A Qualitative Investigation of Men’s Attitudes about Family Planning among HIV-Affected Couples in Nyanza Province, Kenya

Sara J. Newmann, University of California, San Francisco
Elizabeth A. Harrington, Oregon Health & Science University
Elizabeth A. Bukusi, Kenya Medical Research Institute (KEMRI)
Craig R. Cohen, University of California, San Francisco
Shari L. Dworkin, University of California, San Francisco

BACKGROUND: In sub-Saharan Africa, much has been written about men’s decision-making power concerning family planning (FP). Few studies provide an in-depth examination of the reasons behind male disapproval. METHODS: This study explores perceptions of male disapproval of FP by men and women in Kenya through individual, in-depth interviews conducted among 40 HIV-affected, married couples in Nyanza Province. RESULTS: Women believed men desired many children, regardless of the consequences. Male disapproval of FP was related to beliefs that FP fostered female infidelity, promiscuity and had negative health effects, especially infertility. Male disapproval was also influenced by fears of child death and socio-cultural issues, including gender role expectations, large family preferences, and beliefs that God should control fertility. CONCLUSIONS: Improving men’s knowledge and understanding of FP’s benefits is required. Understanding how gender relations elicit men’s fears concerning their role in families and communities could help more effectively engage men in FP.