Male Involvement in Family Planning &
Reproductive Health in Rural Central India
By Arundhati Char
Tampere University Press
Distributed by Coronet Books Inc.
$87.50 Paper original
Male involvement in reproductive health and family planning has recently been understood as an important area among reproductive health programme designers, policy makers, and population researchers for the overall reproductive well-being of the couple. Non-involvement of males in such areas contributes to major initiatives failing to achieve their desired objectives. To implement effective programmes to include men, it is therefore essential to first understand whether men are at all interested to be part of reproductive health programmes, and the barriers that they face while accessing services and how best can these be overcome. Despite almost two decades since the call to involve men actively in such programmes, men still feel ignored or are missing from such initiatives in India and other developing societies.
The present study was conducted in rural central India in the state of Madhya Pradesh and the overall objective of this research was to examine men’s family planning and reproductive health needs and constraints in an ideologically patriarchal and patrilineal society. The study investigated major factors that hindered men from seeking reproductive health information and services for enhancing their own and their partner’s reproductive health situation.
A mixed-methods approach was used, with a combination of qualitative focus group discussions and in-depth interviews, and quantitative Knowledge, Attitude, Practice surveys among different primary and secondary subjects. The primary research subjects were currently married (with wives in the reproductive age group of 15–45 years) and unmarried (aged 17–22 years) men. Secondary audiences included the mothers-in-law, wives of married men and the health care providers in rural India. This thesis is a compilation of four sub-studies.
Sub-study I analysed male conceptualisation and perceptions of family planning, paying special attention to male knowledge, decision making and reliance on female sterilisation. A total of seven focus group discussions and 793 structured interviews among a representative sample of currently married men constituted this study.
In sub-study II, intra-family relationships and communication, and their influence on choice of contraceptive method and timing of use were discussed. Family ‘triad’ interviews were conducted among currently married men, their wives aged 15–45 years, and their mothers. A total of 60 family triads were conducted using in-depth interviews.
Sub-study III assessed the accessibility of reproductive health information and services, and analysed the vulnerabilities of young, unmarried men aged 17 to 22 years. Four focus group discussions and 316 structured interviews in a representative sample were conducted among this group of respondents.
Sub-study IV examined the extent, motivation and prevalence of village-level health workers’ interaction with men concerning reproductive health issues in rural central India and studied the existing public health care system and the reasons for the non-involvement of men in reproductive health care information and services.
A total of 52 in-depth interviews among a range of rural health care providers were conducted.
The study results bring out the following: a. Men conceptualised family planning to mean female sterilisation while contraception connoted spacing methods, and pointed to a clear male preference for female sterilisation as the preferred family planning method. b. The mother-in-law’s role with regard to female sterilisation acceptance by the daughter-in-law continued to pre-dominate. However, her role with regard to couple’s decision to accept reversible methods had considerably reduced. c. Young unmarried men lacked information on reproductive health issues and access to condoms, even in their own settings. d. Men felt ignored by the government health care providers who were yet not oriented towards involving men in reproductive health and family planning services.
The results indicated that men were indeed interested and willing to be part of the broader reproductive health programme. However, they lacked sufficient knowledge to accomplish the same. Also, they lacked information and access to specific family planning services, for example, inter-personal discussions with health care providers on sexual and reproductive health.
While government policies are in place to encourage male involvement in reproductive health, these policies have failed to be put in practice. A set of guiding principles needs to be developed to support those involved in the health sector to mainstream male involvement into reproductive health strategies in India and in comparable Eurasian developing societies.
Acta Universitatis Tamperensis No. 1687
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