Inadequate male engagement in family planning continues to weaken overall progress in reproductive health

reproductive health

Across the globe, women have historically shouldered the main responsibility for family planning. Deeply rooted cultural and social norms often position men as household decision-makers, leaving women with little influence over family size or access to reproductive health services. This imbalance limits women’s autonomy and slows the path toward fairer health outcomes.

In much of Africa, entrenched gender expectations reinforce the idea that women alone should manage childbirth through modern contraceptive use. Although men play a central role in household decision-making, they are frequently excluded as passive observers instead of active participants. In Uganda, this has meant women face the heavier burden of using contraceptives, coping with stigma, and managing health risks — while men continue to hold power over decisions on family size, finances, and healthcare.

The MenPlus Project was created to close this gap. Established in 2019 by Reach A Hand Uganda (RAHU), in collaboration with Reproductive Health Uganda, private health facilities, and with support from the Erik E. and Edith H. Bergstrom Foundation, the initiative set out to redefine men’s role in family planning — positioning them not as bystanders, but as users, partners, and advocates.

Five years of progress

Five years later, the project has shown that engaging men in family planning delivers measurable results. By June 2024, MenPlus had supported 668 vasectomies, 870 bilateral tubal ligations (BTLs), and thousands of insertions of implants, IUDs, and injectables. These services are estimated to have prevented 2,334 unintended pregnancies, 688 abortions, 524 unsafe abortions, and 60 maternal and child deaths.

Still, male-focused contraceptive use in Uganda remains low. Vasectomy, for instance, represents only 0.6% of the national contraceptive method mix. Persistent myths around masculinity, virility, and sexual performance — alongside limited rural access due to shortages of skilled providers — continue to pose challenges.

Changing mindsets

Despite these hurdles, MenPlus has sparked positive shifts in the communities it serves. Increasingly, men are challenging harmful myths, supporting their partners, and recognizing family planning as a shared duty. Testimonies from men who have undergone vasectomies, and their partners, have been especially powerful in building confidence and dispelling misconceptions.

The project’s community-driven approach has also stood out. By moving family planning discussions beyond clinics into everyday spaces like sports fields, bars, neighborhood cleanups, and board game gatherings, MenPlus created opportunities for open and relatable conversations.

The project has proven that when men are informed, engaged, and empowered, family planning outcomes improve for women, men, and entire communities. For Uganda to achieve Vision 2040 and universal health coverage, cultural, financial, and structural barriers limiting male involvement must be dismantled.

Family planning is about more than preventing pregnancy — it is about protecting futures, saving lives, and ensuring shared responsibility between men and women.

On this World Contraception Day, the call to action is clear:

• Men must rise as equal partners in family planning.

• Communities must honor men who make responsible, informed choices.

• Policymakers must prioritize and invest in male-focused initiatives.

Scaling up the change

The MenPlus model highlights the urgent need for broader adoption. While progress is evident, traditional outreach alone cannot undo deep-seated barriers. The project recommends:

• Using creative engagement methods — such as cinema screenings (Kwiso Mu Cinema), storytelling, and integrating messages into popular activities — to normalize discussions and reduce stigma.

• Strengthening provider capacity, especially in rural areas, to expand access to male-focused family planning services.

• Replicating proven models, such as the RAHU Mbarara Clinic’s evolution into a Vasectomy Center of Excellence that combines high-quality care with compelling testimonies.

• Leveraging mass media, particularly radio programs, dramas, and jingles, to keep the national conversation on men’s role in family planning alive.