Active Participation of Male in Family Planning

Table of Contents

1. INTRODUCTION

2. DATA AND METHODOLOGY

3. RESULTS
3.1 Differentials in active participation of male in family planning
3.2 Determinants of the active participation of male in FP

4. DISCUSSION AND CONCLUSION

REFERENCES

Abstract

Men are partners in reproduction and sexuality. It is therefore required that both men and women equally share satisfying sexual lives and the burden of preventing diseases and health complications. This paper studies the status of male active participants in family planning in Bangladesh and further explores the associated determinants. The study makes use of Bangladesh Demographic Health Survey, 2007 data (BDHS-2007). Bivariate analysis shows that age of the respondent, age of the partner, family type, respondent’s desire for more children, partners’ desire for more children, discuss FP with partner, education of the respondent, education of the partner and division are significantly associated with active participation of male in family planning. Logistic regression analysis identifies four significant determinants of active participation of male in family planning which are age of the respondent, age of the partner, education of the partner and discuss family planning with partner.

Key words: Male Participation , Family Planning

1. INTRODUCTION

Male’s involvement in family planning is defined as the men’s decision regarding reproductive health issues viz., reproductive rights of women, fertility and its control through direct participation in family planning. Both male and female involvement on fertility and reproductive health was the key message in 1994 International Conference on Population and Development and Fourth World Conference (1995) on Women. It is argued that men are partners in reproduction and sexuality, and therefore it is logical that they equally share satisfying sexual lives and the burden of preventing diseases and health complications (Green et al., 1995). A number of researchers have identified that men are directly responsible for preventing pregnancy through coital-dependent methods such as condoms, withdrawal and periodic abstinence (Greene and Biddlecom, 2000). Historically, the traditional method withdrawal (coitus interrupts) has been used as a contraceptive method since ancient time (PA1, 1991). And use of condom dates back to 400 years (Ross and Frankenberg, 1993). Worldwide, one-third of the eligible couples using family planning rely on methods (vasectomy, condom, withdrawal and periodic abstinence) which require full male co-operation (Hossain, 2003). Men’s acceptance of vasectomy and condoms were found numerous, reflecting the public health problem of sexually transmitted diseases (Bertrand et al.1989; Grady et al.,1993; Greene and Biddlecom, 2000; Ringheim, 1993; Ross and Huber, 1983). Kondel and Pramualratana (1996) conducted a study in Thailand and revealed that while men may think condom use is good in general; their views of actually using condom in sexual relation with spouses may be negative because of the association between condoms and promiscuity, disease and commercial sex. Studies in Uganda and Tanzania reveals little support among men for condom use within marriage (Blance et al., 1996; Pool et al., 1996).

By virtue of tradition and associated social factors, men in China have an active influence upon decisions about which method of contraception will be used in the family. Yunnan and Jilin provinces in 1992 suggested that, in Sichuan province 34 percent of all contraceptive acceptors relied upon male sterilization and 4 percent upon condom (Anonymous, 1995). Low level of male involvement in use of contraceptives is influenced by a misconception about family planning (Akafuah and Sossou, 2008). One of the main findings of this study was that increasing people’s knowledge, changing attitudes, practices of family planning and reproductive decision-making can be influenced by exposure to mass-media education. Demographic factors, religion, education, types of marital relationship can also have positive impact in this regard. Another finding of the study is that the people’s lack of knowledge causes socio-cultural misconceptions. Lack of education is the reason cited for not using various family planning methods (Akafuah and Sossou, 2008).

Bangladesh spousal communication is poor and this often makes it difficult for men to understand the reproductive health problems of women. Prevailing culture and myth do not allow men to visit health facilities with their wives. Husbands do not feel comfortable taking their wives to a health facility because they do not like to discuss sexual and reproductive health issues with the service providers (Kabir and Shahjahan 2007).

