Aga Khan University, Karachi, Pakistan.
Visiting Faculty AKU, Aga Khan University, Karachi, Pakistan.
Reprod Health. 2024 Oct 3;21(1):140. doi: 10.1186/s12978-024-01875-1.
In Pakistan, family planning has traditionally been perceived as primarily a women's concern, resulting in the exclusion of men from relevant initiatives. This situation is further exacerbated by cultural and social barriers that hinder men's access to family planning services. This study addresses a significant research gap by assessing the extent of family planning service provision for men in urban areas of Karachi. It delves into the exploration of men's involvement in family planning service delivery, identifies existing gaps in services catering to men, records men's perceptions of accessibility and acceptability of these services, and ultimately offers recommendations to enhance men's involvement and strengthen service provision to better meet their needs.
We employed a qualitative exploratory research design using semi-structured interviews to investigate perceptions regarding family planning service provision to men. This approach involved 25 interviews, comprising eight key informant interviews with stakeholders, eight with service providers, and nine in-depth interviews with married men.
This study highlights the limited engagement of men in family planning programs, primarily due to entrenched sociocultural norms that confine female healthcare providers to serving women, hindering men's involvement. While national and provincial policies endorse men's participation, they lack defined roles for male providers. Behavioral and information-sharing barriers at the community level discourage male healthcare providers from collaborating with females. Family planning programs, except for NGO-led vasectomy projects, fail to adequately address men's needs. Despite policy recognition, implementation remains inadequate. Bridging the men's involvement gap necessitates more male providers and improved contraceptive stigma combat training. Further research is vital to explore effective methods for involving men in community and service delivery in family planning.
There is a need to change the perception that contraception is solely the responsibility of women, as men's participation in family planning in Karachi is limited. Engaging men can yield positive health and non-health outcomes. Culturally sensitive services, developed with community input using a couple-centered approach, are crucial for equitable family planning. Further research is needed to explore men's inclusion strategies in service provision and utilization.
在巴基斯坦，计划生育传统上被视为女性的主要关注点，这导致男性被排除在相关倡议之外。这种情况因文化和社会障碍而进一步加剧，这些障碍阻碍了男性获得计划生育服务。本研究通过评估卡拉奇城市地区男性计划生育服务的提供程度，填补了一个重要的研究空白。它深入探讨了男性参与计划生育服务提供的程度，确定了针对男性的服务中存在的差距，记录了男性对这些服务的可及性和可接受性的看法，并最终提出了增强男性参与度和加强服务提供以更好地满足他们需求的建议。
我们采用定性探索性研究设计，使用半结构化访谈来调查男性计划生育服务提供的看法。这种方法涉及 25 次访谈，包括与利益相关者的 8 次关键人物访谈、8 次与服务提供者的访谈和 9 次与已婚男性的深入访谈。
本研究强调了男性在计划生育项目中的参与度有限，主要是由于根深蒂固的社会文化规范将女性医疗保健提供者限制在为女性服务，阻碍了男性的参与。虽然国家和省级政策支持男性参与，但缺乏对男性提供者的明确角色规定。社区层面的行为和信息共享障碍阻止了男性医疗保健提供者与女性合作。计划生育项目，除了非政府组织主导的输精管切除术项目外，都未能充分满足男性的需求。尽管有政策认可，但实施仍然不足。缩小男性参与差距需要更多的男性提供者和改进的避孕耻辱感对抗培训。进一步的研究对于探索有效的方法来让男性参与计划生育的社区和服务提供至关重要。
需要改变避孕完全是女性责任的观念，因为卡拉奇男性参与计划生育的程度有限。让男性参与可以带来积极的健康和非健康结果。具有文化敏感性的服务，在社区投入的基础上，采用以夫妻为中心的方法开发，对于公平的计划生育至关重要。需要进一步研究探索在服务提供和利用中纳入男性的策略。
