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Strong J. "Even when you write with a pencil there is an eraser to clean it": Examining men's conceptualisations of and involvement in emergency contraceptive use in Accra, Ghana. Soc Sci Med 2024; 344:116635. [PMID: 38324975 DOI: 10.1016/j.socscimed.2024.116635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 12/01/2023] [Accepted: 01/25/2024] [Indexed: 02/09/2024]
Abstract
Emergency contraceptive pills are an essential and unique post-coital method to avoid a pregnancy, with evidence showing the significant role men can have in procurement and decisions to use. Global Health recommendations specify that emergency contraceptive pills be used sparingly and under specific conditions. This increasingly misaligns with the myriad conceptualisations and rationales among the public for why they choose to use emergency contraceptive pills. There has been a paucity of research aiming to understanding men's involvement and how they shape women's access, choice, and autonomy. This study interrogates how emergency contraceptive pills are conceptualised by men in James Town, Ghana, and how this intersects with their motivations to be involved in its use. Mixed method data from a survey (n = 270) and in-depth interviews (n = 37) were collected between July 2020 and January 2021. The analysis examines men's framings of emergency contraceptive pills and how these shape their involvement in its use. Men's knowledge of post-coital contraceptives was high, while knowledge of the specific term 'emergency contraception' was lower. While some men understood the pills in ways that aligned to Global Health framings, many more men saw emergency contraceptive pills as another means of pregnancy prevention in line with other contraceptives. This included its conceptualisation as a contraceptive that facilitates pleasurable (condomless) and spontaneous sex. Gendered perceptions of women who use emergency contraceptive pills were bound in sexual stigma, and men indicated that emergency contraceptive pills were a directly observable form of contraception that they could pressure their partner into using. Understanding plural conceptualisations away from 'emergency' are necessary to create policies and programmes that account for men's involvement. This includes understanding how emergency contraceptive pills are located within people's sexual and reproductive lives and gendered power dynamics, to reflect the public's own rationales for and experiences using post-coital contraceptives.
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Affiliation(s)
- Joe Strong
- Department of Social Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.
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Kolak M, Agardh A, Rubertsson C, Hansson SR, Ekstrand Ragnar M. Immigrant men 's perceptions and experiences of accompanying their partner for contraceptive counselling provided by midwives in Sweden- a qualitative study. PLoS One 2024; 19:e0295796. [PMID: 38165872 PMCID: PMC10760736 DOI: 10.1371/journal.pone.0295796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 11/29/2023] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Male involvement in maternal health care has proven to be beneficial for improving maternal and child health and is often crucial in areas of family planning and contraceptive use. However, compared to male involvement in maternal health care, male involvement in contraceptive counselling is complex and controversial and thus faces certain challenges. Immigrant men in Sweden are often accompanying their partner for contraceptive counselling. Little is known about their presence and role. AIM To explore how immigrant men from the Middle East and Afghanistan perceive and experience accompanying their partner for contraceptive counselling provided by midwives in Sweden. METHODS Inductive qualitative content analysis guided the interpretation of data based on 21 individual in-depth interviews. FINDINGS Balancing conflicting values and norms about sexual and reproductive health and rights including family planning was challenging and confusing when living in Sweden. Contraceptive counselling was perceived as a joint visit, and men were often acting as decision makers. The midwife's role as a contraceptive counsellor was perceived as trusted, but knowledge was lacking about the Swedish midwifery model and the Swedish healthcare system. Providers' ways of communicating sensitive information were crucial. Without marriage contraceptive counselling was unthinkable. CONCLUSION Highlighting male engagement and including men's sexual and reproductive health at policy levels are necessary for improving women's sexual and reproductive health and rights. Additional and new ways of contraceptive counselling and midwifery services, such as outreach work and joint visits, are needed in order to reach both men and women.
