Examining the association between men's gender equitable attitudes and contraceptive outcomes in rural Maharashtra, India
Background: Previous literature suggests that men reporting more gender-equitable attitudes are more likely to use condoms, but there is a paucity of data evaluating whether these attitudes are associated with contraceptive communication and use. The objective of this study is to test the hypothesis...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-06-01
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| Series: | Dialogues in Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772653324000042 |
| _version_ | 1827224360181563392 |
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| author | Mohan Ghule Anvita Dixit Nicole E. Johns Madhusudana Battala Shahina Begum Sarah Averbach Jay G. Silverman Niranjan Saggurti Anita Raj |
| author_facet | Mohan Ghule Anvita Dixit Nicole E. Johns Madhusudana Battala Shahina Begum Sarah Averbach Jay G. Silverman Niranjan Saggurti Anita Raj |
| author_sort | Mohan Ghule |
| collection | DOAJ |
| description | Background: Previous literature suggests that men reporting more gender-equitable attitudes are more likely to use condoms, but there is a paucity of data evaluating whether these attitudes are associated with contraceptive communication and use. The objective of this study is to test the hypothesis that men reporting more gender-equitable attitudes will be more likely to (a) engage in contraceptive communication with their wives and (b) that they and/or their wives will be more likely to use all forms of family planning, compared to men with less equitable attitudes. Methods: Using cross-sectional dyadic survey data from young married couples from rural Maharashtra, India (N = 989), we assessed the associations between men's gender role attitudes and a) spousal contraceptive communication and b) contraceptive use by type (none, traditional, condoms, pills, or IUD). The contraceptive use outcome is based on wives' report. We assessed these associations via bivariate t-test (communication outcome) or ANOVA test (contraceptive type outcome), as well as unadjusted and adjusted logistic (communication outcome) and multinomial logistic (contraceptive type outcome) regression models. Adjusted models included sociodemographic factors selected a priori based on established associations with gender-equitable attitudes and/or our assessed outcomes. Findings: Men with more gender-equitable attitudes were more likely to discuss family planning with their wives (AOR = 1·05, 95%CI 1·03-1·07, p < 0·001) and to use condoms (ARRR = 1·03, 95%CI 1·00-1·06, p = 0·07). There was no association between gender-equitable attitudes and use of other types of contraception. Interpretation: While gender-equitable attitudes among men may facilitate condom use and family planning communication in marriage, they do not appear to be linked with greater likelihood of use of more effective types of contraceptive use. This suggests that males supportive of gender equity may take greater responsibility for family planning vis a vis a less effective contraceptive, condoms, in the absence of more effective short-acting contraceptives for men. Funding: The National Institutes of Health [Grant number 5R01HD084453-01A1] and the Bill & Melinda Gates Foundation, Seattle, WA [grant number INV-002967]. |
| first_indexed | 2024-03-08T11:23:54Z |
| format | Article |
| id | doaj.art-9f13aa098cc74e42b7c508b7cf2897f2 |
| institution | Directory Open Access Journal |
| issn | 2772-6533 |
| language | English |
| last_indexed | 2025-03-21T17:09:02Z |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
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| series | Dialogues in Health |
| spelling | doaj.art-9f13aa098cc74e42b7c508b7cf2897f22024-06-14T05:47:04ZengElsevierDialogues in Health2772-65332024-06-014100168Examining the association between men's gender equitable attitudes and contraceptive outcomes in rural Maharashtra, IndiaMohan Ghule0Anvita Dixit1Nicole E. Johns2Madhusudana Battala3Shahina Begum4Sarah Averbach5Jay G. Silverman6Niranjan Saggurti7Anita Raj8Center on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, School of Medicine, University of California San Diego, San Diego, USACenter on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, School of Medicine, University of California San Diego, San Diego, USA; Joint Doctoral Program in Public Health (Global Health track), University of California San Diego/San Diego State University, USACenter on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, School of Medicine, University of California