Male involvement in Spacing births, Afghanistan

Date of Award


Document Type


Degree Name

Master of Science in Health Policy & Management (MSc Health Policy & Mgmt)


Community Health Sciences


Involvement of men in supporting women for fertility control, safe pregnancy, and child bearing has been recognized as an important element of reproductive health in International Conference on Population and Development (ICPD) held in Cairo in 1994. In male dominant society such as Afghanistan, the role of men in supporting reproductive health and the use of birth spacing methods is essential. Early marriages, low contraceptive prevalence rate, and short inter-pregnancy intervals are the explanations for the high fertility, maternal and infant mortality in Afghanistan. Few studies have been conducted to provide information about Afghan men's perception and behavior regarding use of birthspacing methods. Successful interventions to reduce maternal and infants mortality requires a better understanding of awareness, attitude and practices of men towards the use of family planning methods. This study aimed to assess the knowledge, attitude, and behavior of Afghan men towards birth spacing methods; and to look into factors influencing men to adopt such methods. This was a cross-sectional survey that used both qualitative (formative research) and quantitative tools. Initially a formative research in the form of six in-depth interviews was carried out, with the purpose to identify barriers to the implementation of the cross sectional survey and to finalize the response categories of the data collection tool. The cross sectional study was conducted from July to September 2006 in the district Tagab-e Keshem, Badakhshan province Afghanistan. We were able to complete interviews on 309 married men aged 18-60 years. Unadjusted Odds ratios were used to determine the factors that influence Afghan men to practice birth spacing methods. The contraceptive prevalence rate (both men and wives) was 8.4 %. Only 28.5% of the respondents had heard about the contraceptive methods. Educational status (OR=2.7), access to radio (OR=6.36), income (OR=9.8), and couple's discussion (OR-1.00) about birth spacing were the main factors influencing men to use any contraceptive method. Our study findings reveal that nearly 72 % of the men had no knowledge about the family planning even though majority can read and write; moreover, a fraction of men or their spouses were using any method at the time of the interview. Broad and effective information, education, and communication strategies should be undertaken to promote awareness regarding birthspacing and its advantages. In addition, family planning programs in Afghanistan should involve men and particularly invite couple discussion as a key strategy. Inter spousal communication should be made part of national family planning program.

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