New Game for Ugandan Men Uncovers Behavioral Barriers to Family Planning

Uganda has a high fertility rate and a declining mortality rate, resulting in rapid population growth. This has led to a dependent population that is not conducive to economic production, savings, investment, or development.

With funding from the Hewlett Foundation and in partnership with ideas42, IntraHealth International conducted a preliminary behavioral study in the RHITES-E-supported districts of Serere, Kibuku, and Kapchorwa to identify the behavioral barriers to contraception that postpartum women and their male partners face. The study found that:

• Couples typically do not discuss how many children to have or when to have them.
• Couples typically do not discuss whether to use modern contraceptive methods.
• Couples decide to have another child because they either underestimate the cost or overweigh specific benefits of having a child.
• Couples do not consider modern contraceptive methods because they think their current actions to avoid children are enough.
• Men and women do not have a “moment of choice” during visits to health facilities to consider modern contraceptive methods because health workers do not consistently discuss them with clients.
• Couples choose not to use modern contraceptive methods because they are afraid of the side effects, including actual side effects (such as heavy bleeding) and perceived side effects (such as cancer).

One of the interventions they designed to address these behavioral barriers was called Together We Decide, an interactive game specifically for men, since they can be either enablers or inhibiters of contraceptive use. The game teaches men ways to keep their families healthy and how to discuss health topics with their partners.

During the game, the players are prompted to think about the realities of having children with “cost” playing cards that require them to pay for things like school fees and medical bills. With these costs in mind, the men discuss ways they can ensure they have money for all of their children, such as spacing childbirths and keeping mothers and babies healthy.

The game ends with households dividing their wealth per child. The household with the most wealth per child wins. The teams then discuss what they learned from the game and what they will share with their partners.

Source: VITAL

Date of Publication: June 15, 2020