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Men’s Involvement in Wives’ Contraceptive Choices: A Comparative Study in Rural and Urban Communities of Akure South Local Government Area

Received: 1 June 2024    Accepted: 21 June 2024    Published: 26 June 2024
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Abstract

In rural Nigerian communities, men play a crucial role in family planning decisions, often determining if and how their wives can practice contraception. This study aimed to examine the extent of husbands' influence on their wives' contraceptive choices, comparing rural and urban areas in Akure South local government area. The research included a sample of 360 men, using a researcher-developed questionnaire and interview guide for data collection. Descriptive statistics such as frequencies, percentages, means, and standard deviations were used to analyze the data, and chi-square inferential statistics tested the hypothesis at a 0.05 significance level using SPSS version 17. Findings revealed that only 46% of rural respondents participated in family planning practices. Men’s engagement in these activities showed low mean values (2.21, 2.11, 2.25), indicating minimal involvement, primarily due to lack of information (40.5%) and limited contraceptive options (34.8%). Most men used condoms (23.8%), a combination of condoms and withdrawal (27.5%), or vasectomy (13.1%). The study concluded that male participation in family planning was low. To improve this, communities need better access to information, education, and communication. Cultural and religious barriers hindering male involvement in family planning should be addressed, and more male contraceptive options should be made available.

Published in World Journal of Public Health (Volume 9, Issue 2)
DOI 10.11648/j.wjph.20240902.20
Page(s) 199-205
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Contraceptives, Rural and Urban Communities, Men’s Involvement

