Male involvement in family planning. A review of the literature and selected program initiatives in Africa. Participation des hommes a la planification familiale. Revue de la litterature et analyse d'initiatives choisies de programmes en Afrique.
This report presents a review of the literature on male attitudes and behaviors concerning family planning and male initiatives in Africa. Only recently have family planning programs targeted men in service delivery strategies. Strategies may include the following: special hours for men in Maternal-Child Health and Family Planning Clinics, male-only clinics, sexually transmitted disease clinics, integrated family planning promotion in AIDS prevention programs, mobile units, and male-to-male community-based distribution (CBD) of condoms. Findings indicate that men have positive attitudes towards family planning, but women believe that their husbands disapprove of family planning. Spousal communication was found to be positively associated with contraceptive use. An Ethiopian study found that when men were involved in home visit talks about family planning there was greater use of contraception and modern methods. Men's lack of access to information and services is a barrier to family planning use. Recent African demographic and health surveys reveal that mean ideal family size was very high and contraceptive use was very low in West Africa, lower in East Africa, and much lower in North Africa. It has been learned that well-designed IEC efforts can have a positive effect on men. Work-site clinics, innovative programs, and provision of vasectomy with good counseling were well received. Men preferred a range of reproductive health services. The author recommends assessing local needs, closing the knowledge gap, developing appropriate service strategies, including evaluation in the program design, exchanging experiences, learning about the male audience, targeting messages to men, developing education for young men, and moving urban lessons to rural areas. There is a need for promoting research on male contraceptives, advocacy training for program managers and male opinion leaders, and analyzing national policy affecting family planning.