Nkonde Hildah, Mukanga Bright, Daka Victor
The Copperbelt University, Michael Chilufya Sata School of Medicine, Public Health Department, P. O. Box 71769, Ndola, Zambia.
Heliyon. 2023 Mar 11;9(3):e14405. doi: 10.1016/j.heliyon.2023.e14405. eCollection 2023 Mar.
Family planning services are essential in reducing maternal deaths as well as improving the reproductive and sexual health of women. Although family planning services are frequently focused on women, men are often the primary decision-makers. We conducted a study to explore male partner influence on women's choices and utilisation of family planning services in Mufulira district, Zambia.
A qualitative explorative study design that utilised two focus group discussions (n = 20) and in-depth interviews (n = 30) involving women of reproductive age was conducted. Convenient sampling was employed to select participants. In-depth interviews and focus group discussions were recorded, translated, and transcribed verbatim. Content analysis was utilised through code classification and theme identification. Data were imported into NVivo.×64 for coding and node generation.
The study revealed key themes on male partner influence on contraception use such as fear of infidelity, fear of physical abuse, preference for a large family size , disruption of sexual pleasure, and perceived side effects of contraceptives. These themes highlight the influence of culturally driven gender and power dynamics on male partner attitudes towards contraception. Participants described how their male partners exhibited prenatal attitudes and control over them thereby limiting their decision-making power on contraception use. Undesirable contraception side effects such as reduced vaginal lubrication contributed to sexual pleasure disruption among men. Concerns that women's use of contraception can lead to infidelity also contributed to male partner disapproval of contraception use.
Understanding barriers to contraception utilisation presented by male partners is essential in preventing contraception discontinuation and can increase contraception uptake among women. Our findings highlight the influence of culturally driven gender and power dynamics on male partner attitudes towards contraception. Therefore, male partner education on family planning services is key. Also, men need to be incorporated as key stakeholders when planning and implementing family planning programmes.
计划生育服务对于降低孕产妇死亡率以及改善妇女的生殖和性健康至关重要。尽管计划生育服务通常以女性为重点，但男性往往是主要决策者。我们开展了一项研究，以探讨男性伴侣对赞比亚穆富利拉区妇女计划生育服务选择和使用的影响。
采用定性探索性研究设计，进行了两次焦点小组讨论（n = 20）和对育龄妇女的深入访谈（n = 30）。采用便利抽样法选择参与者。深入访谈和焦点小组讨论进行了录音、翻译，并逐字转录。通过代码分类和主题识别进行内容分析。数据导入NVivo.×64进行编码和节点生成。
该研究揭示了男性伴侣对避孕使用影响的关键主题，如对不忠的恐惧、对身体虐待的恐惧、对大家庭规模的偏好、性快感的破坏以及对避孕药具副作用的认知。这些主题凸显了文化驱动的性别和权力动态对男性伴侣避孕态度的影响。参与者描述了她们的男性伴侣如何表现出产前态度并对她们进行控制，从而限制了她们在避孕使用上的决策权。诸如阴道润滑减少等不良避孕副作用导致了男性的性快感破坏。担心女性使用避孕会导致不忠也导致男性伴侣不赞成使用避孕。
了解男性伴侣提出的避孕使用障碍对于防止避孕中断以及增加女性的避孕采用率至关重要。我们的研究结果凸显了文化驱动的性别和权力动态对男性伴侣避孕态度的影响。因此，对男性伴侣进行计划生育服务教育是关键。此外，在规划和实施计划生育项目时，需要将男性纳入关键利益相关者。