1. Introduction
Globally, 190 million adolescent girls and women of reproductive age have an unmet need for contraception, affecting 10% of the population in need . This unmet need, defined as the gap between women's reproductive intentions and their contraceptive use , results in significant setbacks in ensuring positive reproductive health outcomes. Contraception, essential for effective family planning, includes modern and traditional methods such as oral contraceptives, implants, IUDs, and the rhythm method . However, a substantial unmet need persists due to factors like limited access to modern contraceptives, particularly for adolescents and unmarried women, cultural and religious restrictions, fear of side effects, and provider bias .
The framing of contraception primarily as a family planning resource for couples often excludes unmarried and adolescent girls seeking to prevent pregnancy or manage menstrual health. This exclusion leads to stigma and higher unmet needs among younger women . Additionally, religious beliefs significantly influence cultural norms about contraception, contributing to the global unmet need. Religions such as Catholicism, Christianity, Judaism, and Islam often discourage premarital sex and contraceptive use, leading to shame and reluctance among women and girls to seek contraception . Healthcare providers' personal beliefs can also affect their willingness to provide contraceptives . Misconceptions and lack of education about contraceptives further exacerbate fears of side effects, despite serious side effects being rare. Accurate reproductive health education, as advocated by Hennegan et al. , is crucial to improving contraceptive knowledge and usage.
High unmet contraceptive needs are linked to negative health outcomes, including high maternal mortality rates. Maternal mortality, defined as the death of a woman during pregnancy or within 42 days of termination due to pregnancy-related causes , predominantly occurs in low- and middle-income countries (LMICs), particularly in sub-Saharan Africa and South Asia . Over 300,000 women die annually from pregnancy and childbirth complications, with a global maternal mortality ratio (MMR) of 216 deaths per 100,000 live births . Adolescent pregnancies significantly contribute to these statistics, being the leading cause of death among adolescents aged 15-19 and often resulting in unsafe abortions due to restricted access to services . These pregnancies also negatively impact infant mortality rates and disrupt educational and economic prospects for adolescent mothers .
In Nigeria, a country with a projected population growth from 183 million to 285 million by 2050, there are about 35 million women of reproductive age, contributing to over 7 million births annually. The country’s high fertility rate of 5.5 children per woman, coupled with significant economic challenges, exacerbates health issues. Nigeria's maternal mortality rate is high, with 145 deaths per 100,000 live births, and infant mortality stands at 78 per 1,000 live births . A woman's risk of dying from pregnancy and childbirth in Nigeria is as high as 1 in 13 , partly due to the low contraceptive prevalence rate.
Despite global recognition of the importance of male involvement in family planning, Nigerian programs largely focus on women, neglecting the significant role men can play. Men’s participation is crucial, either as users of male contraceptive methods or as supportive partners . This is particularly relevant in rural areas like Akure, where traditional and cultural norms heavily influence family planning decisions. Rural communities often resist change, and men exercise considerable control over reproductive health decisions . Addressing these cultural and educational barriers is essential for improving family planning acceptance and reproductive health outcomes in these communities.
2. Materials and Methods
2.1. Study Design
This study employs a cross-sectional descriptive design to collect both quantitative and qualitative data. Cross-sectional designs are useful in observing and analyzing the current status of variables within a population at a single point in time, facilitating the understanding of prevalent conditions and behaviors. This design is particularly suitable for this study as it aims to assess the influence of male participation in family planning practices among married men in Akure South local government area. The descriptive nature of the design allows for detailed documentation and analysis of the existing attitudes, knowledge, and practices related to family planning.
2.2. Sampling Technique
A simple random sampling technique will be utilized to select the study participants. This method ensures that every member of the target population has an equal chance of being included, thereby minimizing selection bias and enhancing the representativeness of the sample. The target population comprises married men living with their wives and having at least one child within Akure South local government area. The local government area is divided into 15 districts, from which a sample size of 360 respondents will be drawn. This sample size is considered adequate to provide reliable and valid data for the study's objectives.
2.3. Data Collection
Data collection will involve both questionnaires and interviews to gather comprehensive information. Structured questionnaires will be distributed to the selected sample of married men. The questionnaires will include a series of closed-ended questions designed to elicit specific responses about family planning knowledge, attitudes, and practices. A total of 360 questionnaires will be distributed across the 15 districts within Akure South local government area. To accommodate respondents who may be illiterate, trained interviewers will assist in administering the questionnaires orally, ensuring accurate and complete data collection. In addition to questionnaires, in-depth interviews will be conducted with a subset of respondents. These interviews will focus on exploring subjective experiences and perceptions related to contraceptive use and family planning. The combination of quantitative data from questionnaires and qualitative data from interviews will provide a well-rounded understanding of the factors influencing family planning practices in the study area.
2.4. Ethical Consideration
Ethical considerations are paramount in this study to ensure the rights and well-being of participants are protected. Approval for the study will be sought from the relevant ethical review board. Informed consent will be obtained from all participants prior to data collection. Participants will be fully informed about the purpose of the study, the procedures involved, and their right to withdraw at any time without any penalty. Confidentiality will be strictly maintained, with data anonymized to protect the identities of the respondents. The study will also adhere to ethical principles regarding data handling and reporting. Data will be securely stored, and access will be limited to the research team. Findings will be reported in an aggregated manner to prevent the identification of individual participants. By adhering to these ethical guidelines, the study aims to maintain high standards of integrity and respect for the participants' dignity and autonomy.
3. Results
3.1. Socio Demographic Characteristic of the Respondents
Table 1 revealed that 75 respondents (21.6%), 84 respondents (24.1%), and 189 respondents (54.3%) were between the ages of 30 and 49. Additionally, 54 respondents (15.5%) had no formal education, 42 (12.1%) completed primary education, 93 (26.7%) completed secondary education, and 159 (45.7%) completed tertiary education. The occupations of the men were as follows: 78 (22.4%) farmers, 62 (17.8%) traders, 196 (56.3%) public servants, and 12 (3.4%) artisans. The majority of the men were Christians (87.9%), followed by Muslims (18.2%) and traditionalists (6.9%).
Table 1. Socio demographic characteristic of the respondents.

Gender

Frequency

Percentage

Age range

20-29

-

-

30-39

84

24.1

40-49

75

21.6

50& above

189

54.3

Mean age = 45.2 yrs

Level of education

No formal education

54

15.5

Primary education

42

12.1

Secondary education

93

26.7

Tertiary education

159

45.7

Occupation

Farming

78

22.4

Trading

62

17.8

Public servant

196

56.3

Artisan (plumber, electricians)

12

3.4

Religion

Christianity

306

87.9

Moslem

18

5.2

Traditional religion

24

6.9

3.2. Proportion of Men Engage in Family Planning
Table 2 reveals that 188 (54%) of the men do not now use family planning, whereas 160 (46%) of them do. In the communities, less than 50% of the men use family planning.
Table 2. Respondents responses to the percentage of men who get involved in practicing family planning.

