Male-controlled modern contraceptive method
Men as CONTRACEPTIVE USERS and FAMILY PLANNING CLIENTS
Engaging men in sexual and reproductive health, particularly family planning, can improve health outcomes for men, women, and children. Moreover, involving boys from a young age through comprehensive sexuality education can have a positive effect into adulthood, promoting critical reflections on masculinity and on gender equality.
Expanding family planning outreach and services to include men across the life course may help normalize the concept of men as contraceptive users. It can foster shared responsibility for contraceptive use among couples, open the door to more gender-equitable relationships, and increase the use of male contraceptive methods. In turn, programs can better meet the contraceptive and family planning needs of men and women, helping countries achieve family planning and development goals.
This infographic presents a snapshot of modern male-controlled and cooperative contraceptive method use around the world and highlights data that identify opportunities to engage more adolescent boys and men as contraceptive users and family planning clients.
Modern Contraceptive Methods for Men
Male Condoms
Type
How It Works
A male condom is a barrier that prevents sperm from entering the vagina. Condoms must be used each time a couple has sex.
Details
- With correct and consistent use, only two out of every 100 couples will experience a pregnancy within one year. However, typical use—when condoms are not always used correctly or consistently—results in 18 out of 100 couples experiencing a pregnancy within one year.
- Condoms are inexpensive and widely available without a prescription.
- Condoms reduce the risk of pregnancy and sexually transmitted diseases, including HIV, when used alone or in combination with other contraceptive methods.
Standard Days Method®
Type
Cooperative modern contraceptive method (participation by both partners)
How It Works
Couples track the woman’s menstrual cycle using CycleBeads®, a strand of color-coded beads that correspond to fertile days and “safe” days. Couples abstain from sex or use a barrier method on fertile days when the woman is at risk for pregnancy.
Details
- With correct and consistent use, fewer than five out of every 100 couples will experience a pregnancy within one year. Typical use—when the method is sometimes used correctly and couples occasionally have sex during the fertile period—results in 12 out of 100 couples experiencing a pregnancy in one year.
- This fertility-awareness based method requires men to actively participate in family planning decisionmaking and use.
- The couple must understand the woman’s menstrual cycle and decide whether to avoid sex or use a barrier method during days when conception is likely.
Male Sterilization Nonscalpel
Vasectomy
Type
Male-controlled modern contraceptive method
How It Works
Prevents sperm from traveling out of the testicles by cutting or blocking the vas deferens (ducts leading from the testicles). The procedure takes less than 30 minutes, involves a local anesthesia, and is performed by a trained health professional.
Details
- Nonscalpel vasectomy (NSV) is one of the most highly effective contraceptive methods. Only 1.5 out of every 1,000 couples will experience an unplanned pregnancy in the first year following the procedure. When the procedure is performed by a health professional, there is no difference between correct use and typical use.
- It is safer, less invasive, and less expensive than female sterilization.
- NSV is a good contraceptive method for men and couples
who are certain they want no
more children.
Men’s Use of Family Planning
10%Global prevalence of modern male contraceptive methods among married couples
vs. 47% for modern female contraceptive methods.
vs. 47% for modern female contraceptive methods.
Young
men
15-24
years make up the majority of condom users.
men
15-24
years make up the majority of condom users.
12%Prevalence of vasectomies in North America among married couples, the highest in the world.
0.1% to 0.6% Prevalence of SDM® in countries where it is measured.
Low use of vasectomy due to:
- Men’s hesitancy to adopt a permanent method.
- Myths and misconceptions.
Increases in education, wealth, and urban residency are associated with an increase in condom use.
Knowledge, Attitudes, and Intentions
Since 1992, Demographic and Health Surveys (DHS) have interviewed adolescent boys and men in many developing countries. These surveys ask men about their knowledge of family planning, attitudes towards family planning, and their desired number of children. Explore the sections below to learn how knowledge, attitudes, and intentions vary within and between countries.
Almost all men in recent DHS know at least one modern method of family planning. But, aside from condoms, knowledge of male-controlled and cooperative modern methods is less common. Recent surveys show that men are more likely to know about female than male sterilization. The surveys also indicate that men’s knowledge of modern contraceptive methods varies by age and education.
