Case Study of Successful Male Engagement in Family Planning in Pakistan

The need to engage men as equal partners with women in family planning decision-making is widely recognized. The number of programs that engage men has increased over the past two decades, but most remain small in scale. To foster scale up of these initiatives, we must first understand how these programs were successful in improving outcomes related to family planning, reproductive health, and gender dynamics.

Engaging men is especially relevant in a country such as Pakistan, where the fertility rate is high, partly owing to factors such as unequal gender norms and men’s dominant role in contraceptive decision-making. Between 2007 and 2012, the Family Advancement for Life and Health (FALAH) Project, a USAID-funded initiative implemented by the Population Council, focused on engaging men to as a way to increase the uptake of birth-spacing behavior and contraceptive use practices.

FALAH improved access to services in the public and private sectors by creating demand through community mobilization, building provider capacity through skills development, ensuring availability of supplies at the facility level, and expanding the reach of social marketing activities. Men were newly engaged in family planning through the media, male group meetings, and access to services. FALAH worked at scale in 15 districts across four provinces, namely Baluchistan, Khyber Pakhtunkhwa, Punjab, and Sindh.

FALAH demonstrated strong results, reaching more than nine million married men and women with birth-spacing messages. The contraceptive prevalence rate increased by 8.5 percentage points, unmet need dropped from 14.2 percent to 10.8 percent, and total demand for family planning increased from 64 percent to 71 percent.

Engaging men through a multifaceted approach paid significant dividends by positively influencing husbands’ acceptance of family planning. The researchers found that contraceptive uptake was indeed higher for women whose husbands attended FALAH events.

The Evidence Project is conducting a case study to provide greater detail about how the interventions were implemented, what challenges were faced and how they were addressed, and how the interventions led to positive outcomes in contraceptive use and other areas. Documenting and analyzing such a large and successful male-engagement initiative as FALAH will help inform and spur efforts by the family planning community to take to scale smaller yet effective gender-responsive approaches.