What does your partner want? Using a gender equality lens to assess partner support and involvement in Family Planning in Uganda

Abstract

Background: While partner involvement in health-related decision-making is linked with positive health behaviors, a key gap in the literature exists on how this construct should be measured and the specific ways men and women in Uganda perceive partner support in the context of family planning. The USAID-funded Social and Behavior Change Activity (SBCA) in Uganda explored the differences in male versus female priorities in the decision-making considerations and preferred measures of partner support related to family planning in order to design contextually relevant solutions. Methods: Cross -sectional study using a nationally representative telephone survey among 1177 men and women aged 18-49 years old in sexual partnerships. Key measures included current family planning use (Are you or your partner currently doing anything to prevent or delay becoming pregnant?); family planning decision-making considerations (In your experience, which of the following are the three most important considerations as you make family planning decisions?); and preferred partner support (What level of involvement would you like to see from your partner in your family planning decisions?). Multivariable logistic regressions explored factors associated with decision-making priorities and preferred partner support, adjusting for sociodemographic confounders. Results: Two-thirds (66%) of men and women wanted a high level of involvement from their partner, which was associated with higher odds of using family planning (aOR: 2.46, 95% CI: 1.87 - 3.24). Specific ways partners could be involved included accompanying them to health services (39%), permitting them to get family planning services (26%), and jointly discussing family planning options (23%). Of note, more women wanted their partner to accompany them (45%) than men (33%) while more men (29%) wanted to jointly discuss options than women (15%). Conclusions: Partner support needs to be operationalized differently for men and women; therefore, social and behavior change (SBC) interventions should employ a gender lens when implementing family planning programs. The project used these insights to implement a health campaign that leverages the views of key audiences; explicitly encourages partner dialogue across the various life stages; and empowers women with knowledge and skills to have honest conversations with their partners about when to have children and how many to have.