Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-26T17:57:38.023Z Has data issue: false hasContentIssue false

A qualitative examination of men’s participation in contraceptive use and its barriers in Tehran

Published online by Cambridge University Press:  14 October 2020

Reyhaneh Bagheri
Affiliation:
Centre for Research on Women and Gender (KANITA), Universiti Sains Malaysia (USM), Malaysia
Rashidah Shuib
Affiliation:
School of Health Sciences (PPSK), Universiti Sains Malaysia (USM), Malaysia
Premalatha Karupiah
Affiliation:
School of Social Sciences, Universiti Sains Malaysia (USM), Malaysia
Panteá Farvid
Affiliation:
School of Public Engagement, The New School, New York, USA
Farideh Khalajabadi-Farahani*
Affiliation:
Department of Population & Health, National Population Studies and Comprehensive Management Institute of Iran, Tehran, Iran
*
*Corresponding author. Email: [email protected]

Abstract

From 1989 to 2014, Iran was known as a country with a successful family planning programme, and has experienced a sharp decline in fertility over recent decades. This led to the introduction of pronatalist policies in 2014 and the restriction of family planning services. The aim of this study was to explore men’s views on their access to contraceptive information and services and the socio-cultural barriers to such access in Tehran. The qualitative study was conducted in 2014 using in-depth interviews with 60 married men of varying ages and socioeconomic status from across Tehran. The data were analysed with a basic interpretive approach using MAXQDA10. Although the majority of the men acknowledged the importance of family planning and contraceptive use, they reported that their access to contraceptive information and services was limited. Discussion of sexual matters and contraception among men was identified as being somewhat embarrassing. Three main issues were identified: (1) men’s poor awareness of contraceptive use; (2) men’s poor access to high-quality health care services; and (3) cultural taboos and gender norms as barriers to contraception use by men. Socio-cultural and gender norms were found to significantly affect the men’s contraceptive use. The study results support the growing call for gender-transformative approaches to family planning and reproductive health service delivery in Iran, to involve men and facilitate their greater participation.

Type
Research Article
Copyright
© The Author(s) 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abbasi Shavazi, M and Hosseini-Chavoshi, M (2014) Population trends and policies in Iran: the necessity for comprehensive national population plan. Journal of the Population Association of Iran 7 (13), 177196.Google Scholar
Aghajanian, A (1994) Family planning and contraceptive use in Iran, 1967–1992. International Family Planning Perspectives 20 (2), 6669.CrossRefGoogle Scholar
Akbari, N, Ramezankhani, A and Pazargadi, M (2013) Accelerators/decelerators of achieving universal access to sexual and reproductive health services: a case study of Iranian health system. BMC Health Services Research 13, 241.CrossRefGoogle ScholarPubMed
Ali, M, Rizwan, H and Ushijima, H (2004) Men and reproductive health in rural Pakistan: the case for increased male participation. European Journal of Contraception and Reproductive Health Care 9 (4), 260266.CrossRefGoogle ScholarPubMed
Bagheri, R (2017) Men’s Involvement in Family Planning and Reproductive Health Matters in Tehran, Iran. Doctoral dissertation, Universiti Sains Malaysia.Google Scholar
Barker, G, Ricardo, C and Nascimento, M (2007) Engaging Men and Boys in Changing Gender-Based Inequity in Health: Evidence From Programme Interventions. World Health Organization, Geneva.Google Scholar
Behboudi-Gandevani, S, Tehrani, FR, Cheraghi, L, Noroozzadeh, M, Farahmand, M and Azizi, F (2017) Trends of contraception use among married reproductive age women: Tehran lipid and glucose cohort study 2002–2011. Sexual & Reproductive Healthcare 12, 116122.10.1016/j.srhc.2017.04.003CrossRefGoogle ScholarPubMed
