Potential effect of male attitudes on family planning choice in Mali and India: Views on a fertility awareness method

Relationships between women and men are a mitigating factor in family planning (FP) method choices and use. The Standard Days Method® (SDM), a fertility awareness-based FP method, necessitates couple involvement and communication. Men participate in SDM use by using a condom or abstaining on woman's fertile days, helping their partners keep track of fertile days and purchasing CycleBeads® and condoms. Past operations research demonstrated that program efforts to include men through provider interaction and client counseling have shown some success. Male involvement helped increase SDM awareness and improved couple communication and male participation in SDM use at the community level in India and El Salvador. Yet, to date, male perceptions of the SDM have not been examined. We carried out baseline household surveys in India (N = 790) and Mali (N = 622) to ascertain both positive and negative perceptions of SDM, prior to scale-up activities. Awareness of SDM (described as “ever heard” of method) was limited in India (2%), but high in Mali (71%). The majority of men found SDM effective and acceptable in both countries. Few felt SDM was difficult to understand or interfered with sexual relationships. Yet, nearly half of men believed SDM would be difficult for their partner to understand, and some believed SDM has side effects or causes health problems. The basis for these misperceptions concerning use of this couple-focused natural, fertility-awareness method should be explored. These data highlight the importance of educating and involving men in FP, as attitudes/perceptions may impact FP use.