Abstract:
Background: Contraceptive use is low in developing countries which are still largely driven by male dominated
culture and patriarchal values. This study explored family planning (FP) decisions, perceptions and gender dynamics
among couples in Mwanza region of Tanzania.
Methods: Twelve focus group discussions and six in-depth interviews were used to collect information from married
or cohabiting males and females aged 18–49. The participants were purposively selected. Qualitative methods were
used to explore family planning decisions, perceptions and gender dynamics among couples. A guide with questions
related to family planning perceptions, decisions and gender dynamics was used. The discussions and interviews were
tape-recorded, transcribed verbatim and analyzed manually and subjected to content analysis.
Results: Four themes emerged during the study. First, “risks and costs” which refer to the side effects of FP methods
and the treatment of side -effects as well as the costs inherit in being labeled as an unfaithful spouse. Second, “male
involvement” as men showed little interest in participating in family planning issues. However, the same men were
mentioned as key decision-makers even on the number of children a couple should have and the child spacing of
these children. Third, “gender relations and communication” as participants indicated that few women participated in
decision-making on family planning and the number of children to have. Fourth, “urban–rural differences”, life in rural
favoring having more children than urban areas therefore, the value of children depended on the place of residence.
Conclusion: Family Planning programs should adapt the promotion of communication as well as joint decision-making
on FP among couples as a strategy aimed at enhancing FP use.
