title: Couple based family planning education: changes in male involvement and contraceptive use among married couples in Jimma Zone, Ethiopia.
abstract: BACKGROUND
  Family planning contributes substantially in achieving the Millennium Development Goals. Recently, male involvement has gained considerable attention in family planning programs but the implementation thereof remains a challenge. In that context, our study aimed at measuring the effect of a six-month-long family planning education program on male involvement in family planning, as well as on couples' contraceptive practice.
  
  
  METHODS
  We conducted a quasi-experimental research among 811 married couples in Jimma Zone, southwest Ethiopia. Our study consisted of an intervention and a control group for comparative purpose; and surveyed before and after the implementation of the intervention. The intervention consisted of family planning education, given to both men and women at the household level in the intervention arm, in addition to monthly community gatherings. During the intervention period, households in the control group were not subject to particular activities but had access to routine health care services.
  
  
  RESULTS
  We obtained follow-up data from 760 out of 786 (96.7%) couples who were originally enrolled in the survey. Findings were compared within and between groups before and after intervention surveys. At the baseline, contraceptive use in both control and intervention households were similar. After the intervention, we observed among men in the intervention arm a significantly higher level of willingness to be actively involved in family planning compared to the men in the control arm (p < 0.001). In addition, the difference between spouses that discussed family planning issues was less reported within the control group, both in the case of men and women ((p = 0.031) and (p < 0.001)) respectively. In general, a significant, positive difference in male involvement was observed. Concerning contraceptive use, there was change observed among the intervention group who were not using contraception at baseline.
  
  
  CONCLUSIONS
  This study showed that family planning educational intervention, which includes both spouses and promotes spousal communication, might be useful to foster contraceptive practice among couples. The results also offer practical information on the benefits of male involvement in family planning as a best means to increase contraceptive use. Thus, providing opportunities to reinforce family planning education may strengthen the existing family planning service delivery system.
authors.affiliation: College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia. tiztatilahun@yahoo.com.
authors.forename: Tizta
authors.initials: T
authors.lastname: Tilahun
authors.affiliation: Rhea, Research Center on Gender and Diversity, Brussels University, Brussels, Belgium. Gily.Coene@vub.ac.be.
authors.forename: Gily
authors.initials: G
authors.lastname: Coene
authors.affiliation: International Centre for Reproductive Health, Department of Obstetrics and Gynaecology, Ghent University, Ghent, Belgium. marleen.temmerman@ugent.be.
authors.forename: Marleen
authors.initials: M
authors.lastname: Temmerman
authors.affiliation: International Centre for Reproductive Health, Department of Obstetrics and Gynaecology, Ghent University, Ghent, Belgium. Olivier.Degomme@ugent.be.
authors.forename: Olivier
authors.initials: O
authors.lastname: Degomme
mesh_terms: D000328:Adult; D003142:Communication; D003267:Contraception / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D005002:Ethiopia; D005193:Family Planning Services / Q000458:organization & administration*; D005195:Family Relations; D005260:Female; D005783:Gender Identity; D006801:Humans; D008297:Male; D008875:Middle Aged; D012736:Sex Education / Q000458:organization & administration*; D018454:Spouses