Bertrand, JT, Hardee, K, Magnani, RJ and Angle, MA (1995) Access, quality of care and medical barriers in family planning programs. International Family Planning Perspectives 21 (2), 6474.CrossRefGoogle Scholar
Connell, RW (1987) Gender and Power: Society, The Person and Sexual Politics. Stanford University Press, California.Google Scholar
Croce-Galis, M, Salazar, E and Lundgren, R (2013) Male Engagement in Family Planning: Reducing Unmet Need for Family Planning by Addressing Gender Norms. Institute for Reproductive Health, Georgetown University,Washington, DC.Google Scholar
Cupples, JB, Zukoski, AP and Dierwechter, T (2010) Reaching young men: lessons learned in the recruitment, training, and utilization of male peer sexual health educators. Health Promotion Practice 11 (Supplement 3), 19S25S.CrossRefGoogle ScholarPubMed
Elo, S and Kyngus, H (2008) The qualitative content analysis process. Journal of Clinical Nursing 62 (1), 107115.Google ScholarPubMed
Erfani, A (2011) Induced abortion in Tehran, Iran: estimated rates and correlates. International Perspectives on Sexual and Reproductive Health 37 (3), 134142.CrossRefGoogle ScholarPubMed
Erfani, A (2013a) Fertility in Tehran city and Iran: rates, trends and differentials [in Persian]. Population Studies 1 (1), 87107.Google Scholar
Erfani, A (2013b) Levels, trends, and determinants of unintended pregnancy in iran: the role of contraceptive failures. Studies in Family Planning 44 (3), 299317.CrossRefGoogle ScholarPubMed
Erfani, A (2015) Curbing family planning in Iran: an appraisal of Bill 446. Journal of Family Planning and Reproductive Health Care 41 (4), 317.CrossRefGoogle ScholarPubMed
Erfani, A (2017) Curbing publicly-funded family planning services in Iran: who is affected? Journal of Family Planning and Reproductive Health Care 43 (1), 3743.CrossRefGoogle ScholarPubMed
Fallahi, H, Tavafian, SS, Yaghmaiee, F and Hajizadeh, I (2012) Perceived barriers of condom use in people living with HIV/AIDS: a qualitative research. Payesh 11 (6), 831840.Google Scholar
Fereshtehnejad, SM, Asadi-Lari, M, Moradi Lakeh, M, Vaez-Mahdavi, MR, Motevalian, SA and Afkari, ME (2010) Estimation of life expectancy and its association with social determinants of health (SDH) in urban population of different districts of Tehran in 2008 (Urban HEART Study). Teb va Tazkiyeh 19 (2), 2540.Google Scholar
Gheissari, A (2009) Contemporary Iran: Economy, Society, Politics. Oxford University Press.CrossRefGoogle Scholar
Greene, M, Mehta, M, Pulerwitz, J, Deirdre, W, Bankole, A and Singh, S (2006) Involving Men in Reproductive Health: Contributions to Development. Background paper prepared for the UN Millennium Project to contribute to the report Public Choices, Private Decisions: Sexual and Reproductive Health and the Millenium Development Goals.Google Scholar
Gueye, A, Speizer, IS, Corroon, M and Okigbo, CC (2015) Belief in family planning myths at the individual and community levels and modern contraceptive use in urban Africa. International Perspectives on Sexual and Reproductive Health 41 (4), 191.CrossRefGoogle Scholar
Gupta, N, Katende, C and Bessinger, R (2003) Associations of mass media exposure with family planning attitudes and practices in Uganda. Studies in Family Planning 34 (1), 1931.CrossRefGoogle ScholarPubMed
Hoodfar, H and Assadpour, S (2000) The politics of population policy in the Islamic Republic of Iran. Studies in Family Planning 31 (1), 1934.CrossRefGoogle ScholarPubMed
Hosseini-Chavoshi, M, Abbasi-Shavazi, MJ and McDonald, P (2016) Fertility, marriage, and family planning in Iran: implications for future policy. Population Horizons 13 (1), 3140.CrossRefGoogle Scholar
Karamouzian, M, Sharifi, H and Haghdoost, AA (2014) Iran’s shift in family planning policies: concerns and challenges. International Journal of Health Policy and Management 3 (5), 231.CrossRefGoogle ScholarPubMed
