[Role of men in family planning decisions in Mali]

The birth control program was in place and functional since 1970, and it was integrated with maternal and infant health activities in 1978: knowledge about contraception is increasing among women and men respectively 75.6% and 87.6% according to EDSM II, 2001. Nevertheless, only 5.7% of women and 10% of men reported the use of one of the modern contraceptive methods. This is a transversal descriptive and analytic study which included men of 14 years old and above residing in Kayes, Koulikoro, Mopti, Sikasso and Bamako. We used a random choice of 6 out of the 9 regions in Mali (Bamako and the 5 regions supported by partners funding the present study) followed by a non-random choice at different degrees. Data were uniformly collected from One thousand and four men. The mean age was 37.6 +/- 15.6 years, 44.7% of the men were monogamous whereas 23.1% were polygamous and 30.6% were either single or had a fiancé. Most of the men in the study group had more than 2 children compared to 34.2% without children and 19.9% with either one or two children. Among them, 89.1% reported to have heard about birth control program and 70.3% had listed Planned Parenthood as an objective of birth control. The most used methods of birth control the most used are contraceptives (66.7%), condoms (60.5%) and injections (30.8%). However, only 30.6% of men used one birth control method with their partners; among those studied in the cohort, 40.8% used birth control method with their wives. Condom was the main method used by 86% of the men compared to utilization of contraceptive pills and injections respectively 66.7% and 25.6%. Birth control methods were used mainly to protect against sexually transmitted diseases (20.7%), then maternal and infant health respectively 6.0% and 5.8%. 60.7% of men think that the decision to use birth control method should be made by them whereas 25.7% think that the decision should be made by the couples. Many strategies are being proposed to involve men in the wider implementation of birth control program; these strategies will be more efficient when the age group 20-29 and 30-44 are targeted nationwide including rural areas, as well as couples especially those polygamous and illiterate.