Are you currently involved in family planning

Frequency

Percentage

Yes

160

46

No

188

54

Total

348

100

3.3. Men's Engagement in Their Spouse Contraception Decisions
Table 3 shows that 32 respondents (9.2%) strongly disagree that cultural ignorance affects men's involvement in family planning, while 148 (42.5%) strongly agree, 118 (33.9%) agree, and 50 (14.4%) disagree. The low standard deviation of 1.26 and high mean value of 3.10 indicate limited diversity of replies and a majority agreement. Regarding the lack of contraceptive methods, 35 respondents (10.1%) strongly agree, 141 (40.1%) agree, 126 (36.2%) strongly agree, and 46 (13.2%) disagree. The low standard deviation of 1.27 and high mean value of 3.03 again indicate limited response diversity and a majority agreement. For the lack of male-specific family planning facilities, 109 (31.3%) strongly disagree, 103 (29.6%) disagree, 81 (23.3%) agree, and 55 (15.8%) strongly agree. The low mean value of 2.24 and small standard deviation of 1.45 suggest more respondents disagree. On poor IEC as a factor, 74 respondents (21.3%) strongly disagree, 67 (19.3%) disagree, 128 (36.8%) agree, and 79 (22.7%) strongly agree. The mean value of 2.61 and standard deviation of 1.33 indicate more respondents agree. Regarding religious views, 87 respondents (25.0%) strongly agree, 80 (23.0%) strongly disagree, 62 (17.8%) disagree, and 119 (34.2%) agree. The mean value of 2.61 and standard deviation of 1.33 reveal a tendency towards agreement. For cultural impact, 62 respondents (17.8%) strongly disagree, 68 (19.5%) disagree, 106 agree, and 112 strongly agree. The high mean value of 2.77 and standard deviation of 1.52 indicate more agreement. On economic concerns, 81 respondents (23.3%) strongly disagree, 87 (25.0%) disagree, 109 (31.3%) agree, and 71 (20.4%) strongly agree. The mean value of 2.49 and standard deviation of 1.49 suggest more disagreement. Regarding spousal influence, 88 respondents (25.3%) strongly disagree, 39 (11.2%) disagree, 120 (34.5%) agree, and 101 (29.0%) strongly agree. The mean value of 2.67 and standard deviation of 1.45 indicate more agreement. Lastly, on provider availability, 105 respondents (30.2%) strongly disagree, 114 (32.8%) disagree, 73 (21.0%) agree, and 56 (16.1%) strongly agree. The mean value of 2.23 and standard deviation of 1.37 suggest more disagreement. Overall, a high mean value of 2.64 indicates these factors determine their participation.
Table 3. Respondents response to aspects of men's engagement in their spouse’s contraception decisions.

