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Fertility limiting intention and contraceptive use among Indian men

Globally, about 48.5% of women in their reproductive ages were using some form of contraception in 2019. However,
it was much lower in the least developed regions with only about 29% in Sub Saharan African countries followed by
about 34% in Northern Africa and western Asian countries and highest (60%) in Eastern and Southeastern Asian region
(United Nation, 2019). According to the United Nation (2019), female sterilization was the most common contraceptive
method used worldwide in 2019, accounting for 23.7% among those women with any methods globally, followed by male
condom (21.6%), IUDs (17.3%), and pill (16.5%). Male sterilization accounted for 1.8%, and withdrawal accounted for
5.2%. About 27.4% of couples using methods related to men (male sterilization, male condoms, and withdrawal). The
highest prevalence of these methods was 36.5% in Europe and Northern America and the lowest share was around 20%
in sub-Saharan Africa and Latin America and the Caribbean. Only 10.5% of women of reproductive ages in the Southern
Asia countries (India, Nepal, Bangladesh, etc.) were relying on methods that required active male participation such as
vasectomy, condoms, periodic abstinence, or withdrawal (United Nation, 2019).
The prevalence of unmet for family planning was 14.2% at the world level in 2019, and it was much higher in the
less developed regions with 87 million of women in Southern Asia, 28 million women in Eastern Asia and 23 Million in
South-Eastern Asia have unmet need of family planning in 2019 (Kantorová, Wheldon, Ueffing, et al., 2020). Moreover,
the global number of women in reproductive ages using contraception is projected to rise by 76 million, from 842 million
in 2019 to 918 million in 2030 (Kantorová, Wheldon, Ueffing, et al., 2020). Growth in the number of contraceptive users
is projected to be high for all regions of Africa and in Southern Asia (United Nation, 2019). In line with this vision, India
had committed to upsurge of the modern contraceptive usage from 53.1% to 54.3% and ensure that 74% of the demand
for modern contraceptives are satisfied by 2020 (GOI, 2017).
However, family planning programs have conventionally focused mainly on women, with the aim to help reduce
the burden of unintended pregnancies, overlooking the importance of male participation in family planning programs
(Blossfeld and Kiernan, 1995); men have been long considered to be beyond the scope of family planning programs
(Cleland, Bernstein, Ezeh, et al., 2006). Despite women’s increasing influence on household decision-making, their
preferences of regarding contraceptive choices and family size may not be translated into practice unless they conform
to their husband’s wishes (Dahal, Padmadas, and Hinde, 2008). The reasons include that reproduction is primarily a
women’s issue and that men usually do not take responsibility for reproductive health and family planning (Cleland,
Bernstein, Ezeh, et al., 2006; Raju and Leonard, 2000; Ha, Jayasuriya, and Owen, 2003).
Fortunately, there is a growing body of research in both Africa and Asia that gender and social norms play a significant
role in determining the use of contraceptive, with men playing a greater role in the decision-making (Mishra, Nanda, Speizer,
et al., 2014; Withers, Dworkin, Zakaras, et al., 2015). Many studies further show that women’s fertility preferences and
contraceptive adoption are influenced by husband’s influence on women’s decision-making as well as their own attitudes
(Beekle, 2006; Bogale, Wondafrash, Tilahun, et al., 2011; Greene and Biddlecom, 2000; Niraula, 1998; Nte, Odu, and
Enyindah, et al., 2009; Tuloro, Deressa, Ali, et al., 2006). Several studies have also found that men’s attitudes toward
gender equality are associated with condom use to prevent HIV/AIDS (Bruhin, 2003; Bogale, Wondafrash, Tilahun, et al.,
2011; Pulerwitz, Amaro, Jong, et al., 2002).
Past studies further asserted that discussion of family planning with a health worker, region, education, wealth
index, number of surviving children, exposure to media, men’s working status, and fertility preference are the most
important determining factors of the contraceptive use among men (Chauhan and Prasad, 2021; Kabagenyi, Ndugga,
Wandera, et al., 2014; Kogay and Itua, 2017; Ochako, Temmerman, Mbondo, et al., 2017; Okigbo, Speizer, Corroon,
et al., 2015). Researches further suggested that contraceptive use is likely to be more operative for women when men are
enthusiastically involved by the programs, through any means (Shattuck, Kerner, Gilles, et al., 2011; Terefe and Larson,
1993). The perceptions of community norms and social network also influence the approval of family planning among
men (Dynes, Stephenson, Rubardt, et al., 2012). In addition, it is found that men with more gender equitable attitudes are
more likely to use modern methods (Mishra, Nanda, Speizer, et al., 2014; Chauhan and Prasad, 2021). Similarly, studies
conducted in Nepal and Uganda show that fertility intension and fertility preference (>2 children) generally determines by
the various demographic, socio-economic, and culture factors of the individuals and communities (Dahal, Padmadas, and
Hinde, 2008; Matovu, Makumbi, and Wanyenze, et al., 2017; Paudel and Acharya, 2018; Aung, Soe, and Moh, 2019). In
sum, the men’s view of their family size, gender preferences, timing of childbirth, length of birth intervals, the usage of
contraceptives, and the social and cultural environment where they live affect their reproductive behavior were evidenced
to be associated with the contraceptive use (Koffi, Weidert, Bitasse, et al., 2018).
Since men are the heads of households, they make decisions around the well-being of their households including
decisions on family planning (Adelekan, Omoregie, Edoni, et al., 2014). Men should be deliberated not only as women’s
partners but also as individuals with diverse reproductive behavior and desires of their own (Greene, Mehta, Pulerwitz,

2 International Journal of Population Studies | 2021, Volume 7, Issue 1