Association of men's contraceptive knowledge, attitude and behavior with modern contraceptive use: evidence from Nepal demographic health survey 2022.

BACKGROUND

Men can play a crucial role in the effective use of contraceptives, both by utilizing themselves and by supporting their partners in preventing unwanted pregnancies; and addressing reproductive health issues. This study aims to examine the association of men's contraceptive knowledge, attitudes, and behaviors (KAB) with the use of modern contraceptives.

METHODS

This study utilized data from the Nepal Demographic and Health Survey 2022, which included a total weighted sample of 2,649 married men aged 15-49 years. The Demographic and Health Survey is a nationally representative cross-sectional study. A weighted analysis of the samples was carried out accounting for the complex survey design. Bivariable and multivariable logistic regression analyses were conducted and the odds ratio (OR) with 95% confidence intervals (CIs) were presented to determine the association between men's KAB and the use of modern contraception in Nepal.

RESULTS

The findings revealed that half of the married men (51.2%; CI: 48.5, 53.9) or their spouses have used some form of modern contraceptives. Interestingly, all men (100%) knew at least one type of modern contraceptive, while only one-third (33.7%; CI 3.12, 3.64) were aware of the ovulatory cycle period. Men with no knowledge of the ovulatory cycle (aOR: 1.31; CI: 1.07, 1.60), men who disagreed that women using contraceptives may become promiscuous (aOR: 1.27; CI:1.01,1.61) and men who discussed family planning with health workers (aOR: 1.72; CI:1.30, 2.28) were more likely to use modern contraceptives. Additionally, the use of modern contraceptives was more likely among men aged 20 to 29 (aOR: 8.04; CI: 2.19, 22.18), 30 to 39 (aOR: 17.11; CI: 6.20, 47.20), and 40 to 49 years (aOR: 23.25; CI: 8.41, 64.30) than their counterparts less than 20 years, as well as among men living in rural areas (aOR: 1.33; CI: 1.05, 1.67). Conversely, modern contraceptive use was less likely among highly educated men (aOR: 0.57; CI: 0.33, 0.97) and men living in Gandaki province (aOR: 0.87; CI: 0.59, 1.29).

CONCLUSION

This study highlights significant role of men's KAB in the utilization of modern contraception among married men in Nepal. Contraceptive use can be promoted by enhancing the knowledge of men, developing a positive attitude, and encouraging supportive behaviors regarding reproductive health. The appropriate use of contraceptives can improve the reproductive health outcomes of both men and women. Providing a conducive environment for men to learn more about reproductive health including contraception is a key to positive health outcomes in Nepal.