The contribution of male involvement in family planning uptake. A case study of Emanzi strategy in Kamwenge District

Abstract

Background: Women with access to family planning (FP) not only have an increased level of autonomy but more opportunities for education and making economic contributions. Yet, millions of women in developing countries lack access to FP information and services due to various barriers including opposition from husbands, cultural, religious and economic factors that hinder women’s contraceptive use. It is widely established that men play a key role in decisions around family planning. While there have been sporadic attempts to engage men in FP programs, they have not been systematic or sustained. Furthermore, little is known about the drivers and barriers for men’s participation in equitable family planning decision-making and contraceptive uptake, as well as the mechanisms for sustainablity. This study attempted to: determine if the training offered under the Emanzi program has an effect on male involvement in FP; Establish the effect of Emanzi program on couple communication about FP; and determine the extent to which Emanzi program influenced perceptions of men and involvement in FP.

Methods: The study adopted a cross-sectional research design using both qualitative and quantitative research methods. The study was conducted in four sub counties Kamwenge district namely; Kahunge, Biguli, Ntara and Kicheche. The study participants were men who had graduated from Emanzi program implemented by implemented by FHI 360 in Uganda in Kamwenge District and their wives. In total 100 couples (husbands and wives) participated in the study. Six in-depth interviews were also held with key informants and 2 FGDs with community members.

Results: The findings suggest that male involvement (MI) increases uptake of FP and there are two forms of male involvement in Family Planning. There is MI in the promotion of family planning and as the target group that is men as a husbands and fathers. This study found that men were involved as a conduit to transfer sexual and reproductive health information to their friends and partners. The second area of involvement is in taking up a shared responsibility in pregnancy and childbirth, household work (gender roles) and child caring. The findings also showed MI’s positive outcome which resulted in their increased communication among partners especially on family health including FP. Men’s attitudes and behaviours altered to become supportive of their wife in the decision-making process regarding FP led to increased uptake.

Conclusion: This study suggests that the contribution of men in FP is crucial. The current strategies for men’s involvement in FP in Uganda are more of engaging them as supportive partners. This study also concludes that men’s current involvement and uptake is linear although various barriers may hinder their full involvement in FP. It is an oversimplification to simply incorporate men into the existing FP programmes without considering its complexity and interconnected issues, including an inadequate understanding of masculinities alongside gender norms and other influential sociocultural factors in society.