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      Impact of male partner’s awareness and support for contraceptives on female intent to use contraceptives in southeast Nigeria

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          Abstract

          Background

          Despite the growing body of evidence on use of modern contraceptives among women in sub-Saharan African countries, little is known about the broader context in which female decision-making concerning contraceptive use occurs, particularly the role of their male partners’ awareness and support of modern contraceptives.

          Methods

          We conducted a cross-sectional survey of 2468 pregnant women and their male partners enrolled in the Healthy Beginning Initiative (HBI), an intervention to increase HIV testing among pregnant women in Enugu, southeast Nigeria. The aims of this study were to determine: 1) male partners’ awareness of, and support for, female contraceptive methods, and 2) influence of male partners’ contraceptive awareness and support on pregnant women’s expressed desire to use contraception. We used logistic regression models to examine the association between male partners’ awareness and support of modern contraceptives on their spouses’ desire to use contraceptives.

          Results

          Men’s awareness of, and support for, use of modern contraceptives were significantly associated with their female partners’ desire to use contraception. A majority of the men who were aware of modern contraceptives (66.5 %) and those who supported their spouses’ use of contraception (72.5 %) had partners who expressed a desire to use contraception. Men who were aware of female contraception were 3 times more likely to have spouses who desired to use contraception (AOR = 3.17, 95 % C.I: 2.70–3.75). In addition, men who showed support for their spouses’ use of contraception were over 5 times more likely to have spouses who indicated a desire to use contraception (AOR = 5.76, 95 % C.I: 4.82–6.88). Living in a household of 5 or more people (AOR = 1.45, 95 % C.I: 1.23–1.72) and residing in an urban area (AOR = 0.81, 95 % C.I: 0.67–0.97) were also significantly associated with women’s expressed desire to use modern contraception.

          Conclusion

          Men’s awareness of, and support for, use of modern contraceptives were markedly associated with their spouses’ desire to use contraception. This underscores the need for men’s involvement in programs that seek to address women’s uptake of contraception in low and middle income countries.

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          Most cited references20

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          Social networks and changes in contraceptive use over time: evidence from a longitudinal study in rural Kenya.

          The impacts of social networks on changes in contraception in rural Kenya are investigated using special data from a longitudinal household survey. An analytic model, informed by detailed knowledge of the setting, yielded estimates that indicate that (1) social networks have substantial effects even after unobserved factors (e.g., homophily) that may determine social networks are controlled; (2) controlling for these unobserved factors may substantially alter the estimated effects of networks (these controls were not used in previous studies); (3) network effects are important for both men and women; and (4) network effects are nonlinear and asymmetric, suggesting that networks provide information primarily through social learning, rather than by exerting social influence.
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            Barriers to men's participation in antenatal and prevention of mother-to-child HIV transmission care in Cameroon, Africa.

            Men's role in HIV prevention is pivotal to changing the course of the epidemic. When men participate in Prevention of Mother-to-Child Transmission (PMTCT) programs, their knowledge of HIV increases, their behavior becomes supportive, and their receptiveness to HIV testing increases. In Cameroon, Africa, multiple efforts have been implemented that encourage men to "follow" their wives to obstetric/PMTCT care and to undergo HIV testing. However, only 18% of men have participated in this care. As a quality improvement initiative, a survey was administered to identify men's knowledge and attitudes regarding antenatal care (ANC), PMTCT, and HIV. The survey consisted of a questionnaire with an emphasis on identifying barriers to men's participation in PMTCT programs and obtaining HIV testing. A convenience sampling method was used, and no participant identifying information was collected. Men's participation in ANC/PMTCT is affected by sociocultural barriers centered in tribal beliefs and traditional gender roles. The barriers identified included the belief that pregnancy is a "woman's affair"; the belief that a man's role is primarily to provide financial support for the woman's care; the man's perception that he will be viewed as jealous by the community if he comes to clinic with his pregnant wife; and cultural gender-based patterns of communication. Most men consider accompanying their wife to ANC/PMTCT a good practice. Yet fewer men actually do this, because they feel that the provision of finance for ANC registration and delivery fees is their most important role in supporting their wife's pregnancy. Health care workers should encourage individuals and community leaders to build upon the traditional value of financial responsibility, expanding a man's involvement to include supportive social roles in obstetric care, PMTCT, and HIV testing. Copyright 2010 American College of Nurse-Midwives. Published by Elsevier Inc. All rights reserved.
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              Having a Say Matters: Influence of Decision-Making Power on Contraceptive Use among Nigerian Women Ages 35–49 Years

