Project – Effect of Reproductive Health Literacy and Gender Norms on Male Support for Modern Contraceptive Use among Couples in Selected Communities of Karu Local Government Area, Nasarawa State

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Reproductive health remains a critical component of global public health because it influences individual wellbeing, family welfare, population growth, and socioeconomic development. Among the major interventions aimed at improving reproductive health outcomes is the promotion of modern contraceptive use through effective family planning programmes. Modern contraception enables couples to prevent unintended pregnancies, space births, improve maternal and child health outcomes, and make informed decisions about their reproductive goals. According to the World Health Organization (WHO, 2023), access to accurate reproductive health information and contraceptive services is a fundamental human right and an essential strategy for reducing maternal mortality and improving family health.

Modern contraceptive methods include oral contraceptive pills, injectable contraceptives, implants, intrauterine devices (IUDs), condoms, and other medically approved methods designed to prevent pregnancy. Despite global improvements in contraceptive availability, many couples in low- and middle-income countries continue to experience barriers that limit the adoption and consistent use of modern contraceptive methods. The United Nations Population Fund (UNFPA, 2022) reported that inadequate access to reproductive health information, sociocultural restrictions, misconceptions about contraceptive methods, and gender inequalities remain major challenges affecting family planning practices.

One important factor influencing contraceptive use among couples is reproductive health literacy. Reproductive health literacy refers to the ability of individuals to obtain, understand, evaluate, and apply reproductive health information in making appropriate health decisions. It extends beyond basic awareness of contraception to include knowledge of available methods, understanding of benefits and side effects, ability to access healthcare services, and capacity to make informed reproductive choices. According to Sørensen et al. (2012), health literacy plays a significant role in improving individuals’ ability to navigate health information and make decisions that promote positive health outcomes.

In the context of family planning, reproductive health literacy is particularly important because misconceptions and inadequate knowledge about modern contraceptive methods often influence couples’ attitudes and behaviours. Men with limited reproductive health knowledge may develop negative perceptions about contraceptives, including fears about infertility, reduced sexual ability, health complications, or cultural incompatibility. Such misconceptions may reduce their willingness to support their partners’ use of modern contraceptives. Studies have shown that men’s knowledge and understanding of reproductive health significantly influence their acceptance and support for family planning practices (Blackstone, Nwaozuru, & Iwelunmor, 2017).

Male involvement in contraceptive decision-making has become increasingly recognized as an essential component of successful family planning programmes. Although women are usually the primary users of contraceptive methods, decisions regarding contraceptive adoption are often made jointly by couples. Men may influence contraceptive decisions through their attitudes, financial support, communication with partners, and approval or opposition to contraceptive use. According to Hardee, Croce-Galis, and Gay (2017), engaging men in family planning improves communication between couples, promotes shared responsibility, and contributes to improved reproductive health outcomes.

However, male support for modern contraceptive use is influenced not only by knowledge but also by prevailing gender norms within communities. Gender norms refer to socially constructed expectations, beliefs, and behaviours regarding the roles and responsibilities of men and women in society. In many African societies, traditional gender norms often portray men as household decision-makers and women as responsible for reproductive matters. Such beliefs may limit women’s autonomy while also shaping men’s attitudes toward contraceptive use.

Gender norms can influence whether men perceive family planning as a shared responsibility or as a woman’s issue. In societies where masculinity is associated with having many children, controlling reproductive decisions, or demonstrating fertility, men may resist modern contraceptive use. Conversely, progressive gender norms that promote communication, equality, and shared decision-making may encourage men to support contraceptive practices. According to Connell (2005), gender relations influence social behaviours by shaping expectations regarding power, responsibility, and decision-making between men and women.

In Nigeria, family planning practices are influenced by diverse cultural, religious, and social factors. Although government and health organizations have implemented programmes to increase contraceptive awareness and access, contraceptive prevalence remains relatively low compared with global targets. The Nigeria Demographic and Health Survey (NDHS) reported that modern contraceptive utilization among women remains limited, with factors such as knowledge gaps, partner opposition, cultural beliefs, and gender dynamics contributing to low uptake (National Population Commission [NPC] & ICF, 2019).

Nasarawa State, including Karu Local Government Area, reflects many of the reproductive health challenges experienced in other parts of Nigeria. Karu is a rapidly developing area with a mixture of urban and rural communities, diverse cultural groups, and varying socioeconomic conditions. Despite the availability of healthcare facilities and family planning services, some couples continue to experience challenges related to contraceptive acceptance and male support. Understanding the influence of reproductive health literacy and gender norms within these communities is therefore important for improving family planning interventions.

Reproductive health literacy may influence male support by increasing men’s understanding of the benefits of modern contraception and reducing misconceptions. When men possess adequate information about contraceptive methods, they may be more likely to communicate effectively with their partners, encourage contraceptive use, and participate in reproductive decisions. Conversely, limited literacy may reinforce misinformation and negative attitudes toward modern contraceptive methods.

