Assefa Lemessa, Shasho Zemenu, Kasaye Habtamu Kebebe, Tesa Edao, Turi Ebisa, Fekadu Ginenus
Department of Public health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
Deputy of the health center, Gimbi Health Center, Western Wollega Zone, Gimbi, Ethiopia.
Contracept Reprod Med. 2021 Jun 1;6(1):16. doi: 10.1186/s40834-021-00160-x.
Men involvement is one of the important factors in family planning (FP) service utilization. Their limitation in the family planning program causes a decrease in service utilization as well as the discontinuation of the method which eventually leads to failure of the program. Family planning uptake is low but there is no enough study conducted on the parameters of husband involvement in Ethiopia. Hence, this study focused to assess men's involvement in family planning service utilization in Kondala district, western Ethiopia.
Community based comparative cross-sectional study design was employed in urban and rural kebeles of kondala district using quantitative and qualitative data collection tools. The multi-stage sampling method was employed to select 370 participants from each of the four urban and eight rural kebeles. Logistic regression analysis was used to identify variables that affect husbands' involvement in FP service utilization. Statistical significance was declared at p-value of < 0.05 with 95% confidence interval (CI) and strength of association was reported by odds ratio (OR).
The study showed that 203(55.6%) men from urban and 178(48.8%) from rural were involved in FP service utilization. The median age of the respondents was 36+ 8.5 years (IQR: 27.5-44.5) in urban and 35 years (IQR: 25-45) in rural parts. Respondents who had four and above current children (AOR = 3.25, 95%CI = 1.51-7.02) in urban and (AOR = 4.20, 95%CI = 1.80-9.79) in rural were positively associated with men's involvement in FP service utilization. In the urban setting, being government employee (AOR = 2.58, 95%CI = 1.25-5.33), wishing less than two children (AOR = 3.08, 95%CI = 1.80-5.24) and having a better attitude towards FP methods (AOR = 1.86, 95%CI = 1.16-2.99) were positively associated with FP service utilization. While good educational background (AOR = 2.13, 95%CI = 1.02-4.44), short distance from home to health facility (AOR = 2.29, 95%CI = 1.24-4.19) and having better knowledge (AOR = 4.49, 95%CI = 2.72-7.38) were positively associated with men involvement in FP service utilization in the rural area.
Low involvement of men in family planning service utilization was reported in both settings. Factors associated with husbands' involvement were varied between the two setups, except for the current number of children. Future FP program should incorporate infrastructure associated with the health facility, knowledge, and attitudinal factors.
男性参与是计划生育服务利用的重要因素之一。他们在计划生育项目中的局限性导致服务利用率下降以及方法的中断，最终导致项目失败。埃塞俄比亚的计划生育普及率较低，但针对丈夫参与计划生育项目的参数方面的研究还不够充分。因此，本研究旨在评估埃塞俄比亚西部孔达拉区男性在计划生育服务利用方面的参与情况。
采用基于社区的比较横断面研究设计，在孔达拉区的城乡社区使用定量和定性数据收集工具。采用多阶段抽样方法，从四个城市社区和八个农村社区各选取370名参与者。采用逻辑回归分析来确定影响丈夫参与计划生育服务利用的变量。当p值<0.05且95%置信区间（CI）时具有统计学意义，并通过比值比（OR）报告关联强度。
研究表明，城市中有203名（55.6%）男性、农村中有178名（48.8%）男性参与了计划生育服务利用。城市地区受访者的中位年龄为36 + 8.5岁（四分位间距：27.5 - 44.5），农村地区为35岁（四分位间距：25 - 45）。城市中目前有四个及以上孩子的受访者（调整后比值比[AOR] = 3.25，95%CI = 1.51 - 7.02）和农村中（AOR = 4.20，95%CI = 1.80 - 9.79）与男性参与计划生育服务利用呈正相关。在城市环境中，身为政府雇员（AOR = 2.58，95%CI = 1.25 - 5.33）、希望生育少于两个孩子（AOR = 3.08，95%CI = 1.80 - 5.24）以及对计划生育方法态度较好（AOR = 1.86，95%CI = 1.16 - 2.99）与计划生育服务利用呈正相关。而在农村地区，良好的教育背景（AOR = 2.13，95%CI = 1.02 - 4.44）、从家到医疗机构的距离较短（AOR = 2.29，95%CI = 1.24 - 4.19）以及知识水平较高（AOR = 4.49，95%CI = 2.72 - 7.38）与男性参与计划生育服务利用呈正相关。
在两种环境中均报告了男性在计划生育服务利用方面的参与度较低。除了目前的孩子数量外，与丈夫参与相关的因素在两种环境中有所不同。未来的计划生育项目应纳入与医疗机构相关的基础设施、知识和态度因素。
