When people think about family planning in Africa, they often picture women visiting clinics, women making decisions, and women bearing the responsibility. Yet family planning affects both men and women.
How is male involvement being studied? Are men being included in both practice and research? And what does that mean for future health policy?
To find answers, our team of demographers, reproductive health researchers and population scientists analysed the way male involvement in family planning has been measured and conceptualised in Africa-based research over the past three decades.
Our study reviewed 152 scientific publications from 23 African countries. We examined trends in authorship, research focus, country distribution and thematic framing. The goal was to see whether the research landscape was evolving in a way that genuinely included men, and whether that inclusion supported broader goals of gender equity in health.
Our analysis revealed that only around one in five studies claiming to examine male involvement in family planning actually collected data directly from men. This raises important questions about how researchers understand “involvement”. We argued that assessing male involvement without incorporating men’s own perspectives falls short of capturing the true picture.
Among the studies that did collect data from men, the focus was primarily on whether men approved the use of family planning by their partners. We contend that mere “approval” is not genuine involvement.
Our findings highlight a major gap in how male involvement in family planning is studied. This matters because true involvement is more than just saying “yes”. Future research and interventions must collect data from men themselves and consider aspects of involvement like emotional support, shared decision-making, communication, and joint responsibility.
Why male involvement in family planning matters
Across Africa, family planning programmes have focused mainly on women. This has undoubtedly improved maternal health and reduced unintended pregnancies. For instance, within a decade (2010-2020), there was a 35% decline in under-five mortality and a 28% reduction in maternal mortality. But the focus on women has also reinforced a view that family planning is primarily a woman’s concern.
In many communities, it’s men who decide how many children to have, when to have them and whether contraception should be used at all.
Therefore, leaving men out of family planning conversations undermines the success of family planning programmes.
Involving men doesn’t mean shifting responsibility away from women. Rather, it means recognising that shared decision-making, mutual respect, and supportive partnerships are critical to long-term reproductive health goals. Involving men also helps dismantle harmful stereotypes – like the idea that “real men” must have many children or control their partners’ fertility choices.
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Nigeria’s cities are growing fast: family planning must be part of urban development plans
Our research
We analysed peer-reviewed studies published between 1996 and 2023.
The results showed that research on male involvement has increased significantly in recent years, especially since 2015.
This is a good sign. It reflects growing recognition that men must be included if family planning programmes are to succeed.
Many of these studies, however, still focused narrowly on men as “supporters” of women’s use of family planning, rather than as equal stakeholders with their own needs, attitudes and roles.
Few papers explore men’s own fertility intentions, experiences with contraceptive methods, or perceptions of health services.
Even more concerning was the geographic concentration of the research. Most studies came from just four countries: Nigeria, Ethiopia, Uganda and Kenya. Large parts of the continent were underrepresented.
That means researchers risk building a knowledge base that doesn’t reflect the diversity of African societies, cultures and health systems.
Authorship is another critical equity issue. Some studies were led or dominated by authors affiliated with non-African institutions.
For instance, the top 51 of the 100 most influential authors (based on citation impact) of the 152 reviewed articles were non-African affiliates. Equitable collaboration in research is essential, not only for fairness, but also for cultural relevance and sustainability. African researchers must be at the forefront of research that informs African health policy.
Men’s involvement improves outcomes
Several programmes in Africa show that engaging men in family planning improves outcomes.
In Senegal, media and community campaigns led to increased male support and contraceptive use.
Malawi’s “Male Motivator” project used peer outreach to boost uptake among men.
In Tanzania, involving men by inviting them to clinics led to a 71% attendance rate among men accompanying their wives to the family planning visits.
Kenya introduced male-only clinics and targeted media campaigns, increasing male participation.
In Ghana, family planning services targeted specifically at men — often via male-focused clinics and outreach — resulted in increased male involvement.
These initiatives demonstrate that when men are intentionally included, through outreach, peer education, or clinic-based strategies, they are more likely to support and engage in family planning. This leads to stronger, more effective reproductive health programmes.
Read more:
Ghana’s fathers: maternal health services must do more to help them get involved
What needs to be done
Our study highlighted the principle that equity in health cannot be achieved without equity in knowledge production. When research excludes men, ignores African voices, or focuses on a narrow set of countries, it leads to policies and programmes that are out of touch with people’s real lives.
For reproductive health policies that work, stakeholders must ensure they are built on inclusive, representative, and culturally grounded evidence. That means bringing both men and women into the conversation, as equal participants and as valued subjects of research. And it means investing in African researchers, because the people closest to the challenges are also the ones best positioned to find the solutions.
The findings of this study have clear implications for researchers, policymakers and health professionals:
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Researchers need to include diverse aspects of male reproductive health, including men’s experiences, perceptions and involvement in communications.
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Policy makers should ensure that national health strategies and family planning campaigns include men as active participants, not just as supporters of women.
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Health professionals must receive training to engage with men in ways that are respectful, nonjudgmental and informed by local contexts.
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Donors and funders must prioritise equity in authorship, promote capacity building for African researchers, and support regionally diverse studies.
Improving male involvement in family planning isn’t about choosing between men and women. It’s about designing health systems and research agendas that reflect the reality that reproductive health is a shared responsibility.
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