A USAID funded report on family planning produced by Pathfinder International recommends that contraception programs work with key household members, such as mothers-in-law, husbands and co-wives. The report presents findings from fieldwork in Burkina Faso.
“It is above all a matter of understanding the circle of influence that surrounds [young married women] and meeting that circle and convincing that circle first before any meeting with [young married women].”
The report specifies two key objectives for family engagement: (1) cultivate the support of husbands, parents, and in-laws to delay second and subsequent births and (2) encourage better communication between spouses regarding family planning.
Trained ‘animateurs’ were employed to engage with families. Training included skills for engaging with men and with mothers-in-law, skills for couple counselling and education about gender norms and how they influence behaviour. The animateurs reached out to family members both during home visits (though few men were to be found there) and in the community, for example, visiting husbands at their places of employment or leisure.
The report discusses in detail the experience of engaging family members (pages 20-23), running peer groups (pages 23-24), home visiting (page 24) and couple counselling (page 29). There is much practical advice here for frontline workers organising family inclusive care.
The reports distinguished husbands who are similar in age to the mother and those who are much older – these situations require different approaches. While couple counselling was found to be an appropriate strategy for engaging young husbands, individual approaches were more appropriate for older husbands.
The fieldwork found that husband engagement was easier in the context of also engaging mothers-in-law and community members.
A challenge for family engagement is keeping the confidentiality of the women, some of whom do not want their husbands to know they use contraception.
“While it was important to inform husbands about the project and involve them as much as possible in home visits, it was also important for animateurs to respect young married women’s wishes for privacy and confidentiality.”
Chau K, Benevides R, Cole C, Simon C, Balde A & Tomasulo A (2015), Reaching First-Time Parents and Young Married Women for Healthy Timing and Spacing of Pregnancies in Burkina Faso: Key implementation-related findings from Pathfinder International’s “Addressing the Family Planning Needs of Young Married Women and First-Time Parents Project”, Evidence to Action Project/Pathfinder International, Washington DC