title: 'Women now wear trousers': men's perceptions of family planning in the context of changing gender relations in western Kenya.
abstract: Gender inequity has been closely linked with unmet need for family planning among women in sub-Saharan Africa but the factors related to male family planning disapproval are not well-understood. This qualitative study explored men's perspectives of gender roles and cultural norms as they pertain to family planning. Twelve small group meetings were held with 106 married men in Nyanza Province, Kenya. Shifting gender relations made the definitions of manhood more tenuous than ever. Men's previous identities as sole breadwinners, which gave them significant control over decision-making, were being undermined by women's increasing labour force participation. While many men viewed family planning positively, fears that family planning would lead to more female sexual agency and promiscuity or that male roles would be further jeopardised were widespread and were major deterrents to male family planning approval. By addressing such fears, gender-sensitive programmes could help more men to accept family planning. Increased family planning education for men is needed to dispel misconceptions regarding family planning side-effects. Focusing on the advantages of family planning, namely financial benefits and reduced conflict among couples, could resonate with men. Community leaders, outreach workers and healthcare providers could help shift men's approval of joint decision-making around family size to other reproductive domains, such as family planning use.
authors.affiliation: a Institute for Global Health, University of Southern California , Los Angeles , USA.
authors.forename: Mellissa
authors.initials: M
authors.lastname: Withers
authors.forename: Shari L
authors.initials: SL
authors.lastname: Dworkin
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Zakaras
authors.forename: Maricianah
authors.initials: M
authors.lastname: Onono
authors.forename: Beryl
authors.initials: B
authors.lastname: Oyier
authors.forename: Craig R
authors.initials: CR
authors.lastname: Cohen
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Bukusi
authors.forename: Daniel
authors.initials: D
authors.lastname: Grossman
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Newmann
mesh_terms: D000328:Adult; D005193:Family Planning Services; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007398:Interpersonal Relations; D007630:Kenya; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D060728:Reproductive Health
keywords: couple communication; family planning; gender roles; men; reproductive health; sub-Saharan Africa