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      Gender norms and family planning decision-making in Tanzania: a qualitative study

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          Abstract

          Experience suggests that the incorporation of gender approaches into family planning (FP) and reproductive health (RH) programs may increase their impact and sustainability, but further work is needed to examine the interactions between gender norms and family planning and to incorporate this understanding into behavior change communication (BCC) in specific social contexts. We conducted open-ended, in-depth interviews with 30 young currently married men, 30 young married women and 12 older people who influenced FP decisions. Six focus group interviews were also conducted. The interviews focused on the role of gender norms in reproductive decision-making and contraceptive use among young married men and women in Tanzania. The findings suggest that gender factors, such as men's dominance in decision-making do function as barriers to the use of modern contraceptives, but that fear of side effects, by both men and women, may be even more important deterrents. Results from this research will inform the development of BCC interventions to be tested in a subsequent intervention study in which gender factors and poor information about contraceptive methods will be addressed.

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          Most cited references15

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          Aborting and suspending pregnancy in rural Tanzania: an ethnography of young people's beliefs and practices.

          The World Health Organization estimates that 3.1 percent of East African women aged 15-44 have undergone unsafe abortions. This study presents findings regarding abortion practices and beliefs among adolescents and young adults in Tanzania, where abortion is illegal. From 1999 to 2002, six researchers carried out participant observation in nine villages and conducted group discussions and interviews in three others. Most informants opposed abortion as illegal, immoral, dangerous, or unacceptable without the man's consent, and many reported that ancestral spirits killed women who aborted clan descendants. Nonetheless, abortion was widely, if infrequently, attempted, by ingestion of laundry detergent, chloroquine, ashes, and specific herbs. Most women who attempted abortion were young, single, and desperate. Some succeeded, but they experienced opposition from sexual partners, sexual exploitation by practitioners, serious health problems, social ostracism, and quasi-legal sanctions. Many informants reported the belief that inopportune pregnancies could be suspended for months or years using traditional medicine. We conclude that improved reproductive health education and services are urgently needed in rural Tanzania.
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            Farming with your hoe in a sack: condom attitudes, access, and use in rural Tanzania.

            This study examines condom knowledge, attitudes, access, and practices in rural Mwanza, Tanzania. From 1999-2002, six researchers carried out participant observation in nine villagesfor a total of 158 person-weeks. Many villagers perceived condoms negatively for multiple reasons, for example, the method's association with infection or promiscuity, reduced male sexual pleasure, and cultural understandings of meaningful sex. Men controlled the terms of sexual encounters and reported that they would use condoms only with risky partners, but few perceived their partners as such. Use of condoms appeared to be very low, primarily as a result of limited demand, although barriers to access also existed. These qualitative findings contrast with inconsistent survey reports of relatively high condom use in the same population. Intervention efforts should address the tradeoff between possible short- and long-term consequences of condom use, particularly for men, for example, reduced pleasure versus reduced HIV risk. If possible, surveys should assess the validity of reported condom use through comparison with other data, including qualitative findings and distribution/sales records.
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              Cultivating men's interest in family planning in rural El Salvador.

              A pilot project in rural El Salvador tested the integration of family planning into a water and sanitation program as a strategy for increasing male involvement in family planning decison making and use. The organizations involved posited that integrating family planning into a resource management and community development project would facilitate male involvement by diffusing information, by referring men and women to services, and by expanding method choice to include the new Standard Days Method through networks established around issues men cared about and were already involved in. This article examines data from a community-based household survey to assess the impact of the intervention and finds significant changes in contraceptive knowledge, attitudes, and behavior from baseline to endline. Because the differences between baseline and endline are greater than the differences between participants and nonparticipants at endline, the study demonstrates the power of informal networks for spreading information.
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                Author and article information

                Journal
                J Public Health Africa
                JPHIA
                JPHIA
                Journal of Public Health in Africa
                PAGEPress Publications (Pavia, Italy )
                2038-9922
                2038-9930
                05 September 2011
                05 September 2011
                : 2
                : 2
                : e25
                Affiliations
                [1 ]Academy for Educational Development, Washington DC, USA
                [2 ]Synovate Tanzania, Dar es Salaam, Tanzania
                Author notes
                Correspondence: Elisabeth Rottach, Academy for Educational Development, 1825 Connecticut Ave NW, Washington, DC, USA. Tel. +1.202.8848857. E-mail: erottach@ 123456aed.org

                Contributions: SRS, study conception and design of the, data analysis and interpretation, article drafting and revising; ER, study design contribution, data analysis and interpretation, article drafting and revising; PM, data collection supervision, contribution to data analysis and interpretation.

                Conflict of interest: the authors report no conflicts of interest.

                Article
                jphia.2011.e25
                10.4081/jphia.2011.e25
                5345498
                28299066
                78dcd64d-80d6-47ad-a501-6bb4e52ad240
                ©Copyright S.R. Schuler et al., 2011

                This work is licensed under a Creative Commons Attribution NonCommercial 4.0 License (CC BY-NC 4.0).

                Licensee PAGEPress, Italy

                History
                : 10 September 2010
                : 25 May 2011
                Categories
                Article

                family planning,gender norms,tanzania.
                family planning, gender norms, tanzania.

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