductive age group women in Chidambaram.

Materials and Methods:

The study was a community-based cross-sectional study of married women of the reproductive age group, between 15 and 49 years. The sample size required was 700. The cluster sampling method was adopted. Unmarried, separated, divorced and widows were excluded.

Results:

The prevalence of unmet need for FP was 39%, with spacing as 12% and limiting as 27%. The major reason for unmet need for FP among the married group was 18%, for low perceived risk of pregnancy, 9%, feared the side effects of contraception 5% lacked information on contraceptives, 4% had husbands who opposed it and 3% gave medical reasons. Higher education, late marriage, more than the desired family size, poor knowledge of FP, poor informed choice in FP and poor male participation were found to be associated with high unmet need for FP.

Conclusion:

Unmet need for younger women was spacing of births, whereas for older women, it was a limitation of births. Efforts should be made to identify the issues in a case by case approach. Male participation in reproductive issues should be addressed.

Luba-Kasai Men and the Prevention of Mother to Child Transmission (PMTCT) of HIV program in Lusaka

Male participation in the prevention of mother-to-child transmission (PMTCT) of HIV has been determined as one of the key factors in sub-Saharan African countries, but its realization is challenging because of male-related and institutional factors. The purpose of this study is two-fold: first, we explored the views of Luba-Kasai men, living in Zambia in the Lusaka Province, on the factors that encourage, inconvenience or inhibit them in accompanying their wives to the antenatal clinic and their ideas to improve their experience. Secondly, the study considered their knowledge of the PMTCT program and how such knowledge conformed to the Zambian National Protocol Guidelines Integrated PMTCT of HIV /: AIDS. Twenty-one interviews were analyzed using qualitative inductive content analysis. The National Protocol Guidelines Integrated PMTCT of HIV/AIDS were analyzed using the deductive content analysis. The encouraging factors that emerged were involvement in the program, the time of delivery, love and care, and also the suspicion of corruption. The inconveniencing factors were the arrangements and working culture of the clinic, together with stigma and guilt. A lack of motivation, fear of death, socioeconomic circumstances and again the arrangements and working culture at the clinic were held as inhibiting factors. The ideas to remove inconvenient factors were maintaining a spiritual outlook on life, education, interaction, a good mood and a sense of meaningfulness. Considering such male views and paying attention to minorities in the development of national PMTCT of HIV Programs may enhance male participation in the process.

Barriers and resources to PMTCT of HIV: Luba-Kasai men's perspective in Lusaka, Zambia

The purpose of this study was to describe the views of Luba-Kasai (a Congolese tribe) men on barriers inhibiting them from the prevention of mother-to-child transmission (PMTCT) of HIV and the resources they need to implement such prevention in Lusaka, Zambia. Twenty-one men were interviewed and the data were analyzed using qualitative content analysis. The barriers identified in the data were poverty, refugee status, absence of support arrangements, and the working culture in antenatal care, passivity, ignorance, marital disharmony, HIV-related stigma, and cultural characteristics, such as ways of being a man and religious beliefs. The resources were spiritual outlook on life, knowledge of HIV issues, support and availability of advanced health services, and satisfaction of basic needs. Improving male participation in PMTCT in this subpopulation presupposes cooperation between different sectors of society and inspiring trust in antenatal care.

The participation of prospective fathers in preconception care

We present the data of male participants in the Coordinating Center of the Hungarian Preconception Service (HPS), Budapest, 1984–2010. One of main objectives of the HPS was the incorporation of male partners of female participants into the preparation of childbirth. The HPS is based on three steps: (I) Reproductive health check-up. (II) A 3-month preparation for conception with the major determinants of the development of new life such as sex, health and/or some diseases. Smoking and illicit drug use cessation and limitation of alcohol intake was suggested in the male participants (III) to achieve optimal conception and better protection of early pregnancy. Pregnant women usually visit prenatal care clinics between the 7th and 12th gestational week when it is too late to reduce the risk of congenital abnormalities. Male participation in HPS will help to enhance use of appropriate preconception methods at the appropriate time.

Male participation in prevention programmes of mother to child transmission of HIV: a protocol for a systematic review to identify barriers, facilitators and reported interventions

BACKGROUND

Infection with the HIV and AIDS are leading causes of morbidity and mortality among women and children worldwide. Prevention of mother-to-child transmission of HIV (PMTCT) programs were developed to protect women and their babies from having HIV infection. However, knowledge on how male participation has been applied to these programs is limited. We present a research protocol for a review which seeks to determine the effects of male participation on female uptake of PMTCT programs, and assess how this male participation has been investigated and documented worldwide.

METHODS

This is a systematic review of published literature. We will attempt to identify all studies relevant to the subject written in the English language from January 1998 to June 2011. Electronic searches of the PubMED, EMBASE, CINAHL, and LILACS databases will be conducted using the relevant medical subject headings. Reference lists of identified studies and previous reviews will be manually checked for articles of interest. We shall also contact authors on the field for any relevant material. Two authors (FM and LM) will independently screen potential articles for eligibility using well-defined inclusion and exclusion criteria. They will independently assess the methodological quality of each included paper using the Jadad scale for randomized controlled trials, and the Newcastle-Ottawa scale for observational studies. Then they will independently extract data from the studies using a pre-established data extraction form. The primary outcome data will be female uptake of PMTCT services following a male/couple intervention, while secondary outcome measures will include indicators and barriers of male participation in PMTCT activities among others. During the data extraction process, discrepancies between the two authors will be sorted out by discussion or consultation with a third party (LT). The analysis and reporting of the review will be according to the PRISMA and MOOSE guidelines. Any identified clinical or statistical heterogeneity will be explored. Where possible, a random-effects meta-analysis will be performed to obtain aggregate estimates. We will also assess publication bias using funnel plots. Analysis of other outcomes will be descriptive.