MALE INVOLVEMENT IN FAMILY PLANNING IN SOME SELECTED RURAL COMMUNITIES

ABSTRACT
 
Men involvement in family planning would increase its recognition, acceptance and practice by people especially within the rural communities.  This is because in rural communities in Nigeria including Enugu, men are still the gate keepers in our families who control power and major decision making.  Some of them decide whether their wives will practice family planning or not and the methods to be adopted.    This implies the men seem to have the finally say on the number of children the family should have, the spacing, maternal health and general level of reproductive health in the family.    In Nigeria male involvement in family planning from previous studies is low, pregnancy and delivery problems are treated as women affair. Though men do not carry pregnancy, they are the initiators of the process and therefore should be involved in family planning for better success. The purpose of the study was to examine Male involvement in family planning in some selected rural communities in Enugu East Local Government Area in Enugu State, Nigeria.  The target population of the study were 3320 men.  Sample size was 360 men. The instrument for data collection was a researcher developed questionnaire which was also used as an interview guide for illiterate subjects.  Data were analysed using descriptive statistics such as frequencies, percentages, mean and standard deviation.  Statistical analyses was done using the statistical Package for Social Sciences (SPSS) version 17.  Chi-square inferential statistics was used for testing the hypothesis at 0.05 level of significance. Results showed there was a significant association between male involvement in family planning and socio demographic variables (age, educational level, occupation and religion).  Other findings revealed that less than half of the respondents (46%) got involved in family planning practice in the rural communities studied.  There were low mean response values of 2.21, 2.11 and 2.25 to the nature of men’s involvement in family planning. The main factors that affected their involvement were inadequate knowledge (40.5%), lack of many contraceptives options (34.8%).  Most of the men used withdrawal method (35.5%) or condom (23.8%) and a combination of withdrawal and condom (27.5%) while (13.1%) use vasectomy.  The study concluded that men’s involvement in family planning was low in the communities studied.  Adequate information, education and communication is needed in the communities to improve their knowledge. Some cultural and religious beliefs that hinder men’s involvement in family planning should be discouraged.  More male contraceptive options should be promoted as well as made available.
 
 
 
 
 
 
 
 
 
CHAPTER ONE
INTRODUCTION
Background to the Study
Family planning is a way of thinking and living that is adopted voluntarily on the basis of knowledge, attitude and responsible decision by individuals and couples in order to promote health and welfare of the family, groups and thus contribute effectively to the social development of the country (WHO, 2011).It involves practices that will enable couples or individuals to determine the number of children they would like to have, when to have them, that is both the timing and spacing and most importantly, those they have the capability or the means with to cater for. (Fumilayo and Kolawole, 2000).
 
Men are pivotal decision makers at all household level within the rural communities.  The duty of men in the society seems supreme; especially in rural communities they are in charge of the family, they run the world governments, they control religious organizations and they co-ordinate all social systems. (Okeke, 2005).  Furthermore, they play vital role in pregnancy and delivery and transmission of sexually transmitted infections.   Onuoha (2000) stated that African men are mainly responsible for deciding whether their wives will practice family planning and the methods to be adopted.  He further stated that the true position is that in traditional African societies, including Nigeria, men are conferred with authority to determine who gets what, how and when in the family. This authority implies that they have the final say on the number of children the family should have, the spacing, maternal health and general level of reproductive health in the family. Thus any family planning programme that excludes men is may to have  minimal impact on the targeted population.
 
Male involvement in family planning would increase its recognition, acceptance and practice by people especially within the rural communities. This is because in rural communities in Nigeria, including Enugu, men are still the gate keepers in the families who control power and decision making. Their involvement will  help to achieve huge success in the numerous campaigns aimed at reducing, population explosion in Africa, arrest the increasing surge of sexually transmitted infections and reduce maternal and infant morbidity and mortality (Onuoha, 2000).
 
In European countries, statistics show that an average of 65% of men go for family planning yearly. In America about 70% of males go for treatment of sexually related infections like HIV/AIDS yearly due to awareness campaigns about the importance of involving men in family planning (Davidson, 1999).In African countries, for example in South Africa, about 35% of the people that attend family planning and immunization clinics are males. In Togo, it was noted that male involvement in family planning and voluntary health screening and counseling compared with the females is in the ratio of 1:3 (Robert and Brown, 2000).
 
Despite global recognition of the importance of male involvement in family planning, Nigeria has not developed programmes in family planning that fully involve men.  Most family planning programmes in our environment seem to focus on women only, the non- inclusion of men in various family planning programmes by program planners has made men not to know much about family planning and the benefits to their spouses and family especially in rural communities. Yet men can participate in family planning either as users of male methods or as supportive partners of users. (Fumilayo and Kolawole, 2000).
 
With the above scenario, one wonders what then will be the situation in rural communities in Enugu East Local Government Area where tradition is still highly upheld. Rural communities have typical characteristics such as: they share common interest, bound or tied to tradition and culture, resist change among others. These make men exercise undue authority or control over their wives in family matters such as issues of child bearing and contraceptive use. All these seem to make the acceptance of family planning more difficult in these rural communities (Onuoha, 2000).
Therefore, it is very important to get them involved in family planning  in order to achieve better success. This will improve health of both themselves and their spouses.
 
