"A sweet in a polythene is not sweet": men's perceptions of their roles and experiences with family planning in East Uganda

The significance of men's influence as partners in contraceptive decision-making and family size is often understated, particularly in patriarchal societies. Understanding men's experiences and perceptions of family planning is necessary to address women's unmet needs for contraception. This study examined men's involvement in contraceptive use and decision-making in the Busoga region of east Uganda. Twenty-four in-depth interviews were conducted with both male users and non-users of contraception living in urban and rural areas. Among participants, differences in preferred family size were influenced by competing norms valuing large families and economic wellbeing as reflections of men's role as a provider. Although the majority of interviewees were not opposed in principle to contraception, some men felt contraceptives undermined their own desire for a larger family. Men who supported family planning cited the economic benefits of smaller, healthier families and being able to fulfil their role as the primary breadwinner. Resistance to vasectomy and perceptions of condom use as protection against unwanted pregnancies and STIs/HIV in casual relationships, meant participants were unlikely to use male contraceptives. Efforts to increase contraceptive uptake among men should recognise the socio-cultural context of men's place within Ugandan society, to design reproductive health initiatives that engage men effectively.