CHANGING MINDS, SHAPING FUTURES:
HUSBAND ENGAGEMENT FOR POSITIVE CHANGE IN SEXUAL REPRODUCTIVE HEALTH AND FAMILY PLANNING.
Author: Fana Abay, Marketing and Communications Director, PSI Ethiopia
In Ethiopia’s rural communities, the influence of husbands on the outcomes of sexual and reproductive health (SRH) and family planning (FP) initiatives cannot be overstated. Traditionally overlooked, husbands play a crucial role in influencing women’s acceptance of family planning methods, improving coordination between spouses, and supporting the success of family planning programs, especially in areas where misconceptions and cultural barriers persist. Studies in developing countries have examined men’s involvement in family planning and have shown that it increases women’s acceptance of family planning methods improves coordination between spouses, supports the success of such programs, and strengthens women’s reproductive health rights [1, 2, 3].
The Owning Their Future (OTF) project is committed to engaging and empowering husbands in SRH and FP decision-making. The project has witnessed a transformative shift in household dynamics through strategic husband engagement interventions such as workshops and community education campaigns. Husbands now actively support their wives’ SRH and FP decisions, which is an important step towards inclusion and recognition in rural Ethiopia.
The OTF project adopts a strategy of engaging husbands by working with male gatekeepers and community volunteers to dispel misconceptions and promote awareness of the benefits of SRH and FP products and services. From inception to August 2023, the project has reached an impressive 232,921 men, breaking down barriers to SRH and FP services.
In places like Omo Nada, where husbands have great influence, it is difficult to mobilize young girls for SRH and FP counseling. Religious misconceptions about contraceptives causing harm or abortion as a sin are widespread. A Woman Development Army volunteer in this woreda pointed out a significant challenge: “One of the biggest challenges we faced in mobilizing young and adolescent girls for Smart Start counseling was convincing husbands. Unfortunately, many husbands have misconceptions based on religious beliefs. They fear that contraceptives could harm or abort a fetus, which is considered a sin in their faith. These misconceptions stem mainly from the fact that they do not know how contraceptives work biologically.”
Naji Shafi Jemal, a father of six, is an example of the initiative’s impact. After initially needing more education, Naji became a male gatekeeper, actively educating other husbands in addition to the Health Extension Workers. “Participating males in family planning counseling eases our work. Suppose a husband refers his wife after attending a husband engagement training. In that case, she can easily adopt family planning by her choice. We don’t have to waste time to convince the mother,” says a Health Extension Worker from Nada Sokote’s health post.
The collaboration between the male gatekeepers, Health Extension Workers and Smart Start Navigators organizes biweekly sessions to engage husbands. In these sessions, the Smart Start counseling tool is used to link financial planning to family planning and explain the benefits of using contraceptives. The husbands are informed about contraceptive methods, how they work and possible side effects. The Smart Start model ingeniously combines family size management with financial stability, promoting economic prosperity through responsible family planning.
Program implementation results show that women whose husbands participated in the sessions had a higher rate of contraceptive use (70.76%) than women whose husbands did not participate (61.8%). Male gatekeepers such as Naji contribute significantly to positive change through their peer-oriented approach to culturally sensitive issues.
Testimonials from male participants in Bachili kebele, Wando woreda underline the transformative impact of the program. They report a new awareness, the ability to openly support women and the freedom to choose between different family planning options.
Male participants during husband engagement session from Bachili kebele, Wando woreda, expressed their sentiments, “Previously, no one informed us about family planning in our vicinity. Women took family planning secretly without telling their husbands. I am delighted to be invited to this exciting and educational meeting today. We can now support women in obtaining family planning, discuss with them freely, and choose from the family planning options.”
“I had only heard about family planning methods but had never seen or felt them. But when I saw them today, they were not metal wire, but rather flexible plastic,” remarked a Golja kebele, Oromia region husband.
By involving husbands in SRH and FP, the program dispels misconceptions, promotes joint decision-making, and supports wives on their sexual reproductive health and family planning journey. This initiative is essential to the implementation of a broader gender-specific program that promotes equality and understanding within communities. It deserves the continued support of donors, partners, and government actors to sustain its inclusive and transformative impact.
- Vouking MZ, Evina CD, Tadenfok CN. Male involvement in family planning decision making in sub-Saharan Africa-what the evidence suggests. Pan Afr Med J. 2014;19.
- Assefa L, Shasho Z, Kasaye HK, et al. Men’s involvement in family planning service utilization among married men in Kondala district, western Ethiopia: a community-based comparative cross-sectional study. Contracept Reprod Med. 2021;6(1):1–16.
- Kassa M, Abajobir AA, Gedefaw M. Level of male involvement and associated factors in family planning services utilization among married men in Debremarkos town, Northwest Ethiopia. BMC Int Health Hum Rights. 2014;14(1):1–8.
