Factors that hinder married men from participating in family planning in Nairobi, Kenya; a case of Kibera slums
Family planning programs have traditionally focused on women as the primary beneficiaries and men have been considered as the silent partners of the services. Research on contraceptive use and acceptance has mainly concentrated on the methods while few studies have examined the barriers affecting the individual fertility regulation decisions or the decision making dynamics within couples. Even though perspectives on male involvement are often rooted in negative assumption, family planning (FP) is not a woman affair alone as it requires a joint effort of both wife/ sexual partner to consider success of its use. When effective, it reduces unplanned pregnancies, reduces fertility rate improving hence the health of both the children women and the economic status of the family communities and the country. This was a descriptive cross sectional study that utilized both qualitative and quantitative methods of data collection to assess the knowledge, attitudes and practices on married men who are residing in Nairobi's populous Kibera slum, aged between 18 years and 49 years on participation in family planning. The study included only married men regardless of weather they are staying with their wives of not. Laini Saba one of the nine villages in Kibera slum was purposively selected because it has relatively higher population density than the other areas and also easily accessible. The estimated population of the area is 100,000, there are no well defined divisions in Laini Saba however, for the purpose of this study, it is seen to be in four sections, namely; A, B, C and D, each with a population of approximately 25,000 ( KDS 2008).Having obtained verbal informed consent from respondents, Standardized Questionnaires were administered and Interview schedule were used to capture data from the respondent, whereby the knowledge, attitude and practice on barriers to participation of men in family planning was collected. Focus group discussion and in-depth interview guide were used to complement the structured questionnaire, The results indicated that the knowledge of family planning was high and these findings are consistent with the findings of Kenya Demographic Health survey 2006. Men are more interested in reproductive health than most people think. Recent surveys and studies seem to contradict popular views about men's participation and involvement in family planning for example, that most men know little about contraception, do not want their partners to use it, and are not interested in planning their families. This study's respondent's knowledge on family planning was quite high. The mass media was found to be the first and most common sources of family planning information. Most of the respondents wanted more information on family planning. Most of the respondents, three-quarters discuss family planning with their wives. Whoever, men mostly make the decision on family planning. A quarter of the respondents feared their wives practicing family planning. The fears included; infidelity and lack of respect for them. More than two-thirds of the respondents said avoiding pregnancy is the responsibility of women. However, majority of them makes decision on family planning. Almost a quarter of them does not approve of male contraception, those who approved said the condom was the most ideal for them. About one-quarter of them are not currently using a method with their wives. The reasons given include: intend to get another child, Religion, not yet decided; health reasons and wife disapproves. Slightly less than a third would like their wives to use contraceptives. Since men's knowledge of and expressed interest in, family planning methods is generally high in the study area it is therefore recommended that more emphasis is put on men's participation in reproductive health. Plans to intensify programme outreach and initiate male motivational campaigns possibly through print, electronic media, barazas, and dramas should be encouraged and even promotion of condom use possibly through social marketing and distribution at places appropriate and convenient for men.