Exploration of roles and barriers of husband involvement in family planning among married couples in Afar pastoral communities of Ethiopia

Abstract

Background: Despite its potential to improve the lives of women, family and community, family planning service use remains low among less educated and rural resident couples. Evidence shows that husband involvement in family planning service significantly improves uptake of the service. However, in pastoral communities where family planning use is affected by range of socio-cultural barriers, the role of husband involvement and the barriers associated with it are less evident. The current study aimed to explain the potential roles husband from pastoralist communities and exploring the barriers for husband involvement.

Methods: An explorative qualitative study that employed 16 purposively selected participants (ten family planning users and six non-users) to explore the potential roles of and barriers to husband involvement in family planning use. Each in-depth interview was conducted using semi-structured guide for a minimum of 45 minutes. Each interview was audio-taped, transcribed verbatim and imported into Atlas ti, window for qualitative data software, for coding and analysis. Thematic analysis was applied to explore roles of and barriers for husband involvement from the use and non-user‟s perspectives.

Results: The critical roles husbands from pastoralist communities played were discussing with spouse about the need to use family planning, approving spouse‟s intention to use it if it comes from her, authoritative decision to use the service and accompanying wives to health facility, though rarely, for the service. Husbands remained behind their wives to proactively initiate discussion about the need to family planning. Both the users and non-users agreed that the decision to use family planning lay to the husband and its disapproval leads to strict service non-use. Moreover, accompanying wife to health facility for obtaining family planning services were rarely reported. Religious disapproval, husband‟s low awareness on the need to regulate fertility and desire to have more children were the paramount barriers for husband involvement.

Conclusion: Husband‟s low involvement in companionship and discussion in family planning kept the service utilization low in pastoralist communities. The decision on family planning use continues to depend on the husband and, in turn, the barriers for husband involvement are backed in religiously and culturally based predisposition to have more children than regulating fertility. Thus, Targeting and involving husbands in family planning awareness and demand creation activities is crucial for increasing uptake of family planning among pastoralist community.