Exploring Male Involvement In Contraceptive Decision-Making And Support For Long-Acting Reversible Methods Among Couples In Kampala, Uganda

Male involvement in family planning remains a critical yet underexplored factor influencing contraceptive uptake and decision-making support for long-acting reversible contraceptives (LARCs) in Kampala, Uganda. This mixed-methods study assessed male participation in decision-making and support for long-acting reversible contraceptives among couples in Kampala. The study involved 362 male participants who completed structured questionnaires, six focus group discussions (FGDs) conducted with both men and women, and five key informant interviews (KIIs) with healthcare providers. Ethical approval was obtained from the Kampala International University Research Ethics Committee and the Uganda National Council for Science and Technology. Quantitative findings revealed that 96.4% of men reported that their partners discussed contraception with healthcare providers ({chi}{superscript 2} = 31.366, p < 0.001), yet only 9.7% of men accompanied their partners to clinics. Male support for family planning was primarily financial (60.2%), while joint decision-making on LARCs was reported by only 38.7% ({chi}{superscript 2} = 2.776, p = 0.596). Key determinants of male involvement included marital status, education level, and number of children. However, cultural norms ({chi}{superscript 2} = 42.813, p < 0.000) and religious beliefs ({chi}{superscript 2} = 29.402, p < 0.021) were identified as significant barriers to male participation. Qualitative findings from FGDs and KIIs echoed the limited involvement of men in family planning services, attributing this to entrenched gender norms, misconceptions about contraceptives, and the perception that reproductive health services are primarily for women. Although 44.2% of participants indicated that mens concerns were addressed during consultations, 77.3% reported limited availability of couple-focused counseling ({chi}{superscript 2} = 6.294, p = 0.178). The study concludes that male involvement in family planning decision-making and support for LARCs remains low, largely due to socio-cultural barriers and limited male-friendly services. The study recommends strengthening male engagement strategies by training health workers on inclusive counseling, involving community and religious leaders in awareness campaigns, and promoting male-friendly and couple-centered reproductive health services through community-based platforms.