SN

Factors

Strongly Agree

Agree

Disagree

Strongly Disagree

Mean

1

Inadequate knowledge

148

42.5%

118

33.9%

50

14.4%

32

9.2%

3.10 ± 1.26

2

Lack of contraceptive for men

126

36.2%

141

40.1%

46

13.2%

35

10.1%

3.03 ± 1.27

3

Lack of exclusive family planning for men

55

15.8%

81

23.3%

103

29.6%

109

31.3%

2.24 ± 1.45

4

Poor IEC

79

22.7%

128

36.8%

67

19.3%

74

21.1%

2.61 ± 1.33

5

Religious belief

87

25.0%

119

34.2%

62

17.8%

80

23.0%

2.61 ± 1.32

6

culture

112

32.2%

106

30.5%

68

19.5%

62

17.8%

2.77 ± 1.52

7

Economic concern

71

20.4%

109

31.3%

87

25.0%

81

23.0%

2.49 ± 1.49

8

Spouse influence

101

29.0%

120

34.5%

39

11.2%

88

25.3%

2.67± 1.45

9

Provider availability

56

16.1%

71

21.0%

11.4

32.8%

105

30.2%

2.23 ± 1.37

Overall mean

2.64

3.4. Role Men Play in Family Planning
According to Table 4, 68 (19.5%) and 54 (15.4%) of the men use contraceptives significantly, while 92 (26.4%) use them moderately, and 134 (38.5%) use them extensively. The high average of 2.83 and low standard deviation of 1.53 indicate extensive contraceptive use with little variation in responses. Additionally, 88 (25.3%) and 126 (36.2%) of respondents provide very low or low support for their spouse's use of family planning, with only 64 (18.4%) supporting it highly and 70 (20.1%) moderately. The low mean value of 2.21 and standard deviation of 1.55 indicate low support and little response variability. Decision-making about contraceptive use is very low for 50 (14.4%) respondents, low for 54 (15.5%), moderate for 129 (37.1%), and high for 115 (33%), with a high mean value of 2.89 and low standard deviation of 1.38 indicating significant decision-making involvement. Regarding open discussion of family planning, 59 (17.0%) engage highly, 66 (19.0%) moderately, and 110 (31.6%) very lowly, with a low mean value of 2.21 and standard deviation of 1.46 indicating low discussion levels. Accompanying spouses to family planning facilities is very low for 130 (37.4%) respondents, low for 117 (33.6%), moderate for 33 (9.5%), and high for 68 (19.5%), with a mean value of 2.11 and standard deviation of 1.52 indicating low accompaniment levels. Finally, 104 (29.9%) give money for family planning to a very low extent, 114 (32.8%) to a low extent, 68 (19.5%) to a moderate extent, and 62 (17.8%) to a high extent, with a mean value of 2.25 and standard deviation of 1.46 indicating low financial support. Overall, the mean value of 2.42 indicates poor involvement generally.
Table 4. Showing the kind of role men plays in family planning.

SN

Items

Highly extent

Moderate extent

Low extent

Very low extent

Mean + SD

1

I use contraceptive method

134

38.5%

92

26.4%

54

15.4%

68

19.5%

2.83 ± 1.53

2

I support my wife to use a family planning method

64

18.4%

70

20.1%

88

25.3%

126

36.2%

2.21 ± 1.55

3

I decide in favour of contraceptive use and continuity within the family

115

33.0%

129

37.1%

54

15.5%

50

14.4%

2.89 ± 1.38

4

I discuss family planning freely with my wife

59

17.0%

66

19.0%

113

32.5%

110

31.6%

2.21 ± 1.46

5

I accompany my wife to the facilities to obtain family planning services

68

19.5%

33

9.5%

117

33.6%

130

37.4%

2.11 ± 1.52

6

I give my wife money for family planning

62

17.8%

68

19.5%

114

32.8%

104

29.9%

2.25 ± 1.46

Over all mean

2.42

3.5. Type of Family Planning Male Population in the Communities Under Study Prefer
Table 5 shows that out of 160 men who are currently involved in family planning, 38 (23.8%) use only condom, 21 (13.1%) use only vasectomy, 111 (31.9%) use only withdrawal while 44 (27.5%) use both condom and withdrawal methods of family planning.
Table 5. Respondents responses to the methods of family planning adopted mostly by men in these communities.