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Affiliation(s)
- Mia Kolak
- Division of Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Obstetrics and Gynecology, Skane University Hospital, Malmö, Lund, Sweden
| | - Anette Agardh
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Christine Rubertsson
- Department of Obstetrics and Gynecology, Skane University Hospital, Malmö, Lund, Sweden
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Stefan R. Hansson
- Department of Obstetrics and Gynecology, Skane University Hospital, Malmö, Lund, Sweden
- Department of Clinical Sciences Lund, Lund University, Malmö, Sweden
| | - Maria Ekstrand Ragnar
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
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Alibrahim H, Bohsas H, Swed S, Nasif MN, Siddiq A, Msallam H, Jabban YKE, Almoshantaf MB, Jawed HA, Aswad M, Hallak N, Kasem R, Sawaf B, Elbialy I, Gabr IGM, Abazid RR, Munawar F, Ahmed AB, Elsaadouni NM, Shalaby NY, Hafez W. Emergency Contraception Knowledge, Attitudes, and Barriers Among Men: A Cross-Sectional Study. Cureus 2024; 16:e51937. [PMID: 38333452 PMCID: PMC10851918 DOI: 10.7759/cureus.51937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
Background Emergency contraception (EC) plays a pivotal role in the prevention of unintended pregnancies following unprotected sexual intercourse. Men's awareness regarding emergency contraception is pivotal for informed decision-making and for enhancing reproductive health in this context. This study investigated Syrian men's awareness and perspectives on emergency contraception to inform diverse reproductive health initiatives. Methods We conducted a cross-sectional study in Syria, from June 2022 and April 2023. Our study included male participants aged 18 years or older who held Syrian nationality and volunteered to participate. The data collection involved administering a questionnaire comprising three sections (knowledge, attitude, and barrier assessment), encompassing a total of 30 questions. Data analysis was performed using the Statistical Package for Social Sciences (SPSS) (IBM SPSS Statistics, Armonk, NY). Results Most participants were aged 18-25 (65.7%) and single (75.4%) and held a university degree (79.3%). The knowledge of emergency contraception was low (36.1%), with the Internet and social media (77.5%) being the primary sources of information. While 89% held positive attitudes toward emergency contraception, only 37.3% supported nonprescription availability. Age, income, and desire for children were associated with knowledge, attitudes, and the use of emergency contraception. Men aged 26-35 exhibited the highest positive attitude (8.11±1.83). Those desiring no children showed higher attitude scores (7.42±2.04). Income was positively associated with knowledge (adjusted odds ratio {AOR}=1.75 and confidence interval {CI}=1.02-2.99) and emergency contraception use (AOR=2.87 and CI=1.27-6.48). Conclusion This study underscores the knowledge gap regarding emergency contraception in Syrian men. Despite positive attitudes, awareness remains limited, particularly among those of childbearing age. Targeted education and improved accessibility to emergency contraception can enhance its use among men, particularly in those with low socioeconomic status and younger age groups.
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Affiliation(s)
- Hidar Alibrahim
- Department of Internal Medicine, University of Aleppo, Aleppo, SYR
| | | | - Sarya Swed
- Department of Medicine, University of Aleppo, Aleppo, SYR
| | - Mohamad Nour Nasif
- Department of Laboratory Medicine, Faculty of Medicine, University of Aleppo, Aleppo, SYR
| | | | | | | | | | - Hira A Jawed
- Department of Internal Medicine, Aga Khan Health Services, Karachi, PAK
| | - Moudar Aswad
- Faculty of Medicine, Tishreen University, Latakia, SYR
| | - Nadim Hallak
- Faculty of Medicine, Tishreen University, Latakia, SYR
| | - Razan Kasem
- Faculty of Medicine, University of Aleppo, Aleppo, SYR
| | - Bisher Sawaf
- Department of Internal Medicine, Faculty of Medicine, Syrian Private University, Damascus, SYR
| | - Ibrahim Elbialy
- Department of General Medicine, Burjeel Hospital, Abu Dhabi, ARE
| | | | - Reem Rizk Abazid
- Department of Obstetrics and Gynecology, New Medical Centre (NMC) Royal Hospital, Abu Dhabi, ARE
| | - Farida Munawar
- Department of Obstetrics and Gynecology, New Medical Centre (NMC) Royal Hospital, Abu Dhabi, ARE
| | - Azza Bakr Ahmed
- Department of Internal Medicine, Ain Shams General Hospital, Ain Shams, EGY
- Department of Internal Medicine, NMC Royal Hospital, Khalifa City, ARE
| | | | | | - Wael Hafez
- Department of Internal Medicine, National Research Centre, Cairo, EGY
- Department of Internal Medicine, New Medical Centre (NMC) Royal Hospital, Abu Dhabi, ARE
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El Ansari W, Arafa M, Elbardisi H, Majzoub A, Mahdi M, Albakr A, AlRumaihi K, Al Ansari A. Scoping review of sexual and reproductive healthcare for men in the MENA (Middle East and North Africa) region: a handful of paradoxes? BMC Public Health 2023; 23:564. [PMID: 36973770 PMCID: PMC10040932 DOI: 10.1186/s12889-022-14716-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/24/2022] [Indexed: 03/28/2023] Open
Abstract
Background No study appraised the knowledge gaps and factors impacting men’s sexual and reproductive health (SRH) in MENA (Middle East and North Africa). The current scoping review undertook this task. Methods We searched PubMed and Web of Science (WoS) electronic databases for original articles on men’s SRH published from MENA. Data was extracted from the selected articles and mapped out employing the WHO framework for operationalising SRH. Analyses and data synthesis identified the factors impacting on men’s experiences of and access to SRH. Results A total of 98 articles met the inclusion criteria and were included in the analysis. The majority of studies focused on HIV and other sexually transmissible infections (67%); followed by comprehensive education and information (10%); contraception counselling/provision (9%); sexual function and psychosexual counselling (5%); fertility care (8%); and gender-based violence prevention, support/care (1%). There were no studies on antenatal/intrapartum/postnatal care and on safe abortion care (0% for both). Conceptually, there was lack of knowledge of the different domains of men’s SRH, with negative attitudes, and many misconceptions; as well as a deficiency of health system policies, strategies and interventions for SRH. Conclusion Men’s SRH is not sufficiently prioritized. We observed five ‘paradoxes’: strong focus on HIV/AIDS, when MENA has low prevalence of HIV; weak focus on both fertility and sexual dysfunctions, despite their high prevalence in MENA; no publications on men’s involvement in sexual gender-based violence, despite its frequency across MENA; no studies of men’s involvement in antenatal/intrapartum/postnatal care, despite the international literature valuing such involvement; and, many studies identifying lack of SRH knowledge, but no publications on policies and strategies addressing such shortcoming. These ‘mismatches’ suggest the necessity for efforts to enhance the education of the general population and healthcare workers, as well as improvements across MENA health systems, with future research examining their effects on men’s SRH. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14716-2.
