Challa Sneha, Johns Nicole, Nouhou Abdoul Moumouni, Vera-Monroy Ricardo, Silverman Jay G, Shakya Holly
Center on Gender Equity and Health, University of California San Diego, 9500 Gilman Dr, Mail Code 0507, La Jolla, CA, 92093, USA.
The OASIS Initiative - Niger, Oasis Initiative, Niamey, Niger.
SSM Popul Health. 2022 Aug 16;19:101203. doi: 10.1016/j.ssmph.2022.101203. eCollection 2022 Sep.
This work uses data from a family planning (FP) program evaluation and social network study among men married to adolescent girls (ages 13-19) in Dosso, Niger to explore who influences their FP and through which social mechanisms. We asked men (N = 237) to nominate and describe their perceptions of key social contacts (alters). We sought to interview the most influential alter (N = 157 interviewed alters), asking them about their own FP-related attitudes and behaviors. Men primarily nominated male friends as alters. We found that men participating in the program were more likely to perceive alters to hold attitudes supportive of gender equitable FP decisions (AOR: 4.36, 95% CI: 1.83, 10.35) and FP use (AOR: 4.22, 95% CI: 1.72, 10.35). Alters' attitudes supporting FP were related to those of the men who nominated them (1-unit increase in alters' attitudes score related to a 0.48 unit increase in men's attitudes; 95% CI: 0.32, 0.63). Men who perceived their alters would support gender equitable FP decisions were more likely to have ever used FP methods (AOR: 10.43, 95% CI: 2.50, 43.58) as were those who perceived their alters would support their own FP use (AOR: 12.76, 95% CI: 2.55, 63.81). Men who perceived their alters would support gender equitable FP decisions were more likely to report spousal communication (AOR: 8.71, 95% CI: 3.06, 24.83), as were those who perceived that alters would support their own FP use (AOR: 9.06, 95% CI: 3.01, 27.26). Alters' and men's behaviors (contraceptive use and spousal communication) were not associated. These results demonstrate that perceived approval from network members may be critical to FP-related attitudes and behaviors. However, since FP promotion programs may affect perception and/or composition of social networks, future research should include larger sample sizes and longitudinal data to understand the effect of changing norms on social relationships.
本研究使用了一项计划生育（FP）项目评估和社会网络研究的数据，该研究针对尼日尔多索地区与青春期女孩（13至19岁）结婚的男性，以探究谁影响他们的计划生育决策以及通过何种社会机制产生影响。我们让男性（N = 237）提名并描述他们对关键社会联系人（他者）的看法。我们试图采访最有影响力的他者（N = 157名接受采访的他者），询问他们自己与计划生育相关的态度和行为。男性主要提名男性朋友作为他者。我们发现，参与该项目的男性更有可能认为他者持有支持性别平等的计划生育决策的态度（调整后比值比：4.36，95%置信区间：1.83，10.35）以及使用计划生育措施的态度（调整后比值比：4.22，95%置信区间：1.72，10.35）。他者支持计划生育的态度与提名他们的男性的态度相关（他者态度得分每增加1个单位，男性态度增加0.48个单位；95%置信区间：0.32，0.63）。认为其他者会支持性别平等的计划生育决策的男性更有可能曾经使用过计划生育方法（调整后比值比：10.43，95%置信区间：2.50，43.58），认为其他者会支持自己使用计划生育措施的男性也是如此（调整后比值比：12.76，95%置信区间：2.55，63.81）。认为其他者会支持性别平等的计划生育决策的男性更有可能报告与配偶的沟通情况（调整后比值比：8.71，95%置信区间：3.06，24.83），认为他者会支持自己使用计划生育措施的男性也是如此（调整后比值比：9.06，95%置信区间：3.01，27.26）。他者和男性的行为（避孕措施使用和与配偶的沟通）之间没有关联。这些结果表明，来自网络成员的感知认可可能对与计划生育相关的态度和行为至关重要。然而，由于计划生育推广项目可能会影响社会网络的认知和/或构成，未来的研究应该纳入更大的样本量和纵向数据，以了解规范变化对社会关系的影响。