Which of the following family planning methods do you use

Frequency

Percentages

Condom only

38

23.8

Vasectomy only

21

13.1

Withdrawal only

57

35.6

Both condom & withdrawal

44

27.5

Total currently using

160

100

4. Discussion
4.1. To Determine the Percentage of Men Involved in Practicing Family Planning in the Communities Studied
The findings showed that 46% of men engage in family planning, indicating that less than half of the respondents participate in family planning within their communities. This result aligns with Hossain's study in Bangladesh, which reported a low male engagement rate (40%). Conversely, studies in India and Ilorin revealed higher rates of male participation at 65.9% and 58%, respectively.
4.2. To Identify Factors Affecting Men’s Involvement in Family Planning in These Communities
The study identified several factors influencing men's engagement in family planning: limited awareness, few male contraceptive options, poor information, education, and communication (IEC), cultural and religious beliefs, financial concerns, and spousal influence. Nustas found spousal impact significant in Jordan, noting that men who discuss contraception with their wives are more likely to use family planning. Akafuah and Sossou similarly linked spousal communication with contraceptive use. Hossain highlighted that urban men have better access to contraceptives. Bunce et al. in Jordan both found financial difficulties to be a significant motivator for using family planning methods. Religious affiliation also influenced participation, as noted by Gueye et al., , who observed persistent myths about family planning among Tanzanian men, particularly regarding vasectomy.
4.3. To Identify the Nature of Men’s Involvement in family Planning
The findings revealed that 35.3% of men make decisions supporting contraceptive use and family continuity, while 24.7% use contraceptives extensively. However, few men actively encourage their partners to use family planning methods, discuss family planning openly, accompany partners to family planning facilities, or financially support their partners. This suggests limited male involvement in contraception. The results are consistent with Sabir et al., who noted that in Bangladesh, men often decide on family planning. Hossain (19) reported a 62.6% contraceptive use rate among Turkish men, similar to findings from Onuoha (18) in Zimbabwe.
4.4. To Identify Methods Mostly Adopted by Men in the Communities Studied
The findings indicated that withdrawal, condoms, and vasectomy are the most commonly used family planning methods among men. This is consistent with Puri et al. in Chandigarh, India, where 31% of men use condoms. Hossain reported low withdrawal method usage (26.2%) in Turkey, while Olawepo and Okedare found withdrawal and vasectomy to be among the least popular methods in Ilorin.
5. Conclusions
In conclusion, improving family planning programming to better involve men is essential for increasing voluntary uptake among couples, particularly in West Africa, where national goals aim to reach new modern contraceptive users by 2020. Engaging men in family planning not only enhances contraceptive use but also promotes gender equality, as men play a crucial role in decision-making and can act as agents of change. Current programs often exclude men, neglecting their need for collaborative decision-making. Addressing this gap requires understanding men's concerns, misconceptions, and roles in family planning decisions. Programs that encourage joint counseling by community health workers or trusted couples can build trust and facilitate communication. Future research should focus on the practices, attitudes, and motivations that enable men to engage in family planning, integrating these insights into programs and campaigns. Additionally, introducing new male contraceptive methods, ensuring reliable supplies of male condoms, incorporating family planning into formal education, and encouraging men to discuss family planning with their partners can significantly enhance male participation and overall contraceptive use.
Abbreviations

SPSS

Statistical Package for Social Sciences

LMIC

Low- and Middle-Income Countries

MMR

Maternal Mortality Ratio

LGA

Local Government Area

IEC

Information, Education and Communication

Conflicts of Interest
The authors declare no conflicts of interest.
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Cite This Article
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    Daniel, E. O., Olawale, O. O., Bello, A. M., Popoola, I. O., Alewi, O. O., et al. (2024). Men’s Involvement in Wives’ Contraceptive Choices: A Comparative Study in Rural and Urban Communities of Akure South Local Government Area. World Journal of Public Health, 9(2), 199-205. https://doi.org/10.11648/j.wjph.20240902.20

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    Daniel, E. O.; Olawale, O. O.; Bello, A. M.; Popoola, I. O.; Alewi, O. O., et al. Men’s Involvement in Wives’ Contraceptive Choices: A Comparative Study in Rural and Urban Communities of Akure South Local Government Area. World J. Public Health 2024, 9(2), 199-205. doi: 10.11648/j.wjph.20240902.20

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    AMA Style

    Daniel EO, Olawale OO, Bello AM, Popoola IO, Alewi OO, et al. Men’s Involvement in Wives’ Contraceptive Choices: A Comparative Study in Rural and Urban Communities of Akure South Local Government Area. World J Public Health. 2024;9(2):199-205. doi: 10.11648/j.wjph.20240902.20