Karamouzian, M and Shokoohi, M (2014) Sexual and reproductive health education in Iranian schools. Journal of Adolescent Healt 55 (1), 149.CrossRefGoogle ScholarPubMed
Khalajabadi-Farahani, F (2015) Unmet needs of adolescent and young people’s sexual and reproductive health in Iran. Journal of Reproduction & Infertility 16 (3), 121.Google Scholar
Khalajabadi Farahani, F and Erfani, A (2014) Career or educational aspirations? Low fertility intentions and high contraceptive intentions among prospective brides in Tehran, Iran. Paper presented at the 2014 Annual Meeting of the Population Association of America.Google Scholar
Khalajabadi Farahani, F and Heidari, J (2013) Male participation in family planning in Zanjan, 2011: a qualitative study [in Persian]. Hakim Research Journal 16 (1), 5057.Google Scholar
Khalajabadi Farahani, F and Khazani, S (2019) Pronatalist policies and its role in pattern of contraceptive methods among women in reproductive age in Sanandaj City, 2016 [in Persian]. Iranian Journal of Obstetrics, Gynecology and Infertility 22 (6), 2038.Google Scholar
Khalajabadi Farahani, F and Saraie, H (2013) Single child intention and its determinants among about to married men and women in Tehran [in Persian]. Population Studies Journal 1 (1), 6178.Google Scholar
Kohan, S, Mohammadi, F, Mostafavi, F and Gholami, A (2016) Exploring the characteristics of public reproductive health services in the Islamic Republic of Iran from the perspectives of unmarried women: what needs to be changed? Eastern Mediterranean Health Journal 22 (2), 116123.10.26719/2016.22.2.116CrossRefGoogle ScholarPubMed
Kululanga, LI, Sundby, J, Malata, A and Chirwa, E (2011) Striving to promote male involvement in maternal health care in rural and urban settings in Malawi – a qualitative study. Reproductive Health, 8 (1), 112.CrossRefGoogle Scholar
Larsson, EC, Thorson, A, Nsabagasani, X, Namusoko, S, Popenoe, R and Ekström, AM (2010) Mistrust in marriage – reasons why men do not accept couple HIV testing during antenatal care. A qualitative study in eastern Uganda. BMC Public Health 10 (1), 19.CrossRefGoogle Scholar
Lindberg, C, Lewis-Spruill, C and Crownover, R (2006) Barriers to sexual and reproductive health care: urban male adolescents speak out. Issues in Comprehensive Pediatric Nursing 29 (2), 7388.CrossRefGoogle ScholarPubMed
Mehryar, AH, Mostafavi, F and Agha, H (2001) Men and Family Planning in Iran. Ministry of Science, Research & Technology, Population Studies and Research Center for Asia and the Pacific.Google Scholar
Merriam, SB (2002) Qualitative Research in Practice: Examples for Discussion And Analysis. Jossey-Bass Inc. Google Scholar
Mistik, S, Nacar, M, Mazicioğlu, M and Cetinkaya, F (2003) Married men’s opinions and involvement regarding family planning in rural areas. Contraception 67 (2), 133137.CrossRefGoogle ScholarPubMed
Mokhayeri, Y, Mahmoudi, M, Haghdoost, AA, Amini, H, Asadi-Lari, M and Naieni, KH (2014) How within-city socioeconomic disparities affect life expectancy? Results of Urban HEART in Tehran, Iran. Medical Journal of the Islamic Republic of Iran 28, 80.Google ScholarPubMed
Moosazadeh, M, Nekoei-Moghadam, M, Emrani, Z and Amiresmaili, M (2014) Prevalence of unwanted pregnancy in Iran: a systematic review and meta-analysis. International Journal of Health Planning and Management 29 (3), e277e290.CrossRefGoogle ScholarPubMed
Mortazavi, F and Mirzaii, K (2012) Reason of, barriers to, and outcomes of husbands’ involvement in prenatal and intrapartum care program based on midwives’ experiences: a qualitative study. Arak Medical University Journal 15 (1), 104115.Google Scholar
Mullany, BC (2006) Barriers to and attitudes towards promoting husbands’ involvement in maternal health in Katmandu, Nepal. Social Science & Medicine 62 (11), 27982809.CrossRefGoogle ScholarPubMed
O’Byrne, P and Watts, J (2014) Include, differentiate and manage: gay male youth, stigma and healthcare utilization. Nursing Inquiry 21 (1), 2029.CrossRefGoogle ScholarPubMed
