title: Family planning decisions, perceptions and gender dynamics among couples in Mwanza, Tanzania: a qualitative study.
abstract: BACKGROUND
  Contraceptive use is low in developing countries which are still largely driven by male dominated culture and patriarchal values. This study explored family planning (FP) decisions, perceptions and gender dynamics among couples in Mwanza region of Tanzania.
  
  
  METHODS
  Twelve focus group discussions and six in-depth interviews were used to collect information from married or cohabiting males and females aged 18-49. The participants were purposively selected. Qualitative methods were used to explore family planning decisions, perceptions and gender dynamics among couples. A guide with questions related to family planning perceptions, decisions and gender dynamics was used. The discussions and interviews were tape-recorded, transcribed verbatim and analyzed manually and subjected to content analysis.
  
  
  RESULTS
  Four themes emerged during the study. First, "risks and costs" which refer to the side effects of FP methods and the treatment of side -effects as well as the costs inherit in being labeled as an unfaithful spouse. Second, "male involvement" as men showed little interest in participating in family planning issues. However, the same men were mentioned as key decision-makers even on the number of children a couple should have and the child spacing of these children. Third, "gender relations and communication" as participants indicated that few women participated in decision-making on family planning and the number of children to have. Fourth, "urban-rural differences", life in rural favoring having more children than urban areas therefore, the value of children depended on the place of residence.
  
  
  CONCLUSIONS
  Family Planning programs should adapt the promotion of communication as well as joint decision-making on FP among couples as a strategy aimed at enhancing FP use.
authors.affiliation: School of Public Health and Social Sciences, Behavioural Sciences Department, Muhimbili University of Health and Allied Sciences, P,O, Box 65015, Dar es Salaam, Tanzania. ihmosha@yahoo.co.uk
authors.forename: Idda
authors.initials: I
authors.lastname: Mosha
authors.forename: Ruerd
authors.initials: R
authors.lastname: Ruben
authors.forename: Deodatus
authors.initials: D
authors.lastname: Kakoko
mesh_terms: D000293:Adolescent; D000328:Adult; D003268:Contraception Behavior / Q000523:psychology; D003657:Decision Making; D005114:Extramarital Relations; D005191:Family Characteristics; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012307:Risk Factors; D012424:Rural Population; D017678:Sex Distribution; D018454:Spouses / Q000523:psychology* / Q000706:statistics & numerical data; D013636:Tanzania; D014505:Urban Population; D055815:Young Adult