Statement of Problem
Documented evidence shows that three hundred million pregnancies occur in sub Saharan Africa and eleven million Nigerian women get pregnant yearly. (Ntadom, 2007), while half a million women die from complications related to pregnancy and child birth each year, with 99% of these deaths occurring in developing countries including Nigeria. (Chuwa, 2012). It is estimated that approximately, 200 million couples in developing countries would like to delay or stop child bearing but are not using any method of contraception (World Health Organization (WHO), 2011).
 
In Nigeria, male involvement in family planning is low, for example, a study conducted in Ilorin on male involvement in family planning showed that only 20% of respondents were using contraceptives (Levy, 2006). Men control pregnancy especially in the rural communities, yet they treat pregnancy and delivery problems as women’s affair and at the same time control the family size without any reference to the health of the mother. Women bear the brunt of the risks associated with reproductive health matters. For example, they are left to bear the entire burden of prevention of unwanted pregnancies, sexually transmitted infections, as well as the use of contraceptives alone.  This is particularly the issue in the rural communities. Though males do not carry pregnancy,  they are the initiators of the process. Women in rural communities still depend on the consent of their husbands before taking decisions on matters that affect them directly such as adopting family planning methods, frequency of sexual intercourse, family size, etc.
 
In most cultures in Nigeria, men are the sole decision makers and are normally called the gatekeepers in such communities. So their participation or lack of participation in family planning is critical in its acceptance or rejection among the women especially in the traditional rural communities. These problems were observed during the researchers’ community posting in some communities in Enugu East LGA.
 
Records from the maternity department in ESUT Teaching Hospital Parklane  from January to August (2010), showed that out of 40 referral cases from health centres in rural communities in Enugu East Local Government area, 20 were of high parity,  with its associated complications. This high parity was attributed to their husbands’ decision and cultural values. Records in the same hospital showed that family planning attendance by males between 2005 – 2010 was 10% (Records from family planning unit in ESUT Teaching Hospital Park lane, 2011). One wonders what then could be the practice in the rural communities where men’s dominating rights are highly preserved.
 
Purpose of the Study
The purpose of the study is to determine men’s involvement in family planning in some selected rural communities in Enugu East Local Government Area, Enugu State Nigeria.
Objectives
Specifically the study intends to:-

1. Determine the percentage of men who get involved in practicing family planning in the communities studied.

communities studied.

2. Identify factors that affect men’s involvement in family planning in these communities.
3. Define the nature of men’s involvement in family planning
4. Identify methods of family planning mostly adopted by men in the communities studied.

 
Research Question
The study seeks answers to the following questions.

1. What percentage of men get involved in practicing family planning in the communities studied?
2. What are the factors that affect men’s involvement in family planning in these communities?
3. What is the nature of men’s involvement in family planning?
4. What method of family planning do men adopt mostly in the communities studied?

Research Hypothesis
There is no significant association between male involvement in family planning and socio-demographic variables such as level of education, age occupation and  religion.
 
Significance of the Study
Male involvement is a promising strategy for addressing the world’s most pressing family planning needs (Population Reports, 2008). The findings of this study will therefore, reveal the percentage of men that practice family planning and the methods in rural communities in Enugu East Local Government Area, so as to  provide evidence based information for health education.
 
The findings of this study will also reveal the nature of involvement of men in family planning. This will help to build better communication within the family and eventually lead to better decision making concerning continuing contraceptive use. Health workers and programme planners will utilize the findings to plan strategies to offer counseling and quality information education and communication services to men, for example, establishing men’s clinic to address their reproductive health needs.
Policy makers will also utilize the findings to enact laws that will see to the establishment of programmes that will encourage men’s participation in family planning such as male family planning clinic. Other researchers will use the findings as baseline information in their own research projects. They will equally add to existing body of knowledge.
 
Scope of the Study
The variables of interest; include the nature of men’s involvement in family planning, the methods mostly adopted by men, factors that affect men’s involvement in family planning and the percentage of men that practice family planning.  This study is limited to all males resident in Nkwubor, Obinagu- Onuogba and Ugwuomu communities all in Enugu East Local Government Area in Enugu State.
 
Operational Definition of Terms
Males in this study refers to married men aged (20 – 70) years whose wives are within reproductive age (15 – 49) years.
 
Extent of men’s involvement means the level of their involvement in terms of whether they use family planning methods, support their wife use of family planning method, make decision in favour of contraceptive use, discuss family planning freely with wife, etc.   The mean involvement will be calculated and compared with the criterion mean for the individual items and for all the items together.  This will be interpreted as follows: High extent  – a mean of  > 3.5, Moderate extent – > 2.5  < 3.5, Low extent  > 1.5 < 2.5, Very low extent -> 0< 1.5
 
Rural community refers to a geographical area located outside the city and town.  It also applies to individuals living in countryside, towns outside the urban area. It also refers to people living in a rural area as defined by National Statistical Office and is calculated as the differences between total population and urban population.  Rural communities also refers to a population that has common interest, live in the hinter land, lack basic social amenities such as good road network, electricity, water supply and basic health facilities.
 
 Nature of men’s involvement in family planning means the type of the things they do to show their  involvement in terms whether they use family planning methods themselves, support wives use of family planning methods, decide in favour of contraception in the home when needed etc.
Factors affecting means involvement are those things that encourage or discourage men from involving in family planning such as inadequate knowledge, lack many contraceptive option for men, poor education, information, communication, inadequate knowledge, religious beliefs and culture.
Means < 2.5 = negative response, Means > 2.5 = positive response
 
Socio-demographic variables in the study are age, educational level,
occupation and religion.