Similarly, gender norms may either facilitate or hinder male support for contraception. Men who believe in shared decision-making and gender equality are more likely to support their partners’ reproductive choices. However, men who hold traditional beliefs regarding male dominance and fertility expectations may oppose contraceptive use. Therefore, examining gender norms provides insight into the social factors influencing contraceptive decision-making among couples.

Previous research has examined contraceptive utilization, women’s reproductive health behaviours, and access to family planning services; however, fewer studies have focused specifically on how reproductive health literacy and gender norms jointly influence male support for modern contraceptive use. This creates an important research gap because men’s attitudes and behaviours remain central to achieving sustainable improvements in family planning outcomes.

Therefore, this study seeks to examine the effect of reproductive health literacy and gender norms on male support for modern contraceptive use among couples in selected communities of Karu Local Government Area, Nasarawa State. The study aims to provide evidence on how knowledge, social beliefs, and gender expectations influence men’s participation in contraceptive decision-making and contribute to improved reproductive health strategies within the study area.

1.2 Statement of the Problem

Modern contraceptive use remains one of the most effective strategies for improving maternal health, preventing unintended pregnancies, and promoting family wellbeing. Despite continuous efforts by governments, healthcare providers, and international organizations to improve access to family planning services in Nigeria, contraceptive uptake remains relatively low, particularly in many rural and semi-urban communities. One major challenge affecting contraceptive adoption is limited male support and participation in family planning decisions.

Although women are often the direct users of modern contraceptive methods, men significantly influence whether contraceptive practices are accepted, adopted, and sustained within households. In many Nigerian communities, men control major household decisions, including reproductive choices, financial resources, and healthcare utilization. Therefore, negative male attitudes or lack of support may prevent women from accessing and continuing contraceptive methods.

One possible explanation for inadequate male support is insufficient reproductive health literacy. Many men may lack accurate information about modern contraceptive methods, their effectiveness, safety, and benefits. Misconceptions regarding contraceptive side effects, infertility concerns, and moral beliefs may discourage men from supporting their partners’ contraceptive choices. Without adequate reproductive health literacy, men may rely on cultural beliefs and misinformation when making reproductive decisions.

Another significant challenge is the influence of gender norms. Traditional gender expectations in many Nigerian communities often assign reproductive responsibilities primarily to women while positioning men as dominant decision-makers. Such norms may create unequal power relationships that limit communication between couples and discourage men from viewing family planning as a shared responsibility.

Although existing studies have examined factors influencing contraceptive use among women, limited attention has been given to the combined effect of reproductive health literacy and gender norms on male support for modern contraceptive use. Many previous studies have focused on access to services, availability of contraceptive methods, or women’s characteristics, leaving insufficient understanding of the social and knowledge-based factors influencing men’s attitudes and behaviours.

Furthermore, limited empirical evidence exists regarding these relationships in Karu Local Government Area of Nasarawa State. The cultural diversity, socioeconomic characteristics, and changing demographic patterns of communities within Karu make it necessary to investigate how reproductive health knowledge and gender expectations influence male support for contraceptive use.

The absence of adequate understanding of these factors may limit the effectiveness of family planning programmes because interventions that focus only on increasing service availability may fail if men continue to oppose or discourage contraceptive adoption. Therefore, addressing reproductive health literacy and gender norms among men is essential for promoting shared decision-making and improving contraceptive utilization.

Consequently, this study seeks to fill this gap by examining the effect of reproductive health literacy and gender norms on male support for modern contraceptive use among couples in selected communities of Karu Local Government Area, Nasarawa State.

1.3 Aim of the Study

The main aim of this study is to examine the effect of reproductive health literacy and gender norms on male support for modern contraceptive use among couples in selected communities of Karu Local Government Area, Nasarawa State.

1.3.1 Objectives of the Study

The specific objectives of the study are to:

1. Examine the influence of reproductive health literacy on male support for modern contraceptive use among couples in selected communities of Karu Local Government Area, Nasarawa State.
2. Determine the effect of men’s knowledge and understanding of contraceptive methods on their willingness to support modern contraceptive practices among couples.
3. Assess the influence of gender norms on male attitudes and participation in modern contraceptive decision-making among couples.
4. Examine the combined effect of reproductive health literacy and gender norms on male support for modern contraceptive use among couples in selected communities of Karu Local Government Area, Nasarawa State.

