1. Men as Partners: Reaching Influencers Mame Niang, MD, MPH September 18, 2015

2.  Understanding our client means knowing her key influencers  Study questions: –Why do some male partners in Kinshasa support FP use while others oppose it? –How do gender dynamics affect FP use for women in union? Need for the study Kinshasa

3.  86 participants : –43 women “in union” in Kinshasa (aged 18-39 years) –43 men “in union” in Kinshasa (with wives aged 18-39) Methodology Focus group discussions In-depth interviews Women modern FP users2 groups (13 women)6 women Women non-users2 groups (12 women)12 women Male partners of modern FP users 2 groups (10 men)12 men Male partners of non-users2 groups (11 men)10 men Total8 discussions with a total of 46 participants 40 interviews

4.  Know about modern FP  Think modern FP is effective  View birth spacing as beneficial  Are the head of the household  Most do not have time to visit health centers Results: Similarities among supportive and unsupportive male partners

5. Results: Differences between supportive and unsupportive male partners Male partners of FP users  Believe benefits of FP outweigh risks & side effects  Think FP enables harmony  May feel hurt and confused if FP used without his knowledge Male partners of FP non-users  Believe risks & side effects of FP outweigh benefits  Think FP enables infidelity  May resort to violence of divorce if FP used without his knowledge

6. Archetype of an unsupportive partner  Pablo, day laborer, age 38, 4 children  Desire spacing so that all children can attend school  Believes rumors that FP causes infertility  Fears that FP would allow his wife to cheat  Monitor his wife’s movement and use of money

7. Key Recommendations Do Engage religious leaders Encourage couple communication and joint decision-making Show benefits of modern FP Ensure that the ultimate choice to use a method is in the hands of the user Do Not Imply that coming to the health facility is the only way for a male partner to be engaged Focus message on the value of birth spacing Informed choice is critical! No need to preach to the choir!

8. Thank you  Study participants  USAID  IntraHealth  PSI/ASF