Background: In Pakistan, family planning has traditionally been perceived as primarily a women's concern, resulting in the exclusion of men from relevant initiatives. This situation is further exacerbated by cultural and social barriers that hinder men's access to family planning services. This study addresses a significant research gap by assessing the extent of family planning service provision for men in urban areas of Karachi. It delves into the exploration of men's involvement in family planning service delivery, identifies existing gaps in services catering to men, records men's perceptions of accessibility and acceptability of these services, and ultimately offers recommendations to enhance men's involvement and strengthen service provision to better meet their needs.
Methods: We employed a qualitative exploratory research design using semi-structured interviews to investigate perceptions regarding family planning service provision to men. This approach involved 25 interviews, comprising eight key informant interviews with stakeholders, eight with service providers, and nine in-depth interviews with married men.
Results: This study highlights the limited engagement of men in family planning programs, primarily due to entrenched sociocultural norms that confine female healthcare providers to serving women, hindering men's involvement. While national and provincial policies endorse men's participation, they lack defined roles for male providers. Behavioral and information-sharing barriers at the community level discourage male healthcare providers from collaborating with females. Family planning programs, except for NGO-led vasectomy projects, fail to adequately address men's needs. Despite policy recognition, implementation remains inadequate. Bridging the men's involvement gap necessitates more male providers and improved contraceptive stigma combat training. Further research is vital to explore effective methods for involving men in community and service delivery in family planning.
Conclusion: There is a need to change the perception that contraception is solely the responsibility of women, as men's participation in family planning in Karachi is limited. Engaging men can yield positive health and non-health outcomes. Culturally sensitive services, developed with community input using a couple-centered approach, are crucial for equitable family planning. Further research is needed to explore men's inclusion strategies in service provision and utilization.
Keywords: Family planning; Low- and middle-income; Men involvement; Reproductive health.
Many family planning efforts focus solely on women, leaving out men, especially in Pakistan, due to cultural and social barriers. This study aimed to explore men’s involvement in family planning programs in Karachi. We talked to 25 different people, such as those who run family planning programs, provide services, and married men. We found that men aren’t much involved in these programs. Female health providers usually help women, which discourages men from participating or getting involved in such programs. Even though there have been policies to include men since 2002, they don’t have specific roles defined. Men don’t discuss family planning much with female providers due to behavioral differences and lack of open communication. Men mostly prefer condoms, and apart from a small NGO-run vasectomy project, there are few programs-tailored to their needs. Although policies exist, they’re not fully in practice. To change this, we need more male providers and improved training to reduce the stigma around contraception. Future research should explore more effective ways to involve men in family planning, both in communities and service levels. Overall, getting men involved in family planning is important, and services need to be developed with input from communities and couples to ensure fairness. More research is needed to figure out the best ways to do this.
© 2024. The Author(s).