Contraceptive use and fertility preferences among sexually active males in Zambia.

Abstract

Abstract Background: Contraceptive use has been used as one of the methods not only to space but also to limit the number of children that a couple/individuals have. Since their introduction, most of the efforts have concentrated on females than males even though males tend to have huge say on the ideal number of children a couple/individuals have. In our study, we sought to determine linkages between contraceptive use and fertility preferences as well as associated demographic and socio-economic characteristics among sexually active males in Zambia regardless of their marital status. Methods: The study had two outcome variables, namely contraceptive use and fertility preference (measured by desire for more children as a count variable). Data for this paper was the male recode dataset from the 2018 Zambia Demographic and Health Survey. Binary logistic regression was performed to determine odds ratios of contraceptive use by selected characteristics of males. Poisson regression model was used to establish factors associated with fertility preferences. Results: Age of men (20-29, 30-39 and 40-49, respectively), residence in rural areas, wealth quintile, religious affiliation of Protestant or Muslim, media exposure, and having discussed Family Planning with a health worker in the last few months were associated with contraceptive use. Males who reported using any contraception method reported 3% less ideal number of children desired compared with those who were not using any method. Older males (age group 30-49), resident in rural areas, with primary education, married, employed, Protestant by religion, and opinionated to the extent of labeling women who use contraceptives “as promiscuous”, had more ideal number of children comparatively. Conclusions: There were minimal differences in the ideal number of children among males who reported using and not using any contraceptive method. Strategies aimed at encouraging contraception use should cover all categories of males so as to achieve universal involvement of men in family planning in Zambia. A study combining both qualitative and quantitative methods would be ideal to look holistically at the demographic, socio-economic and cultural factors associated with non-contraception use and ideal number of children among males.