Improving male involvement in family planning in Nkwanta District of Ghana: a transtheoretical approach

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Various studies have shown that family planning adoption is likely to be more effective for women when men are actively involved. Male involvement in family planning is an instance of behaviour change. The Transtheoretical model of behaviour change was used to examine men’s involvement in general contraception. The study objectives included testing the reliability of the transtheoretical model constructs, examining the relationship between the constructs as well as socio-demographic variables and the stages of change. The study was an analytical cross-sectional study with a representative sample of 226 men aged between 18 and 55. A multistage sampling involving simple random, systematic and purposive sampling was employed. A staging algorithm to determine the stages of change identified five stages in men’s preparedness to encourage their wives to use contraception. These were the maintenance action, preparation, contemplation and precontemplation stages. Reliable scales were developed and used to test the decisional balance and self-efficacy constructs. All the three scales developed had high cronbach’s alpha values indicating good internal consistency (pros for contraception .9283; cons for contraception .8 150; and self-efficacy .9333). Statistical tests to examine the relationship between stages of change and the transtheoretical model constructs showed that stage was related to both decisional balance (pros and cons of contraception) [F(4,22 1 )=4.329 ;P=.0021 [F(4,22 1 )= 14.182 P=.000 and self efficacy {F(4,221)=1 1.61 1;P=.000]. Residence was found to be related to stage but other socio-demographic variables were not related to stage. The relationship between the TM constructs and the stages were as predicted by the model. Pros increased with stage and the reverse was the case for cons. The scores on the self-efficacy scale also increased with stage. It was noted that 67% of the sample across stages shared similar characteristics. This group represents the maintenance, action, preparation, and contemplation stages of change. Only the group in the precontemplation stage was statistically different. This suggests that the first four stages are equally amendable to contraception. The findings suggests that an effective way of increasing family planning will be to use stage based information to decrease the disadvantages of contraception and increase the advantages of FP and self-efficacy. The Ghana Health service, Nkwanta district health management team and community health officers as well as non-governmental organizations must seek to administer staged based information to clients at the community level by stressing the advantages of contraception to clients in the lower stages while emphasizing self-efficacy to those in the higher stages. Rumors about the disadvantages of contraception must be dispelled and prompt treatment provided for those who experience bad side effects.
A thesis submitted to the School of Graduate Studies, Kwame Nkrumah University of Science and Technology, Kumasi in partial fulfilment of the requirements for the award of Mph Degree in Population and Reproductive Health, 2005