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Affiliation(s)
- Walid El Ansari
- grid.413548.f0000 0004 0571 546XDepartment of Surgery, Hamad Medical Corporation, Doha, Qatar
- grid.412603.20000 0004 0634 1084College of Medicine, Qatar University, Doha, Qatar
- grid.416973.e0000 0004 0582 4340Weill Cornell Medicine – Qatar, Doha, Qatar
| | - Mohamed Arafa
- grid.416973.e0000 0004 0582 4340Weill Cornell Medicine – Qatar, Doha, Qatar
- grid.413548.f0000 0004 0571 546XUrology Department, Hamad Medical Corporation, Doha, Qatar
- grid.7776.10000 0004 0639 9286Andrology Department, Cairo University, Cairo, Egypt
| | - Haitham Elbardisi
- grid.412603.20000 0004 0634 1084College of Medicine, Qatar University, Doha, Qatar
- grid.416973.e0000 0004 0582 4340Weill Cornell Medicine – Qatar, Doha, Qatar
- grid.413548.f0000 0004 0571 546XUrology Department, Hamad Medical Corporation, Doha, Qatar
| | - Ahmad Majzoub
- grid.416973.e0000 0004 0582 4340Weill Cornell Medicine – Qatar, Doha, Qatar
- grid.413548.f0000 0004 0571 546XUrology Department, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Mahdi
- grid.413548.f0000 0004 0571 546XUrology Department, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Albakr
- grid.413548.f0000 0004 0571 546XUrology Department, Hamad Medical Corporation, Doha, Qatar
| | - Khalid AlRumaihi
- grid.412603.20000 0004 0634 1084College of Medicine, Qatar University, Doha, Qatar
- grid.416973.e0000 0004 0582 4340Weill Cornell Medicine – Qatar, Doha, Qatar
- grid.413548.f0000 0004 0571 546XUrology Department, Hamad Medical Corporation, Doha, Qatar
| | - Abdulla Al Ansari
- grid.413548.f0000 0004 0571 546XDepartment of Surgery, Hamad Medical Corporation, Doha, Qatar
- grid.416973.e0000 0004 0582 4340Weill Cornell Medicine – Qatar, Doha, Qatar
- grid.413548.f0000 0004 0571 546XUrology Department, Hamad Medical Corporation, Doha, Qatar
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Leelakanok N, Parmontree P, Petchsomrit A, Methaneethorn J. A systematic review and meta-analysis of attitude and knowledge involving emergency oral contraceptive use in patients and healthcare providers. Int J Clin Pharm 2022; 44:873-893. [PMID: 35732860 DOI: 10.1007/s11096-022-01445-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/12/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Levonorgestrel and ulipristal acetate are common emergency oral contraceptives (EOCs). Lack of knowledge and negative attitude toward EOCs pose barriers to the EOCs access and utilization. AIM This study aimed to summarize the studies on the knowledge and attitudes of healthcare providers and patients on the use of EOCs. METHOD A systematic search was conducted from conception to April 2022 using the following databases: CINAHL Complete, MEDLINE, ScienceDirect, Scopus, and Thai Journal Online. Data were extracted independently and were meta-analyzed using DerSimonian and Laird method for the binary random-effects model. RESULTS 121 articles with a total number of 92,484 participants were included. The awareness of levonorgestrel as an EOC was 66.7% while the awareness of ulipristal acetate as an EOC was 36.9%. EOCs users received EOC information mainly from the internet, media, and friends. We found that 32.2% of EOCs users and providers agreed that EOCs acted post-fertilization, and 39.8% of the prescribers know the correct time to take the pill postcoital. Negative attitudes toward EOC use were found in 25.4% of the participants. For example, 39.4% of the participants agreed that EOCs users had increased sexual activity. CONCLUSION The awareness of EOCs was low and misunderstandings or negative attitudes towards the use or prescription of EOCs were still prevalent. Educating healthcare providers, using media as educational tools, and improving education and economics can be useful in improving EOC users' awareness, knowledge, and attitude towards EOCs.
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Affiliation(s)
- Nattawut Leelakanok
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, Chonburi, 20131, Thailand
| | - Porntip Parmontree
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, Chonburi, 20131, Thailand.
| | - Arpa Petchsomrit
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, Chonburi, 20131, Thailand.,Pharmaceutical Innovations of Natural Products Unit (PhInNat), Faculty of Pharmaceutical Sciences, Burapha University, Chonburi, Thailand
| | - Janthima Methaneethorn
- Pharmacokinetic Research Unit, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.,Center of Excellence for Environmental Health and Toxicology, Naresuan University, Phitsanulok, Thailand
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