Alison B Comfort1,2, Cynthia C Harper3, Alexander C Tsai4, Jessica M Perkins5, James Moody6, Justin Ranjalahy Rasolofomana7, Cora Alperin8, Margaret Schultz9, Anja Noeliarivelo Ranjalahy10, Ravo Heriniaina11, Paul J Krezanoski12,13. 1. University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA. Alison.comfort@ucsf.edu. 2. Opportunity Solutions International, San Francisco, CA, USA. Alison.comfort@ucsf.edu. 3. University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA. 4. Massachusetts General Hospital, Harvard Medical School, 125 Nashua Street, Suite 722, Boston, MA, 02114, USA. 5. Peabody College of Education and Human Development, Vanderbilt University, PMB 90, 230 Appleton Place, Nashville, TN, 37203-5721, USA. 6. Duke University, 268 Soc/Psych Building, Durham, NC, 27708-0088, USA. 7. Institut National de Santé Publique et Communautaire, Ex-Ecole de Médecine de Befelatanana, BP 176, Antananarivo, Madagascar. 8. University of Chicago, 5438 S Woodlawn Avenue, Chicago, IL, 60615, USA. 9. Institute for Global Health Sciences, University of California San Francisco, 550 16th Street, Third Floor, San Francisco, CA, 94158, USA. 10. TANDEM SARL, Lot H 107, Merimanjaka, 102, Antananarivo, Madagascar. 11. Opportunity Solutions International, Lot III G17, Ambalavao, Madagascar. 12. Opportunity Solutions International, San Francisco, CA, USA. 13. University of California San Francisco, Zuckerberg San Francisco General Hospital, 1001 Potrero Ave, San Francisco, CA, 94110, USA.
Abstract
BACKGROUND: Ensuring women have information, support and access to family planning (FP) services will allow women to exercise their reproductive autonomy and reduce maternal mortality, which remains high in countries such as Madagascar. Research shows that women's social networks - their ties with partners, family members, friends, and providers - affect their contraceptive use. Few studies have considered the role of men's social networks on women's contraceptive use. Insofar as women's contraceptive use may be influenced by their male partners, women's contraceptive use may also be affected by their partner's social networks. Men may differ by the types of ties they rely on for information and advice about FP. It is unknown whether differences in the composition of men's FP networks matter for couples' contraceptive use. This study assessed the association between men's FP networks and couples' contraceptive use. METHODS: This egocentric network study was conducted among married/partnered men (n = 178) in rural Madagascar. Study participants listed who they relied on for FP information and advice, including health providers and social ties. They provided ties' gender, age, relationship, and perceived support of contraceptive use. The primary outcome was couples' contraceptive use, and explanatory variables included FP networks and their composition (no FP network, social-only network, provider-only network, and mixed network of social and provider ties). Analyses used generalized linear models specifying a Poisson distribution, with covariate adjustment and cluster robust standard errors. RESULTS: Men who had FP networks were 1.9 times more likely to use modern contraception as a couple compared to men with no FP network (95% confidence interval [CI] 1.64-2.52; p ≤ 0.001). Compared to men with no FP network, men were more likely to use modern contraception if they had a social-only network, relative risk (RR) = 2.10 (95% CI, 1.65-2.68; p ≤ 0.001); a provider-only network, RR = 1.80 (95% CI, 1.54-2.11; p ≤ 0.001); or a mixed network, RR = 2.35 (95% CI, 1.97-2.80; p ≤ 0.001). CONCLUSIONS: Whether men have a FP network, be it provider or social ties, distinguishes if couples are using contraception. Interventions should focus on reaching men not only through providers but also through their social ties to foster communication and support for contraceptive use.
BACKGROUND: Ensuring women have information, support and access to family planning (FP) services will allow women to exercise their reproductive autonomy and reduce maternal mortality, which remains high in countries such as Madagascar. Research shows that women's social networks - their ties with partners, family members, friends, and providers - affect their contraceptive use. Few studies have considered the role of men's social networks on women's contraceptive use. Insofar as women's contraceptive use may be influenced by their male partners, women's contraceptive use may also be affected by their partner's social networks. Men may differ by the types of ties they rely on for information and advice about FP. It is unknown whether differences in the composition of men's FP networks matter for couples' contraceptive use. This study assessed the association between men's FP networks and couples' contraceptive use. METHODS: This egocentric network study was conducted among married/partnered men (n = 178) in rural Madagascar. Study participants listed who they relied on for FP information and advice, including health providers and social ties. They provided ties' gender, age, relationship, and perceived support of contraceptive use. The primary outcome was couples' contraceptive use, and explanatory variables included FP networks and their composition (no FP network, social-only network, provider-only network, and mixed network of social and provider ties). Analyses used generalized linear models specifying a Poisson distribution, with covariate adjustment and cluster robust standard errors. RESULTS:Men who had FP networks were 1.9 times more likely to use modern contraception as a couple compared to men with no FP network (95% confidence interval [CI] 1.64-2.52; p ≤ 0.001). Compared to men with no FP network, men were more likely to use modern contraception if they had a social-only network, relative risk (RR) = 2.10 (95% CI, 1.65-2.68; p ≤ 0.001); a provider-only network, RR = 1.80 (95% CI, 1.54-2.11; p ≤ 0.001); or a mixed network, RR = 2.35 (95% CI, 1.97-2.80; p ≤ 0.001). CONCLUSIONS: Whether men have a FP network, be it provider or social ties, distinguishes if couples are using contraception. Interventions should focus on reaching men not only through providers but also through their social ties to foster communication and support for contraceptive use.
Entities:
Keywords:
Community health workers; Contraceptives; Family planning; Health providers; Influencers; Madagascar; Male partner; Reproductive health; Social networks; Sub-Saharan Africa
Authors: Esambe Emmanuel Edietah; Philip Nana Njotang; Atem Bethel Ajong; Marie José Essi; Martin Ndinakie Yakum; Enow Robinson Mbu Journal: BMC Womens Health Date: 2018-10-20 Impact factor: 2.809
Authors: Alison B Comfort; Cynthia C Harper; Alexander C Tsai; James Moody; Jessica M Perkins; Justin Ranjalahy Rasolofomana; Cora Alperin; Anja Noeliarivelo Ranjalahy; Ravo Heriniaina; Paul J Krezanoski Journal: Contraception Date: 2021-04-24 Impact factor: 3.375
Authors: Alison B Comfort; Alison M El Ayadi; Carol S Camlin; Alexander C Tsai; Hadija Nalubwama; Josaphat Byamugisha; Dilys M Walker; James Moody; Tatyana Roberts; Umar Senoga; Paul J Krezanoski; Cynthia C Harper Journal: BMC Pregnancy Childbirth Date: 2022-09-16 Impact factor: 3.105