ISLAMABAD: Men in Punjab now seem concerned about their fertility intentions and practices due to the financial challenges of raising large families, and this concern has not only increased spousal communication about family size and contraceptive use but also encouraged them to practise family planning, reveals a new study funded by the World Bank.

The study, carried out by the Population Council through World Bank-Netherlands Partnership Programme, found that men indeed want fewer children and are eager to receive technical information about family planning.

Most men in Punjab now realise that either they or their wives should use family planning. It is the next step, however, of translating intentions into practice, which is a challenge, the study says.

Supply side issues, including absence or paucity of family planning services and poor quality of services including service providers’ lack of capability to manage side effects, are main factors hindering couples’ adoption of the family planning. Perceived or experienced side effects of contraceptive methods are other factors, the study notes.

Men’s positive attitudes and their readiness to be involved in family planning programmes suggest that efforts of convincing them to use contraceptives have been effective and this is now the right time for direct reproductive health interventions for men in Punjab.

In its recommendations, the study says men in Punjab need to become the primary focus of family planning programmes. Male-specific interventions are urgently required, and should be introduced in order to augment men’s lack of knowledge of family planning methods, to encourage timely decisions on fertility issues, and to increase contraceptive issues.

The study says that heavy spending on media campaigns may not be as effective as interpersonal interventions.

A focused effort to mobilise men through male-specific interventions is likely to increase the demand for contraceptives.

These interventions have to be backed up by improved supply of contraceptives and availability of family planning services in accessible facilities.

Punjabi men appeared to be more concerned about their fertility intentions and behavior than they were in the early 1990s. Since men are considered the primary earners and decision-makers in households in Pakistan, their primary motivating force is the growing economic challenge leading to an inability to meet household costs.

Economic concerns also provide leverage in improving communication between husbands and wives on family size and contraceptive use. This pattern suggests it is no longer wives’ exclusive responsibility to initiate discussions on their fertility intentions.