PERFECTION CHUKWUEBUKA CHIMA

Background: Family planning is a critical component of reproductive health, yet male involvement in family planning activities remains limited in many low- and middle-income settings. In Nigeria, the contraceptive prevalence rate among married women is only 20%, and men continue to be underrepresented in reproductive health programmes despite their significant influence as household decision-makers. Ovia North East Local Government Area of Edo State reflects these broader national challenges, with inadequate knowledge, socio- cultural barriers, and low male participation identified as key drivers of poor family planning outcomes. Few studies have specifically assessed male involvement using a composite multi￾indicator approach in this setting. Objectives: To assess male involvement in family planning activities in Ovia North East LGA, Edo State. Methodology: A descriptive cross-sectional study design was used. Four hundred and eight (408) adult men in stable sexual relationships or marriages were selected from communities across Ovia North East LGA using a multi-stage sampling technique. Data were collected using a structured, self-administered questionnaire and analysed with IBM SPSS version 27. Descriptive statistics, chi-square tests, and binary logistic regression were performed. A composite ten-indicator score was used to classify male involvement as high (score ≥ 7 out of 10) or low. The level of significance was set at p < 0.05. Results: A total of 408 men participated with a response rate of 100%. The mean age (SD) was 42.7 ± 11.4 years. Most respondents were married 308 (75.5%), predominantly Christian 384 (94.1%), with tertiary education accounting for 203 (49.7%) and the majority belonging to the middle socioeconomic class 312 (76.5%). Of the 408 respondents, 363 (89.0%) had heard of family planning; health workers 195 (53.7%), radio or television 193 (53.2%), and friends or relatives 191 (52.6%) were the most common sources. Overall, 262 (72.2%) of those who had heard of family planning had good knowledge, while 101 (27.8%) had poor knowledge. Being married was the only independent predictor of poor knowledge (OR = 0.466, 95% CI: 0.232–0.934, p = 0.031). Nearly all respondents 391 (95.8%) had a positive attitude towards family planning. Christianity was the strongest independent predictor of positive attitude (OR = 9.086, 95% CI: 2.066–39.953, p = 0.003), followed by nuclear family type (OR = 6.530, 95% CI: 1.400–30.467, p = 0.017). Slightly more than half 226 (55.4%) xiv had discussed family planning with their partner, and most 325 (79.7%) approved of their partner using a method, but only 112 (27.5%) had accompanied their partner to a health facility. Less than half 176 (43.1%) were currently using any family planning method, with condoms 111 (63.1%) and withdrawal 83 (47.2%) being the most common methods; vasectomy remained virtually unused 1 (0.6%). Nuclear family type was the only independent predictor of current family planning use (OR = 1.878, 95% CI: 1.007–3.500, p = 0.047). Knowledge of service location (χ² = 30.702, p < 0.001) and perceived affordability (χ² = 28.824, p < 0.001) were the most strongly associated factors with current use, while cultural or religious beliefs were a significant barrier (χ² = 6.111, p = 0.013). Regarding male involvement, 160 (39.2%) were classified as having high involvement and 248 (60.8%) low involvement. The most commonly met indicator was considering family planning a joint responsibility 376 (92.2%), while community participation in health talks was the least met 107 (26.2%). Education (χ² = 42.035, p < 0.001), occupation (χ² = 32.673, p < 0.001), socioeconomic status (χ² = 38.636, p < 0.001), marriage type (p = 0.014), and family type (p = 0.020) were significantly associated with male involvement. Health worker discussion of family planning was the strongest independent predictor of high involvement (OR = 5.768, 95% CI: 3.366–9.885, p < 0.001), followed by good knowledge (OR = 2.028, 95% CI: 1.137– 3.619, p = 0.017) and upper class socioeconomic status (OR = 27.794, 95% CI: 2.358– 327.618, p = 0.008). Conclusion: Nearly three-quarters of men in Ovia North East LGA had good knowledge of family planning and almost all demonstrated a positive attitude. However, slightly less than two-fifths had high overall involvement, and less than half were currently using any family planning method. Health worker engagement emerged as the most powerful modifiable predictor of high involvement. Health authorities should institutionalise routine male family planning counselling at all primary health centres, expand male-targeted community outreach, and engage religious and traditional leaders to create an enabling environment for active male participation in family planning.