Most men are in favor of sharing the responsibility for family planning to avoid a pregnancy. In sub-Saharan Africa, men’s approval of contraceptive use has increased over time, and in recent years, men are less likely to believe that use of contraception makes women promiscuous. Support for family planning among men increases with higher levels of education, greater wealth, more children, or urban residency.
In most countries, men’s ideal number of children is higher than women’s ideal number of children. Men who are better-educated, have more wealth, are monogamous, or live in urban areas often prefer smaller families.
Case Studies
Interventions that promote modern male contraceptive methods and encourage men’s active participation show promising results that may better meet the contraceptive and family planning needs of adolescent and adult men. Click on a tab below for more details.
Malawi Male Motivators Project
SDM® Introduction Project, El Salvador
The Ghana Vasectomy Initiative
Objective
Increase the use of contraceptive methods among men through male peer engagement.
Methods
Male outreach workers, known as male motivators, were trained to provide information on modern contraceptive methods and family planning services to men ages 18 and older, to educate men on correct condom use, to communicate effectively with their partners about family planning, and to motivate men to use family planning with their female partners.
Results
- Seventy-eight percent of men in the intervention group used family planning compared to 59 percent of men who did not participate in the intervention.
- A majority of male family planning users reported a preference for condoms because they are discreet, readily available, affordable, have minimal side effects, and protect from both pregnancy and sexually transmitted infections.
- Men who participated in the intervention reported improved overall communication with their partners.
- Men who communicated about family planning with their female partners were more likely to use a contraceptive method.
Objective
Involve men in family planning using a variety of approaches.
Methods
From 2001 to 2006, Georgetown University’s Institute of Reproductive Health collaborated with a local partner to integrate family planning information, including on the Standard Days Method® (SDM®), into a water and sanitation program in 13 rural villages in El Salvador. Staff and male volunteers were trained to educate and counsel men, women, and couples on family planning services that included SDM®; and to conduct community outreach and home visits.
Results
- Male participants had significantly higher knowledge about male fertility and family planning.
- There was increased acceptability for discussing family planning within the community and between couples.
- Contraceptive use increased from 44 percent to 63 percent among male participants.
- Couples who were counseled together experienced fewer pregnancies.
Objective
Improve client and provider knowledge and acceptance of nonscalpel vasectomy (NSV) in Ghana.
Methods
From 2003 to 2004 and 2007 to 2008, physicians were trained in NSV and staff were trained in the provision of male-friendly services. Health promotion activities provided NSV information to prospective clients.
Results
- Trained health staff exhibited improved attitudes and knowledge regarding NSV.
- Clients reported receiving accurate, nonjudgmental NSV counseling.
- Awareness of NSV among participants doubled from 31 percent to 59 percent in 2003 to 2004 and remained at 44 percent in 2008.
- The share of men who considered NSV increased from 10 percent in 2007 to 19 percent in 2008.
- NSV procedures increased three-fold (18 procedures in 2007 to 53 procedures in 2008).
Why It Matters
Family planning contributes to a decline in fertility and is recognized as an effective way to reduce maternal mortality. Despite positive global trends, progress toward universal access to reproductive health, especially in developing countries, is slow and falls short of global targets.
The Sustainable Development Goals (SDGs) propose a bold plan to achieve universal access to reproductive health and meet the proposed benchmark for demand for family planning satisfied with modern contraceptive methods of 75 percent by 2030. Efforts to increase access and use of contraceptive methods, such as Family Planning 2020 (FP2020)—a global movement that aims to enable 120 million more women and girls to use contraceptives by 2020—are critical to achieving the SDGs. However, meeting the FP2020 target will be a challenge without the active participation of men.
Men have an important role to play in family planning, particularly in deciding with their partners the number of children to have and which contraceptive method to use. Although data on men are limited, a growing body of research shows that involving men in family planning can increase modern contraceptive use, promote shared decisionmaking between couples, and help shift the belief that family planning is a woman’s issue. Engaging men across the life cycle as contraceptive users and family planning clients is an opportunity to increase the use of modern contraceptive methods, meet FP2020 targets, and remain on track to achieve the SDGs by 2030.
Sources
Dominick Shattuck et al., “Encouraging Contraceptive Uptake by Motivating Men to Communicate About Family Planning: The Malawi Male Motivator Project,” American Journal of Public Health 101, no.6 (2011): 1089-95.