1.4 Research Questions

The study seeks to answer the following research questions:

1. To what extent does reproductive health literacy influence male support for modern contraceptive use among couples in selected communities of Karu Local Government Area, Nasarawa State?
2. How does men’s knowledge and understanding of contraceptive methods affect their willingness to support modern contraceptive practices among couples?
3. What influence do gender norms have on male attitudes and participation in modern contraceptive decision-making among couples?
4. What is the combined effect of reproductive health literacy and gender norms on male support for modern contraceptive use among couples in selected communities of Karu Local Government Area, Nasarawa State?

1.5 Research Hypothesis

The following null hypothesis was formulated and tested at a 0.05 level of significance:

H₀: Reproductive health literacy and gender norms have no significant effect on male support for modern contraceptive use among couples in selected communities of Karu Local Government Area, Nasarawa State.

1.6 Significance of the Study

This study is significant because it provides evidence on how reproductive health literacy and gender norms influence male support for modern contraceptive use among couples. The findings will contribute to a better understanding of the social and knowledge-related factors affecting contraceptive decision-making within households.

The study will be beneficial to government agencies and policymakers involved in reproductive health planning and family planning interventions. Findings from the study may assist policymakers in developing strategies that incorporate men into reproductive health programmes rather than focusing exclusively on women. By understanding the factors that influence male attitudes, policies can be designed to promote shared reproductive responsibility among couples.

The study will also be valuable to healthcare providers and family planning practitioners. Nurses, community health workers, and reproductive health educators may use the findings to design targeted educational programmes aimed at improving men’s reproductive health knowledge and addressing misconceptions about modern contraceptive methods. The study may encourage healthcare providers to include men in counselling sessions and family planning discussions.

Furthermore, the study will benefit married couples and families by emphasizing the importance of communication and joint decision-making in reproductive health matters. Increased awareness of the importance of male support may encourage couples to discuss contraceptive choices openly and make informed decisions regarding child spacing and family size.

The study will also be useful to community leaders, religious organizations, and non-governmental organizations (NGOs) working in reproductive health promotion. Understanding how gender norms influence contraceptive decisions may help these stakeholders develop culturally appropriate interventions that challenge harmful beliefs while promoting positive attitudes toward shared reproductive responsibilities.

Academically, the study will contribute to existing literature on reproductive health, gender studies, and family planning. While previous studies have examined contraceptive use among women, this research focuses specifically on male support and the interaction between knowledge and social expectations. The findings will provide a reference point for future researchers interested in reproductive health behaviours in Nigeria and other developing contexts.

1.7 Scope of the Study

This study focuses on examining the effect of reproductive health literacy and gender norms on male support for modern contraceptive use among couples in selected communities of Karu Local Government Area, Nasarawa State.

The study is limited to married couples residing in selected communities within Karu Local Government Area. The independent variables of the study are:

1. Reproductive health literacy
2. Gender norms

The dependent variable is:

• Male support for modern contraceptive use

Specifically, the study examines:

• Men’s knowledge and understanding of modern contraceptive methods.
• Awareness of contraceptive benefits, effectiveness, and possible side effects.
• Influence of cultural expectations and gender roles on contraceptive decisions.
• Men’s attitudes toward shared reproductive responsibility.
• Male communication, approval, and financial support regarding contraceptive use.

The study does not primarily investigate other factors such as healthcare availability, cost of contraceptives, religious affiliation, or government policies except where they relate indirectly to male support for modern contraceptive use.

1.8 Operational Definition of Terms

Reproductive Health Literacy

Reproductive health literacy refers to the ability of individuals, particularly men, to obtain, understand, evaluate, and use accurate information about reproductive health issues, including modern contraceptive methods, benefits, risks, and available services.

Gender Norms

Gender norms refer to socially constructed beliefs, expectations, and behaviours that define acceptable roles and responsibilities for men and women within a society, particularly regarding reproductive decision-making and family responsibilities.

Male Support

Male support refers to the willingness and active participation of men in promoting and accepting modern contraceptive use through communication, approval, financial assistance, encouragement, and joint decision-making with their partners.

Modern Contraceptive Use

Modern contraceptive use refers to the utilization of scientifically approved family planning methods such as condoms, pills, implants, injectable contraceptives, intrauterine devices (IUDs), and other medically recognized methods for preventing pregnancy.

Family Planning

Family planning refers to the process through which individuals and couples determine the number and spacing of their children through informed reproductive choices and the use of contraceptive methods.

Couples

Couples refer to married men and women who share reproductive decisions, household responsibilities, and family planning choices.

Contraceptive Decision-Making

Contraceptive decision-making refers to the process through which couples discuss, choose, and agree on the use or non-use of modern contraceptive methods.

Selected Communities

Selected communities refer to the specific rural and semi-urban settlements within Karu Local Government Area, Nasarawa State, chosen for the purpose of this study.

Project – Effect of Reproductive Health Literacy and Gender Norms on Male Support for Modern Contraceptive Use among Couples in Selected Communities of Karu Local Government Area, Nasarawa State