              Background Research suggests that women of reproductive age who are involved in household decision-making are more likely than those who are not involved to be able to control their fertility. Little is known, however, about this relationship among women at the upper end of the reproductive spectrum. The aim of this study was to determine the association between household decision-making power and modern contraceptive use among Nigerian women ages 35–49 years. Methods A descriptive, cross-sectional study involving a secondary analysis of data from the Nigerian 2008 Demographic and Health Survey was conducted among women ages 35–49 years who were considered to be in need of contraception. The outcome was modern contraceptive use while the main independent variable was a woman's household decision-making power score, constructed using principal component analysis. Multivariate logistic regression was performed to determine whether the women's household decision-making power score, categorized into tertiles, was independently associated with modern contraceptive use. Data were weighted and adjusted for the complex survey design. Results Prevalence of modern contraceptive use among Nigerian women deemed to be in need of contraception in this study was 18.7%. Multivariate logistic regression showed that women's decision-making power remained statistically significantly associated with modern contraceptive use, even after adjusting for age, education, religion, polygyny, parity, wealth and domicile. Women who were in the highest decision-making power tertile had more than one and a half times the odds of using modern contraception compared with women in the lowest tertile [Adjusted Odds Ratio = 1.70; 95% Confidence Interval = 1.31–2.21, p<0.001]. Significance Older Nigerian women who are involved in making household decisions are also able to make decisions related to their fertility. Programs in Nigeria focused on increasing modern contraceptive use should include strategies to increase women's status through encouraging more visible involvement in decision-making across different spheres of their lives.
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                Author and article information

                Contributors
                echezona.ezeanolue@unlv.edu
                jiwez@illinois.edu
                ibitola@email.arizona.edu
                mobiefune.ihv@gmail.com
                anolue76@yahoo.com
                aaghams.petrgs@gmail.com
                aogidi.petrgs@gmail.com
                aaron.hunt@unlv.edu
                dinap@medicine.nevada.edu
                weiyang@unr.edu
                jehiri@email.arizona.edu
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                10 September 2015
                10 September 2015
                2015
                : 15
                : 879
                Affiliations
                [ ]Global Health and Implementation Science Initiatives, School of Community Health Sciences, University of Nevada, 4505 S. Maryland Pkwy, Box 453064, Las Vegas, 89154 NV USA
                [ ]Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, 123 Huff Hall, 1206S, Fourth St., Champaign, IL 61820 USA
                [ ]Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, Arizona 85724 USA
                [ ]Prevention, Education, Treatment, Training and Research-Global Solutions-PeTR-GS, Plot 25 Liberty Estate, Independence Layout Enugu, 400001 Enugu State, Nigeria
                [ ]Healthy Sunrise Foundation, 8752 Castle Ridge Avenue, Las Vegas, NV 89129 USA
                [ ]School of Community Health Sciences, University of Nevada, MS-274, RM212, Lombardi Recreation Center, Reno, NV 89557 USA
                Article
                2216
                10.1186/s12889-015-2216-1
                4566290
                25563658
                85e7df85-2f21-4d4d-b609-9abb9da89200
                © Ezeanolue et al. 2015

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 22 February 2015
                : 3 September 2015
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                © The Author(s) 2015

                Public health
                Public health

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