Involving Men in Reproductive and Fertility Issues : Insights from Punjab
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World Bank, Washington, DC
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Drawing on three sources, a 2013
qualitative study in four districts of Punjab province; a
targeted analysis of the baseline and end line surveys of
the Family Advancement for Life and Health (FALAH 2007-2012)
project; and the Pakistan Demographic Health Survey (PDHS)
of 1990-1991 and of 2006-2007, this study explores Pakistani
(especially Punjabi) couples' dynamics during their
decision processes on fertility intentions and practices,
along with community perceptions of male-focused
interventions as well as men's suggestions for future
intervention strategies. It finds that men in Punjab seem
now more concerned about their fertility intentions and
practices due to the financial challenges of raising large
families. This concern has not only increased spousal
communication about family size and contraceptive use but
has also encouraged Punjabi men to practice family planning.
Most men now realize that either they or their wives should
use family planning. It is the next step, however, of
translating intention into practice, which is a challenge.
Supply-side issues, including absence or paucity of family
planning services as well as poor quality of services
(including service providers' lack of capability to
manage side effects) are the main factors hindering
couples' adoption of family planning. Perceived or
experienced side effects of contraceptive methods are other
factors. Men's positive attitudes and their readiness
to be involved in family planning programs suggest that the
efforts of convincing men to use contraceptives have been
effective and this it is now time for direct reproductive
health interventions for men in Punjab. Yet heavy spending
on media campaigns may not be as effective as interpersonal
interventions. A focused effort to mobilize men through
male-specific interventions is likely to increase the demand
for contraceptives. These interventions have to be backed up
by improved supply of contraceptives and availability of
family planning services in accessible facilities.
Palabras clave
ABORTION, ABORTIONS, ACCESS TO CONTRACEPTIVES, ACCESS TO INFORMATION, AGED, ANTENATAL CARE, AVAILABILITY OF FAMILY PLANNING, BARRIERS TO FAMILY PLANNING, BEHAVIOR CHANGE, BIRTH SPACING, BIRTHS, BOTH SEXES, CHILD BEARING, CHILD HEALTH, CHILD REARING, CHILDBIRTH, COMMUNICATION EFFORTS, COMMUNITY HEALTH, COMMUNITY HEALTH WORKERS, CONDOMS, CONTRACEPTION, CONTRACEPTIVE KNOWLEDGE, CONTRACEPTIVE METHOD, CONTRACEPTIVE METHODS, CONTRACEPTIVE PRACTICES, CONTRACEPTIVE PREVALENCE, CONTRACEPTIVE SUPPLY, CONTRACEPTIVE USE, CONTRACEPTIVES, DEMAND FOR CONTRACEPTIVES, DISEASES, ECONOMIC RESOURCES, EQUALITY, ETHICAL CONSIDERATIONS, EXERCISES, FAMILY PLANNING, FAMILY PLANNING FOCUS, FAMILY PLANNING METHODS, FAMILY PLANNING PROGRAM, FAMILY PLANNING PROGRAMS, FAMILY PLANNING SERVICES, FAMILY PLANNING USE, FAMILY SIZE, FAMILY WELFARE, FEMALE, FEMALE STERILIZATION, FEMALES, FERTILITY, FERTILITY ATTITUDES, FERTILITY BEHAVIOR, FERTILITY TRANSITION, FEWER CHILDREN, FIRST CHILD, FIRST PREGNANCY, FOCUS GROUP DISCUSSIONS, FORMS OF CONTRACEPTION, GENDER, GENDER DIFFERENCES, GIRLS, HEALTH FACILITIES, HEALTH POLICY, HEALTH WORKERS, HOME, HOSPITAL, HOSPITALS, HOUSEHOLD LEVEL, HOUSEHOLD RESPONSIBILITIES, HOUSES, HUMAN DEVELOPMENT, HUSBAND, HUSBANDS, IDEAL FAMILY SIZE, IDEAL NUMBER OF CHILDREN, IMMUNIZATIONS, IMPORTANCE OF FAMILY PLANNING, INFORMED CONSENT, INJECTABLE CONTRACEPTIVES, INTERNATIONAL CONFERENCE ON POPULATION, INTERPERSONAL COMMUNICATION, INTERVENTION, INTRAUTERINE CONTRACEPTIVE DEVICES, KNOWLEDGE OF FAMILY PLANNING, LACK OF KNOWLEDGE, LARGE FAMILIES, LARGE NUMBER OF PEOPLE, LAWS, LEVEL OF FERTILITY, LIMITED RESOURCES, LIMITING FAMILY SIZE, LOCAL COMMUNITY, LOW CONTRACEPTIVE PREVALENCE, MALE HEALTH, MALE HEALTH WORKERS, MALE INVOLVEMENT, MARITAL STATUS, MARKETING, MASS MEDIA, MEDICINES, MENSTRUAL CYCLE, MENSTRUAL PROBLEMS, MINORITY, MODERN CONTRACEPTIVE METHODS, MOTHER, MOTHERS, NEED FOR FAMILY PLANNING, NEWBORNS, NO MORE CHILDREN, NUMBER OF CHILDREN, NUMBER OF COUPLES, NUMBER OF HOUSEHOLDS, NUTRITION, OBESITY, OLD AGE, OPPOSITE SEX, PARENTS, PATIENT, POLIO, POPULATION AND DEVELOPMENT, POPULATION COUNCIL, POPULATION GROWTH, POPULATION GROWTH RATE, POPULATION STUDIES, PROGRESS, PUBLIC HEALTH, PURCHASING POWER, QUALITY OF SERVICES, RADIO, RELIGIOUS LEADERS, REPLACEMENT LEVEL, REPRODUCTIVE AGE, REPRODUCTIVE BEHAVIOR, REPRODUCTIVE DECISION, REPRODUCTIVE DESIRES, REPRODUCTIVE GOALS, REPRODUCTIVE HEALTH, REPRODUCTIVE HEALTH CARE, REPRODUCTIVE HEALTH INTERVENTIONS, REPRODUCTIVE INTENTIONS, REPRODUCTIVE LIVES, REPRODUCTIVE PATTERNS, RESPECT, RURAL AREAS, RURAL COMMUNITIES, SERVICE PROVIDERS, SEX, SHARIA, SMALL FAMILIES, SOCIAL ACCEPTABILITY, SOCIAL NORMS, SOCIAL PRESSURE, SOCIAL SCIENCE, SPOUSE, SPOUSES, STATUS OF WOMEN, STERILIZATION, SUPPLY OF CONTRACEPTIVES, TELEVISION, TV, UNWANTED CHILDREN, UNWANTED PREGNANCIES, URBAN AREAS, URBAN CENTERS, URBAN COMMUNITY, USE OF CONTRACEPTION, USE OF CONTRACEPTIVES, WIFE, WILL, WIVES, WOMAN