CHAPTER ONE

INTRODUCTION

1.1.1        1.1 Background

Family planning (FP) plays a crucial role in achieving sustainable development goals (SDGs), particularly those related to maternal and child health, poverty reduction, and gender equally[1]

Family planning allows people to attain their desired number of children and determine the spacing of their pregnancies [2]. Traditionally, family planning programs have predominantly focused on women, overlooking the significant influence of men as partners, decision –makers, and agents of change [3]. Growing evidence emphasizes that engaging men in FP is crucial for increasing contraceptive uptake, improving reproductive health outcomes, and promoting gender equality. Globally, the unmet need for FP remains a challenge, and achieving universal access requires a paradigm shift towards greater male participation. In a study conducted by [4] was found that the unmet need of family planning was 33% among men.This background will assess the perception on the use of family planning by men in ntene- ntene community,Bamenda..

Family planning began New Zealand and this was in the year 1936. The organization which began the New Zealand Family Planning Association (NZFPA) in 1939 which was founded in 1936 by a group of Wellington women, including Elsie Locke as the sex hygiene and birth regulation society. Its initial membership was 37. Many of the founders had encounter unhelpful or moralistic advice when the asked their doctor for contraception [5]. It also achieves through the use of contraceptive methods and the treatment of infertility.

Globally understanding men’s knowledge about FP is essential for designing effective interventions. Knowledge encompasses awareness of various contraceptive methods, their mechanism of action, efficacy rates and accessibility. In a systematic review by [6] found that while most men are aware of at least one contraceptive method, the detailed knowledge remained limited, particularly regarding the long-acting reversible contraceptives(LARCs) like IUDs and implants. Misconception and myths about FP are also prevalent, often stemming from cultural beliefs or misinformation. For instance, some men believe that FP methods cause infertility or negatively impact sexual performance [7]. Factors influencing FP knowledge include education, socioeconomic status, age, exposure to FP information through the media and health care services [ 8].

 In a study conducted  in Ethopia found out that men’s knowledge about family planning was positively associated with support for contraceptive use. The highlights the importance of educating men about different contraceptive options and dispelling myths and misconception that may hinder their acceptance of family planning [9]

Men’s attitude towards FP significantly impact their willingness to support and participate in FP programs. Attitude reflects their beliefs, values, and feelings of acceptability, safety, and its influence on gender roles and relationships. A study conducted  in Kenya showed that men who had positive attitude towards FP were more likely to discuss and use contraceptives with their partners [10]

A community cross sectional study conducted in the urban slum areas of Gangwadi reported that only (10%) of married men had a positive attitude family planning while majority (64.4%) had average attitude. 25.6% of the men had a negative attitude towards family planning [11]. In a similar study conducted  it was found out that attitude towards family planning was influenced by diverse cultural, religious, socioeconomic and geographic factors [12]. Also, some men express concerns that FP will enable their partners to engage in extramarital activities. Traditional African societies often place a high value on large families, viewing them as a source of social status, economic support, and continuation of lineage. Also, regarding the practice, (33.1%) of married did good practice, while (39.1%) of men had a negative practice and (28.7%) had an average practice of FP. Therefore, the awareness and utilization of family planning method need to be improved among the less educated families [13].

In Cameroon, like in many African countries family planning has traditionally been considered a woman’s responsibility, with limited involvement of men in contraceptive decision-making.  However, recent studies have highlighted the importance of understanding men’s knowledge, attitudes, and practices regarding family planning to improve reproductive health outcomes in the country [14].

In Cameroon, men’s involvement in family planning is critical for improving reproductive health outcomes, particularly in rural areas where access to family planning services is limited (Cameroon Ministry of public health, 2019). The lack of accurate information often led to a negative attitude towards family and hindering men’s support for contraceptive use.

 In a study conducted in 2019 it was found out that men’s knowledge and attitude towards family planning were significantly associated with their use of family planning methods in Cameroon [15]. However, men’s knowledge and attitudes towards family planning vary widely across different regions and cultures in Cameroon. For example, a study conducted in the North West Region of Cameroon found that men’s knowledge of family planning methods was low, and that many men held negative attitudes towards family planning [16].

To address the knowledge, attitudes, and practices regarding family planning amongst men in Cameroon, targeted interventions are needed. A community –based education programs and outreach initiatives that specifically target men have shown promise in increasing male involvement in family planning discussions [17].

 1.2 Statement of Problem

In the context of family planning men play a crucial but often overlooked role in the decision making process and contraceptive use. Despite the growing awareness of men’s importance in family planning, significant gaps persist in the understanding, acceptance, and active participation. In many settings, men hold misconception and inaccurate knowledge regarding various contraceptive methods, leading to negative attitudes and reluctance to support or engage in family planning. Traditionally gender roles, cultural norms, and power dynamics often perpetuate the notion that family planning is sorely a woman’s responsibility.

This societal pressure, coupled with limited access to male specific family planning information and services, further hinders male involvement. Consequently, women often bear the disproportionate burden of contraceptive use and face challenges in making informed reproductive choices without the support of their partners.

This lack of male involvement contributes to unintended pregnancies, unsafe abortions, and poor maternal and child health outcomes. A research conducted in Nigeria has shown that men often lack comprehensive knowledge about contraceptive methods leading to a misconception and myths hindering their support for family planning [18]

A similar study conducted in Bangladesh have identified a negative attitude towards conception among men rooted in cultural norms and beliefs that prioritize fertility and male dominance in reproductive decision making [19]. The lack of comprehensive information on men’s knowledge, attitude, and practices towards family planning in low and middle income countries hinders efforts to address specific needs and preferences of this population. Without a nuanced understanding of men on contraception and FP health programs may fail to effectively engage men and partners in reproductive health and decision making processes. This gaps don’t only aim at improving maternal and child health outcome.

Therefore, there’s an urgent need to explore the perception towards family planning by men in low and middle income countries (LMICs) by identifying the knowledge gaps and attitude of men in family planning discussions, policy makers, health care providers, stakeholders can improve interventions that promote positive attitudes towards contraception and knowledge about FP and promote active participation of men in reproductive health decision making