Erin Stern et al., “Lessons Learned From Engaging Men in Sexual and Reproductive Health as Clients, Partners, and Advocates for Change in the Hoima District of Uganda,” Culture, Health, & Sexuality 17, sup2 (2015): 190-205.
FHI 360, “Increasing Male Involvement in Family Planning in Jharkhand, India,” (2013), accessed at www.fhi360.org/sites/default/files/media/documents/india-male-involvement-family-planning.pdf.
Georgetown University, “CycleBeads Plan and Prevent Pregnancy Naturally,” (2016), accessed at www.cyclebeads.com/cyclebeads.
Hari Singh et al., “Increasing Male Participation in the Uptake of Vasectomy Services,” Journal of Family Planning and Reproductive Health Care 0 (2013): 1-2.
Jane Kato-Wallace et al., “Adolescent Boys and Young Men: Engaging Them as Supporters of Gender Equality and Health and Understanding their Vulnerabilities,” (Washington, DC: Promundo-US and New York City: UNFPA, 2016).
Jenny Higgins and Nicole Smith, “The Sexual Acceptability of Contraception: Reviewing the Literature and Building a New Concept,” Journal of Sex Research 53, no. 4-5 (2016): 417-56.
John Ross and Ann Blanc, “Why Aren’t There More Maternal Deaths? A Decomposition Analysis,” Maternal and Child Health 16 (2012): 456-63.
Karen Hardee, Melanie Croce-Galis, and Jill Gay, “Male as Contraceptive Users: Programs, Outcomes, and Recommendations,” (2016), forthcoming.
Kerry MacQuarrie et al., “Men and Contraception: Trends in Attitudes and Use,” (2015), accessed at https://dhsprogram.com/pubs/pdf/AS49/AS49.pdf.
Kristin Bietsch, “Men’s Attitudes Towards Contraception in Sub-Saharan Africa,” African Journal of Reproductive Health 19, no. 3 (2015): 41-54.
Laura Subramanian et al, “The Ghana Vasectomy Initiative: Facilitating Client-Provider Communication on No-Scalpel Vasectomy,” Patient Education and Counseling 81, no. 3 (2010): 374-80.
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Melanie Croce-Galis, Elizabeth Salazar, and Rebecka Lundgren, “Male Engagement in Family Planning: Reducing Unmet Need for Family Planning by Addressing Gender Norms,” (2014), accessed at http://irh.org/wp-content/uploads/2014/10/Male_Engagement_in_FP_Brief_10.10.14.pdf.
Mihretie Kassa, Amanuel Abajobir, and Molla Gedefaw, “Level of Male Involvement and Associated Factors in Family Planning Services Utilization Among Married Men in Debremarkos Town, Northwest Ethiopia,” BMC International Health and Human Rights 14, no. 33 (2014).
Miriam Hartmann et al., “Changes in Couples’ Communication as a Result of a Male-Involvement Family Planning Intervention,” Journal of Health Communication 17, no. 7 (2012): 1-18.
Philip Adongo et al., “’If You Do Vasectomy and Come Back Here Weak, I Will Divorce You’: A Qualitative Study of Community Perceptions About Vasectomy in Southern Ghana,” BMC International Health & Human Rights 14, no. 16 (2014).
Population Reference Bureau (PRB) analysis of data from the Burkina Faso Demographic Health Survey (DHS), 2010.
PRB analysis of data from the Kenya DHS, 2014.
Rebecka Lundgren et al., “Engaging Men in Family Planning Services Delivery: Experiences Introducing the Standard Days Method in Four Countries,” World Health & Population 14, no. 1 (2012): 44-51.
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STATcompiler, Demographic Health Survey (2016), accessed at www.statcompiler.com.
Tizta Tilahun et al., “Couple Based Family Planning Education: Changes in Male Involvement and Contraceptive Use Among Married Couples in Jimma Zone, Ethiopia” BMC Public Health 15, no. 682 (2015).
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UN Department of Economic and Social Affairs, Population Division, “Trends in Contraceptive Use Worldwide 2015,” (2015), accessed at www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf.
Acknowledgments
This graphic is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of the PACE Project (No. AID-OAA-A-16-00002). The contents are the responsibility of the Population Reference Bureau and do not necessarily reflect the views of USAID or the United States Government.
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Kristin Bietsch, Research Associate, PRB
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