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  • @article{10.11648/j.wjph.20240902.20,
      author = {Ebenezer Obi Daniel and Oluseyi Oludamilola Olawale and Ahmed Mamuda Bello and Israel Olukayode Popoola and Olukayode Oladeji Alewi and Michael Olabode Tomori and Michael Avwerhota and Adebanke Adetutu Ogun and Taiwo Aderemi Popoola and Aisha Oluwakemi Salami and Celestine Emeka Ekwuluo},
      title = {Men’s Involvement in Wives’ Contraceptive Choices: A Comparative Study in Rural and Urban Communities of Akure South Local Government Area
    },
      journal = {World Journal of Public Health},
      volume = {9},
      number = {2},
      pages = {199-205},
      doi = {10.11648/j.wjph.20240902.20},
      url = {https://doi.org/10.11648/j.wjph.20240902.20},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20240902.20},
      abstract = {In rural Nigerian communities, men play a crucial role in family planning decisions, often determining if and how their wives can practice contraception. This study aimed to examine the extent of husbands' influence on their wives' contraceptive choices, comparing rural and urban areas in Akure South local government area. The research included a sample of 360 men, using a researcher-developed questionnaire and interview guide for data collection. Descriptive statistics such as frequencies, percentages, means, and standard deviations were used to analyze the data, and chi-square inferential statistics tested the hypothesis at a 0.05 significance level using SPSS version 17. Findings revealed that only 46% of rural respondents participated in family planning practices. Men’s engagement in these activities showed low mean values (2.21, 2.11, 2.25), indicating minimal involvement, primarily due to lack of information (40.5%) and limited contraceptive options (34.8%). Most men used condoms (23.8%), a combination of condoms and withdrawal (27.5%), or vasectomy (13.1%). The study concluded that male participation in family planning was low. To improve this, communities need better access to information, education, and communication. Cultural and religious barriers hindering male involvement in family planning should be addressed, and more male contraceptive options should be made available.
    },
     year = {2024}
    }
    

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  • TY  - JOUR
    T1  - Men’s Involvement in Wives’ Contraceptive Choices: A Comparative Study in Rural and Urban Communities of Akure South Local Government Area
    
    AU  - Ebenezer Obi Daniel
    AU  - Oluseyi Oludamilola Olawale
    AU  - Ahmed Mamuda Bello
    AU  - Israel Olukayode Popoola
    AU  - Olukayode Oladeji Alewi
    AU  - Michael Olabode Tomori
    AU  - Michael Avwerhota
    AU  - Adebanke Adetutu Ogun
    AU  - Taiwo Aderemi Popoola
    AU  - Aisha Oluwakemi Salami
    AU  - Celestine Emeka Ekwuluo
    Y1  - 2024/06/26
    PY  - 2024
    N1  - https://doi.org/10.11648/j.wjph.20240902.20
    DO  - 10.11648/j.wjph.20240902.20
    T2  - World Journal of Public Health
    JF  - World Journal of Public Health
    JO  - World Journal of Public Health
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    EP  - 205
    PB  - Science Publishing Group
    SN  - 2637-6059
    UR  - https://doi.org/10.11648/j.wjph.20240902.20
    AB  - In rural Nigerian communities, men play a crucial role in family planning decisions, often determining if and how their wives can practice contraception. This study aimed to examine the extent of husbands' influence on their wives' contraceptive choices, comparing rural and urban areas in Akure South local government area. The research included a sample of 360 men, using a researcher-developed questionnaire and interview guide for data collection. Descriptive statistics such as frequencies, percentages, means, and standard deviations were used to analyze the data, and chi-square inferential statistics tested the hypothesis at a 0.05 significance level using SPSS version 17. Findings revealed that only 46% of rural respondents participated in family planning practices. Men’s engagement in these activities showed low mean values (2.21, 2.11, 2.25), indicating minimal involvement, primarily due to lack of information (40.5%) and limited contraceptive options (34.8%). Most men used condoms (23.8%), a combination of condoms and withdrawal (27.5%), or vasectomy (13.1%). The study concluded that male participation in family planning was low. To improve this, communities need better access to information, education, and communication. Cultural and religious barriers hindering male involvement in family planning should be addressed, and more male contraceptive options should be made available.
    
    VL  - 9
    IS  - 2
    ER  - 

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    1. 1. Introduction
    2. 2. Materials and Methods
    3. 3. Results
    4. 4. Discussion
    5. 5. Conclusions
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