Family Planning Education: Rural Men and Women’s Preferences in Highly Religious, Rural Tanzanian Communities

Northwestern Tanzania has a high unmet need for modern contraception despite its free availability in local clinics. Approximately 34% of women report wanting to delay pregnancy but do not currently use modern contraception. Barriers include religious beliefs, misinformation, and cultural deference to male authority. Understanding people’s preferences for family planning (FP) education could increase uptake of contraceptive use.

A recently published manuscript by our research team in Tanzania describes the results of an innovative interview technique, called a discrete choice experiment (DCE), which explores and ranks Tanzanian men’s and women’s preferences for aspects of family planning education such as location, gender of the educator, and participation in single gender vs. mixed gender educational seminars. A DCE can elucidate which aspects of an intervention are most important to participants, informing the development and implementation of more acceptable, and thus effective, interventions. Results from the DCE highlight the importance of men’s involvement in FP education, and showed that both men and women preferred an educational seminar led by a nurse or doctor, compared to a religious leader, and mixed-gender educational groups compared to single-gender. Women alone preferred educational seminars provided in a clinic, but by a religious leader, and a seminar led by a woman educator. On the other hand, men preferred an educational seminar led by someone outside of their community (i.e. someone they haven’t met before), an educational seminar separating married and unmarried participants and an educational seminar led by a man.  

This innovative approach to assess Tanzanian’s preferences for FP education can inform culturally acceptable interventions which address existing barriers to the utilization of FP services. Based on these data, we have designed and pilot-tested a curriculum about family planning that brings together clinicians and religious leaders, and both men and women, as educators. We are now conducting a cluster randomized trial to determine the impact of an intervention that includes this curriculum on the uptake of modern contraceptives in rural Tanzania.