Ochako, R, Mbondo, M, Aloo, S, Kaimenyi, S, Thompson, R, Temmerman, M and Kays, M (2015) Barriers to modern contraceptive methods uptake among young women in Kenya: a qualitative study. BMC Public Health 15 (1), 19.CrossRefGoogle ScholarPubMed
Petersen, RD and Valdez, A (2005) Using snowball-based methods in hidden populations to generate a randomized community sample of gang-affiliated adolescents. Youth Violence and Juvenile Justice 3 (2), 151167.CrossRefGoogle Scholar
Pournia, Y, Binabaj, NB and Salarvand, S (2012) Young clients’ satisfaction with the quality of premarital family planning counseling services. Middle East Journal of Nursing 6 (4), 1318.Google Scholar
Price, NL and Hawkins, K (2007) A conceptual framework for the social analysis of reproductive health. Journal of Health, Population, and Nutrition 25 (1), 2436.Google ScholarPubMed
Rabbani, R, Afshani, S and Fazel Najaf Abadi, S (2008) Different roles of men and women in the family planning: a case study of the city of najafabad, Iran. Journal of Women Studies (Sociological & Psychological) 5 (3), 5980.Google Scholar
Rakhshani, F, Niknami, S and Ansari Moghaddam, AR (2005) Couple communication in family planning decision-making in Zahedan, Islamic Republic of Iran. Eastern Mediterranean Health Journal 11 (4), 586593.Google ScholarPubMed
Saleh, MF (2008) Sattareh Farman Farmaian: Iranian social work pioneer. Affilia 23 (4), 397402.CrossRefGoogle Scholar
Sandelowski, M and Leeman, J (2012) Writing usable qualitative health research findings. Qualitative Health Research 22 (10), 14041413.CrossRefGoogle ScholarPubMed
Shahjahan, M, Mumu, SJ, Afroz, A, Chowdhury, HA, Kabir, R and Ahmed, K (2013) Determinants of male participation in reproductive healthcare services: a cross-sectional study. Reproductive Health 10 (27), 16.CrossRefGoogle ScholarPubMed
Shaikh, BT and Hatcher, J (2005) Health seeking behaviour and health service utilization in Pakistan: challenging the policy makers. Journal of Public Health 27 (1), 4954.CrossRefGoogle ScholarPubMed
Shokoohi, M, Karamouzian, M, Mirzazadeh, A, Haghdoost, A, Rafierad, AA, Sedaghat, A and Sharifi, H (2016) HIV knowledge, attitudes, and practices of young people in Iran: findings of a national population-based survey in 2013. PLoS One 11 (9), 115.CrossRefGoogle ScholarPubMed
Simbar, M (2012) Achievements of the Iranian family planning programmes 1956–2006. Eastern Mediterranean Health Journal 18 (3), 279286.CrossRefGoogle ScholarPubMed
Simmons, R, Brown, J and Díaz, M (2002) Facilitating large-scale transitions to quality of care: an idea whose time has come. Studies in Family Planning 33 (1), 6175.CrossRefGoogle ScholarPubMed
Sternberg, P and Hubley, J (2004) Evaluating men’s involvement as a strategy in sexual and reproductive health promotion. Health Promotion International 19 (3), 389396.CrossRefGoogle ScholarPubMed
Tran, NT, Dawson, A, Meyers, J, Krause, S and Hickling, C (2015) Inter-Agency Working Group (IAWG) on reproductive health in crisis. Developing institutional capacity for reproductive health in humanitarian settings: a descriptive study. PLoS One 10, e0137412.CrossRefGoogle Scholar
WHO (2012) Male Involvement in the Prevention of Mother-to-Child Transmission of HIV. World Health Organization, Geneva.Google Scholar
Wingood, G and DiClemente, R (2002) The theory of gender and power. In DiClemente, RJ, Crosby, RA & Kegler, MC (eds) Emerging Theories in Health Promotion Practice and Research: Strategies for Improving Public Health. Jossey-Bass, San Francisco, pp. 313345.Google Scholar
Wood, K and Aggleton, P (2002) Promoting Young Peoples’ Sexual and Reproductive Health. Stigma, Discrimination and Human Rights. Centre for Sexual Health Research, Safe Passages to Adulthood Programme, University of Southampton, UK.Google Scholar
Yazdi, C, Aschbacher, K, Arvantaj, A, Naser, HM, Abdollahi, E, Asadi, A et al. (2006) Knowledge, attitudes and sources of information regarding HIV/AIDS in Iranian adolescents. AIDS Care 18 (8), 10041010.CrossRefGoogle ScholarPubMed