A new analysis by the Population Council shows that engaging men in family planning decisions and dialogue can be a powerful way to help change attitudes and behaviors regarding family planning in Pakistan.
Researchers from the Evidence Project examined data from the Council-led USAID-funded Family Advancement for Life and Health project (FALAH) in Pakistan, which was implemented between 2007 and 2012. The Evidence Project, a five-year USAID-funded project led by the Population Council, uses implementation science to strengthen, scale up, and sustain family planning services to reduce unintended pregnancies worldwide.
Through FALAH, the Council worked with health and population-welfare departments of the Pakistani government, religious leaders, and rural communities in more than 20 rural, socially conservative districts to promote birth spacing as an acceptable health intervention to protect the lives of women and infants. A critical objective of the project was including men in family planning efforts, both to address their lack of opportunities to discuss family planning and obtain services, and to counter the widely accepted belief that family planning is solely a women's concern.
FALAH reached more than 9 million married men and women. Among its major achievements were a decrease in fertility (by 0.5 children), an increase in contraceptive use (from 29 percent to 38 percent), and a drop in the percentage of women who say that they want to avoid or delay pregnancy but who are not using contraception (from 14 percent to 11 percent).
FALAH took a unique approach by actively involving men in creating a supportive environment for family planning.
By using the message "Birth spacing saves lives," family planning was positioned as a health intervention. The project encouraged an interval of 24 months from birth to next conception and raised awareness of the age-related risks of pregnancy.
There were five components to FALAH's male-engagement strategy:
Individual counseling through community-based volunteers (falahi workers);
Men's group meetings at the community level;
Friday sermons at mosques by sensitized local religious leaders;
Interactive community theatrical performances;
Electronic media (radio spots and television broadcasts of messages, documentaries, and discussions on family planning).
While there was some variation in approach, and the combination of interventions used in individual districts differed, the focus on the...