Male perspectives on increasing male involvement in family planning in Kenya

INTRODUCTION: Male disapproval is frequently cited as a major barrier to women’s family planning (FP) use in sub-Saharan Africa (SSA). While men in SSA may want to engage more in FP, the factors that inhibit their involvement are not well-understood. METHODS: Twelve focus groups were conducted with married men ages 20-66 in rural Kenya to explore men’s FP perceptions and barriers to involvement.  RESULTS: While most men approved of FP, male acceptance was stigmatized.  Male identity and gender roles were significant barriers to male FP involvement. Men were expected to be dominant, authoritarian, and virile. FP was viewed as a “woman’s matter” and men involved in FP were seen as controlled, overpowered or “herded.” Men feared being criticized for being too proud or embracing Western values over tribal traditions if they had small families.  They also worried about being seen as not able to be good providers or function sexually. Many avoided FP clinics due to fears of forced vasectomies, or disclosure of HIV test results or extra-marital sexual activity to their wives.  Men expected women to initiate FP discussions. Suggested approaches to increase male FP involvement centered around education and outreach by doctors, community health workers and village leaders.  CONCLUSIONS: Programs using male outreach workers to promote FP are needed. Men should be encouraged to discuss their concerns with FP providers privately.  Increased awareness of the positive gender-related benefits that FP holds, such as the ability to be provide financially to fewer children, could encourage more male FP acceptance.