Characterizing Nigerien men's social networks and their influence on family planning-related attitudes and behaviors.

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.