Ekambi Salomine, Sugg Kathryn, Mpata Florence, Aliango Dédé Marachto, Winch Peter J
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
CRIDESS-Université Protestante Au Congo CD, Kinshasa, Democratic Republic of Congo.
Reprod Health. 2025 Jun 27;22(1):120. doi: 10.1186/s12978-025-02029-7.
In the Democratic Republic of the Congo (DRC), a disparity exists in the fertility desires of men and women, with men often expressing a desire for more children than their partners. This disconnect can be attributed to social and gender norms that influence discussions and decision-making regarding birth spacing, birth limiting, and the adoption of modern contraceptive methods. This qualitative study, through semi-structured interviews and focus group discussions, explored the social norms shaping perceptions, attitudes, and decision-making around family planning among men in the DRC.
The study protocol was adapted from the 5-step process set forth in the Social Norms Exploration Tool (SNET). Data collection took place in the three provinces of Kasai Central, Lualaba, and Sankuru. This process was divided into three phases: a reference-group identification phase incorporating a short, quantitative questionnaire, an exploration of norms and attitudes with the population of interest (N = 317) - here married and unmarried men - and further exploration of social norms among the reference groups (N = 144) cited by men.
Social norms around family planning are contradictory and can be better understood by breaking down the concept of family planning into three categories of descriptive and injunctive norms: 1) the use of modern contraceptive methods, 2) birth spacing and family size, and 3) couple communication and decision-making. We found that while social norms oppose the use of modern contraceptive methods and advocate for larger family size, there is notable social support for birth spacing. Some men reported they would support their wives in learning about contraceptive methods if they were able to make the final decision. However, other men felt that allowing their wives to seek a method would undermine their authority or their virility.
To increase modern contraceptive uptake, interventions should address the underlying issues that contribute to non-adherence, addressing the three categories and their associated norms individually and engaging reference groups important to each, including healthcare providers, religious leaders, and male peer groups, in family planning programming.
在刚果民主共和国（DRC），男性和女性的生育意愿存在差异，男性通常表示希望生育的子女数量多于其伴侣。这种脱节可归因于社会和性别规范，这些规范影响着关于生育间隔、生育限制以及采用现代避孕方法的讨论和决策。这项定性研究通过半结构化访谈和焦点小组讨论，探讨了塑造刚果民主共和国男性对计划生育的认知、态度和决策的社会规范。
该研究方案改编自社会规范探索工具（SNET）中提出的五步流程。数据收集在开赛中部、卢阿拉巴和桑库鲁三省进行。这个过程分为三个阶段：一个参考群体识别阶段，包括一份简短的定量问卷；对目标人群（N = 317）——这里指已婚和未婚男性——的规范和态度进行探索；以及对男性提及的参考群体（N = 144）中的社会规范进行进一步探索。
围绕计划生育的社会规范相互矛盾，通过将计划生育概念细分为三类描述性和指令性规范可以更好地理解：1）现代避孕方法的使用；2）生育间隔和家庭规模；3）夫妻沟通与决策。我们发现，虽然社会规范反对使用现代避孕方法并提倡更大的家庭规模，但对生育间隔有显著的社会支持。一些男性报告称，如果他们能够做出最终决定，会支持妻子了解避孕方法。然而，其他男性认为允许妻子寻求避孕方法会削弱他们的权威或男子气概。
为了提高现代避孕方法的使用率，干预措施应解决导致不依从的潜在问题，分别针对这三类及其相关规范，并让对每一类都很重要的参考群体参与计划生育规划，这些群体包括医疗保健提供者、宗教领袖和男性同伴群体。