Men can actively participate in family planning by using any methods viz. condom, male sterilization, periodic abstinence and withdrawal. According to BDHS 2007 the rate of condom user, male sterilization, withdrawal and periodic abstinence are 4.5 percent, 0.7 percent, 2.9 percent and 4.9 percent respectively. Men active participation in family planning is now a growing substance of study. The participation of male in contraception is widely varies with the variation in some socio-economic and demographic characteristic Ghafur and Tehmina, 2005, Islam et el 2005; Olawepo and Oledare, 2006). Therefore this study makes an attempt to find the differential of male active participation in family planning and try to identify the influencing factors that contribute in male participation in family planning activities in Bangladesh.

2. DATA AND METHODOLOGY

The study utilized the matched sample of 3771 husbands with their wives who have participated in the BDHS 2007. The BDHS-2007 survey was conducted under the authority of the National Institute for Population Research and Training (NIPORT) of the Ministry of Health and Family Welfare. Mitra and Associates executed the survey with the technical assistance from ORC Macro and financial support from USAID (NIPORT et al., 2005). The variables that are significantly associated with the active participation examined using bivariate analyses are further explored using binary logistic regression techniques. The dependent variable in the logistic regression analysis is ‘Active participation of male’. The variable takes the value ‘one’ if respondents actively participating in family planning by using any of the method viz, condom, male sterilization, withdrawal and periodic abstinence. And ‘zero’ otherwise. The study has dealt with a large number of explanatory variables such as age of the respondent, age of the partner, respondent’s age at first marriage, marital duration, ideal number of boys, ideal number of girls, ideal number of children, family type, ideal family size, number of living children, respondent’s desire for more children, partner’s desire for more children, discuss FP with partner, respondent approves FP, current working status of partner, religion, education of the respondent, respondent’s occupation, place of residence and exposure to mass media.

3. RESULTS

The participation of male in Family planning method is very low in Bangladesh. Though contraceptive prevalence rate is high (55.8 %) in Bangladesh (BDHS, 2007) but by utilizing the BDHS, 2007 data we find that only ten percentage male actively participate in family planning in Bangladesh (Table 1). Fears among men about losing control; lack of political commitment; policy barriers (strict eligibility criteria for vasectomy); provider bias (programs oriented toward women); and inadequate information may lag behind men from family planning (Green et. al., 1995). Partner support is a significant predictor of the likelihood that women will attempt to use a contraceptive method (Burwell, 1996; Green, 1994). Providing men with information and involving them in counseling sessions can help them supportive of contraceptive use and more aware of the concept of sharing decision making (Wells, 1997).

Table 1: Active Participation of Male in FP: BDHS 2007

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3.1 Differentials in active participation of male in family planning

Differentials in active participation of male in family planning are examined here in order to find the significant factors, which influence contraceptive behaviour. Our study finds active participation of male has significant association with age of the respondent and age of partner. We observed that active participation is the lowest among males whose age above 45 years (8.4 %) and as the partners age increase the participation of male also increases (Table 2). The participation does not associated with respondent’s age at first marriage, marital duration, ideal number of boys, ideal number of girls, ideal number of children, ideal family size, number of living children, respondent approves FP, current use of contraceptives, religion, education of the respondent, respondent’s occupation, place of residence and exposure to mass media.

Family type significantly associated with active participation of male in family planning. It is found that active participation is higher (10.8%) in nuclear family than in extended family (8.5%). Higher participation is viewed who are undecided and partners want no more children. Among those who actively participated in FP 16% of them discuss FP with partner. Though respondent education does not significantly associated but with the increase in the level of partners education respondents participation increase (Table3.2).

A ctive participation differs significantly within the regions. The rate of participation is the highest in Chittagong division (13.6 percent). Sylhet appeared as low performing region of contraceptive use in various studies (Kamal, 2008; Khan and Raeside, 1998; Mannan and Beaujot, 2006) but the rate of male active participation in Sylhet region is higher (10.0%) than Dhaka (7.5%) and Khulna (6.6%) (Table 2)

Table 2: Distribution of Active Participation of Male in FP According to Background Characteristics: BDHS 2007

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