PROTOCOL: Involving men and boys in family planning: A systematic review of the effective components and characteristics of complex interventions in low‐ and middle‐income countries

Abstract

BACKGROUND | The problemFamily planning (FP) helps people avoid unintended pregnancy, attain their desired number of children and/or determine the spacing of pregnancies. Effective FP is achieved through the use of contraceptive methods, provision of safe abortion, and prevention and treatment of infertility. FP also contributes to reduced maternal, neonatal and child morbidity and mortality, as well as the negative economic and psychosocial implications that unintended pregnancy, pregnancy complications and infertility can have. Despite determined progress since the implementation of the UnitedNations' Sustainable Development Goals (SDGs; United Nations, 2015), reports indicate that progress has been slower than expected in relation to maternal and child health and gender equality (FP2020, 2018UNICEF, 2018; World Health Organisation, 2017). If current trends continue, more than 50 low-and middle-income countries (LMICs) will not meet their SDG under-five mortality target by 2030 and 56 million children under age-5 will die (UNICEF, 2018). Equally, achieving the SDG target of a global maternal mortality rate of below 70 per 100,000 births will require a reduction in current rates of an average of 7.5% each year until 2030. This is more than three times the current 2.3% annual global rate of reduction (World Health Organisation, 2016). At the current rate of change, it will take 200 years (nine generations) to reach the SDG 5 goal of achieving gender equality and empowering women and girls (Organisation for Economic Co-operation and Development, 2019). Further, by 2018, only 46 of FP2020′s targeted 120 million additional women using contraception had been reached-a clear indicator of the work that remains to be done in order to reach the 2030 SDGs (FP2020, 2018).Every year, around 300,000 women and girls die during childbirth or from pregnancy-related complications, including unsafe abortion, with the vast majority of these deaths (94%) occurring in LMICs (World Health Organisation, 2019). Equally, unintended and mistimed pregnancies also contribute to the burden of high infant morbidity and mortality (Kozuki et al., 2013;Say et al., 2014;Singh et al., 2013). Around 2.7 million newborns die every year in LMICs and many more suffer from disease relating to preterm birth, being small for gestational age and malnutrition (Guttmacher Institiute, 2018). Provision of evidence-based interventions to accelerate the use of FP is, therefore, a matter of life and death for people in LMICs. Despite declines in global fertility rates, unmet FP needs remain high. An estimated 214 million women in LMICs would like to avoid or delay pregnancy, but are not using contraception (Guttmacher Institiute, 2018). There is, therefore, an urgent need to understand how to accelerate the use and impact of FP programmes.

Male Involvement in Family Planning Decisions in Malawi and Tanzania: What Are the Determinants?

“…It aims at improving family lives and contributing to sustainability efforts at both the micro and macro levels. FP is a method of population control and enhances the reduction of unplanned pregnancies by providing direct or indirect benefits, such as lowered maternal morbidity and mortality [ 5 , 6 ], increased educational and employment opportunities for women who are able to delay childbirth [ 7 , 8 ], decreased use of unsafe abortion methods [ 9 ], reduced risk of HIV transmission to unborn children [ 10 , 11 ], and lowered neonatal, infant, and child mortality [ 12 ]. According to the World Health Organization (WHO) [ 13 ], after years of concerted work, a significant proportion of women worldwide wish to avoid getting pregnant, but neither they nor their partners are using contraceptives.…”

A comparative study of postnatal depression and associated factors in Gauteng and Free State provinces, South Africa

“…Suggestions on improving family planning include involving men. 60 Unplanned pregnancies were also associated in South Africa with antenatal depression, which is one of the strongest predictors of postnatal depression. 61 Multivariate analysis in the current study showed that support from partners or husbands was associated with the decreased odd of having PND than those who did not receive support.…”

“…Suggestions on improving family planning include involving men. 60 Unplanned pregnancies were also associated in South Africa with antenatal depression, which is one of the strongest predictors of postnatal depression. 61 …”

Nothing so practical as theory: a rapid review of the use of behaviour change theory in family planning interventions involving men and boys

“…More information on the review design and methodology is available in the review protocol [ 19 ]. This rapid review was conducted as part of an ongoing systematic review that aims to identify the effective components and characteristics of interventions involving men and boys in LMICs in family planning [ 20 ].…”