Men's involvement in family planning in rural Bangladesh.

Contraceptive prevalence has risen markedly in rural Bangladesh due in part to a doorstep-delivery system initiated by the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B). This study investigates effects of residence in the Matlab MCH-FP treatment area on men's involvement in family planning. The analysis compares for treatment and comparison areas knowledge of and attitudes toward contraception, as well as levels of contraceptive use, among 413 married men interviewed at the baseline of an ICDDR,B men's involvement project. Although residence in the MCH-FP area is associated with a higher overall contraceptive prevalence, it also is associated with a lower adjusted ratio of male-to-female method use, and lower odds of other indicators of men's involvement in family planning. Historical decisions to exclude men from contraceptive decision-making may place the 'burden' of contraception on women and may preclude the productive involvement of men. These and other implications and strategies for increased men's involvement are discussed.