CONTENTS

         Chapters
  1. New Attention to Men
  2. Men Make a Difference
  3. New Survey Findings About Men
  4. Gender and Reproductive Behavior
  5. Couple Communication
  6. Lessons Learned and Program Implications

HIGHLIGHTS

Population Reports is published by the Population Information Program, Center for Communication Programs, The Johns Hopkins School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland 21202-4012, USA


Volume XXVI, Number 2
October, 1998

Series J, Number 46
The Gap Between Approval and Use

While many men know about contraception and approve of it in general, not all who approve of contraception use it. Some are not currently using contraception because they want another child. Others say that they or their partners are sterile. Still others want to prevent pregnancy but do not use contraception for a variety of reasons that family planning programs could address.

When nonusers are asked by the DHS why they do not intend to use contraception, many say they would like more children. Throughout the surveyed countries of West Africa, this is the main reason that men give. For example, in Cameroon more than 70% of these men say they want more children. Desire for more children is also the main reason for nonuse in Morocco, Pakistan, and Tanzania (76).

Men who do not use contraception cite a number of other reasons for not intending to do so. In countries where Islam is strong, men often cite religion—even though, in fact, Islamic teachings do not prohibit family planning. For example, in Senegal 35% of nonusers cite this reason, and in Bangladesh and Egypt, 23% (76). Other reasons for not intending to use family planning include lack of communication between spouses, lack of access to contraceptives, the belief that women are responsible for fertility control, and the need for more family planning information (118).

Many men have fears or misconceptions about contraception (30, 100). Men may worry that certain contraceptive methods, such as the Pill or IUD, will have serious side effects and make their wives sick. Also, some men fear that, if a woman is not at risk of pregnancy, she will be promiscuous (100, 118, ).

Millions of men, like millions of women, have unmet need for family planning (100, 178, , 208, 213) (see Avoiding Unintended Pregnancies, Meeting Unmet Need, Chapter 2.2). While there is no generally agreed-upon formulation of unmet need among men comparable to that among women, men's surveys could provide the basis for it. One such formulation, for example, defines men as having unmet need for family planning if they are sexually active, their partners are fecund and not pregnant, and they do not want their partners to become pregnant, but neither they nor their partners use contraception (160, 208).

While DHS data do not yield estimates of unmet need among men, one indication of unmet need is that, in 8 of 13 countries surveyed, there are more married men who do not want any more children than there are married men who are using contraception (including use by their wives) (76). Also, the Population Reference Bureau used DHS data on men in six African countries to estimate that one-quarter to two-thirds of husbands do not want more children but are not using contraception (213).


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