San Diego, San Diego, USAPopulation Council, New Delhi, IndiaICMR-National Institute for Research in Reproductive and Child Health, Mumbai, IndiaCenter on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, School of Medicine, University of California San Diego, San Diego, USA; Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of California San Diego, USACenter on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, School of Medicine, University of California San Diego, San Diego, USAPopulation Council, New Delhi, IndiaNewcomb Institute, Tulane University, New Orleans, LA, USA; Corresponding author at: Newcomb Institute, 43 Newcomb Place, Suite 301, Tulane University, New Orleans, LA 70118, USA.Background: Previous literature suggests that men reporting more gender-equitable attitudes are more likely to use condoms, but there is a paucity of data evaluating whether these attitudes are associated with contraceptive communication and use. The objective of this study is to test the hypothesis that men reporting more gender-equitable attitudes will be more likely to (a) engage in contraceptive communication with their wives and (b) that they and/or their wives will be more likely to use all forms of family planning, compared to men with less equitable attitudes. Methods: Using cross-sectional dyadic survey data from young married couples from rural Maharashtra, India (N = 989), we assessed the associations between men's gender role attitudes and a) spousal contraceptive communication and b) contraceptive use by type (none, traditional, condoms, pills, or IUD). The contraceptive use outcome is based on wives' report. We assessed these associations via bivariate t-test (communication outcome) or ANOVA test (contraceptive type outcome), as well as unadjusted and adjusted logistic (communication outcome) and multinomial logistic (contraceptive type outcome) regression models. Adjusted models included sociodemographic factors selected a priori based on established associations with gender-equitable attitudes and/or our assessed outcomes. Findings: Men with more gender-equitable attitudes were more likely to discuss family planning with their wives (AOR = 1·05, 95%CI 1·03-1·07, p < 0·001) and to use condoms (ARRR = 1·03, 95%CI 1·00-1·06, p = 0·07). There was no association between gender-equitable attitudes and use of other types of contraception. Interpretation: While gender-equitable attitudes among men may facilitate condom use and family planning communication in marriage, they do not appear to be linked with greater likelihood of use of more effective types of contraceptive use. This suggests that males supportive of gender equity may take greater responsibility for family planning vis a vis a less effective contraceptive, condoms, in the absence of more effective short-acting contraceptives for men. Funding: The National Institutes of Health [Grant number 5R01HD084453-01A1] and the Bill & Melinda Gates Foundation, Seattle, WA [grant number INV-002967].http://www.sciencedirect.com/science/article/pii/S2772653324000042Gender attitudesFamily planningContraceptive communicationMale engagementGender-equitable men scale |
| spellingShingle | Mohan Ghule Anvita Dixit Nicole E. Johns Madhusudana Battala Shahina Begum Sarah Averbach Jay G. Silverman Niranjan Saggurti Anita Raj Examining the association between men's gender equitable attitudes and contraceptive outcomes in rural Maharashtra, India Dialogues in Health Gender attitudes Family planning Contraceptive communication Male engagement Gender-equitable men scale |
| title | Examining the association between men's gender equitable attitudes and contraceptive outcomes in rural Maharashtra, India |
| title_full | Examining the association between men's gender equitable attitudes and contraceptive outcomes in rural Maharashtra, India |
| title_fullStr | Examining the association between men's gender equitable attitudes and contraceptive outcomes in rural Maharashtra, India |
| title_full_unstemmed | Examining the association between men's gender equitable attitudes and contraceptive outcomes in rural Maharashtra, India |
| title_short | Examining the association between men's gender equitable attitudes and contraceptive outcomes in rural Maharashtra, India |
| title_sort | examining the association between men s gender equitable attitudes and contraceptive outcomes in rural maharashtra india |
| topic | Gender attitudes Family planning Contraceptive communication Male engagement Gender-equitable men scale |
| url | http://www.sciencedirect.com/science/article/pii/S2772653324000042 |
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