Table 1. Summary of Studies Included.

From: Evaluating the Effectiveness of Educational Interventions in Family Planning for Men in Developing Countries: A Systematic Review

Author, Year Design Setting Objective Population: Inclusion/Exclusion Intervention/Comparison Outcome
Shattuck, 2011 (24) RCT Malawi; Mangochi To evaluate the effectiveness of peer education intervention based on the information-motivation-behavioral skills (IMB) model on contraceptive use among couples. 397 men
 
Inclusion: Individuals aged 18-25 years, married or cohabiting with a woman who is not pregnant/breastfeeding a child aged <6 months, no infertility treatment in the past 3 months, no use of modern contraception
 
Intervention population (baseline→endpoint): 197→149 (men)
Comparison population (baseline→endpoint): 200→140 (men)
 
Religion: Christian and Muslim
Intervention: Peer educational intervention on family planning (Malawi Male Motivator Project)
[Contents]
Home visits (five times) by trained male motivators: providing information on family planning, sharing experiences, motivating, role-playing, and improving communication skills/6 months
 
Comparison: None
Index: Contraceptive use, knowledge, attitudes, self-esteem, gender norms, communication regarding family planning, communication frequency
 
Assessment: Questionnaire
 
Timepoints:
①baseline
②within 1 month of intervention
Schuler, 2015 (25) cluster-RCT Guatemala; Sacatepéquez, Chimaltenango, Sololá, Huehuetenango, San Marcos; (rural area) To investigate the effectiveness of interventions in rural areas where contraceptive coverage is low and family planning needs are unmet compared with urban areas. 45 communities (15 communities × 3→ a community has gone)
 
Inclusion: Married men or in civil union, wives aged 18-40 years, live in the districts, agreement from both members of couples
 
Intervention population: 597→328 (men and women)
Comparison population: 488→213 (men and women)
 
Religion: Catholic 50%-57%, Protestant 31%-38%.
Intervention: Workshop Session (expressed as “WS” in the following)
[Contents]
WS by trained local promoters: gender issues presenting barriers to sexual and reproductive health, information and role-play on gender equality and family planning/WS for men × 2, WS for women × 2, WS for couple × 2
 
Comparison: None
Index: Gender and Family Planning Equity [GAFPE] Scale: Attitudes toward gender equality, family planning knowledge
Assessment: Interview
Timepoints: ①baseline
②2 months after baseline
Mmbaga, 2017 (26) cluster-RCT Tanzania; Kinondoni Municipality To evaluate the effectiveness of interventions to delay the initiation of sexual activity and promote the use of condoms. 38 schools: 5,091 students
 
Inclusion: Students aged 12-14 years, able to read and write
 

Intervention population: 2,503→2,134 (boys and girls)
Comparison population: 2,588→2,236 (boys and girls)
 
Religion: Christian and Muslim, respectively, approximately 50%
Intervention: Three-component sessions with peers, teachers, and healthcare professionals (PREPARE)
[Contents]
Teachers: In-class interactive teaching and learning sessions; Peers: one session per week for a total of nine life skills training sessions; health professionals: sessions on accessing sexual and reproductive health services and contraceptive use
 
Comparison: None
Index: An action plan for sexual activity, sexual initiation, and condom use
 
Assessment: Questionnaire
 
Timepoints:
①baseline
②6 months after intervention (→booster intervention)
③12 months after intervention
Fleming, 2018 (27) cluster-RCT India; Thane (rural area) To evaluate the effects of the CHARM intervention on gender ideology and household decision-making. 50 clusters: 1,081 couples
 
Inclusion: Married men aged 18-30 years, husbands and wives fluent in Marathi, resided together for the past 3 months with no intent to relocate in the next 2 years.
 
Exclusion: couples who report infertility or surgical sterilization exhibiting severe cognitive or health impairment.
 
Intervention population: 469→397 (couples)
Comparison population: 612→494 (couples)
 
Religion: Designated tribes were the most common (66.1%).
Intervention: Counseling on family planning and gender equality (CHARM)
[Contents]
Counseling sessions with trained village male healthcare providers/sessions (expressed as “S” in the following) for men × 2, S for couple × 1: Providing information on family planning, decision-making related to family planning, gender equality, etc
 
Comparison: Public family planning services
Index: Gender Equitable Men (GEM) Scale: gender ideology, equitable attitudes toward household decision-making
Assessment: Questionnaire
Timepoints:
①baseline
②9 months after baseline
③18 months after baseline
Waidler, 2022 (28) cluster-RCT Tanzania; Mufindi, Mafinga, Busokelo, Rungwe To examine the impacts of a multicomponent intervention targeted to Tanzanian adolescents on their sexual behaviors and reproductive health. 130 clusters: 1,993 individuals (1,065 men)
 
Inclusion: All adolescents aged 14-17 in PNNS households (Productive Social Safety Net program [PNNS]; “Cash”), both in and out of school, were included.
 
Intervention population: 1,272→1,128 (boys and girls)
 
Comparison population: 1,186→1,063 (boys and girls).
Intervention: Cash, livelihood, and life skills training & training on HIV and SRH
[Contents]
Livelihoods and life skills training, mentoring and asset transfer, strengthening youth-friendly HIV and SRH services: topics on contraception, access to gender services, and gender/sessions with online educational curriculum and breakout rooms
 
Comparison: Cash only
Index: Contraceptive knowledge, modern contraceptive knowledge, condom use, modern contraceptive use
 
Assessment: Questionnaire
 
Timepoints:
①baseline
②2-3 months after intervention
③17 months after intervention
Table 2. Supplementary Information of Each Country.

From: Evaluating the Effectiveness of Educational Interventions in Family Planning for Men in Developing Countries: A Systematic Review

Country Income class Population Fertility rate Birth rate Gender gap
Guatemala (Schuler, 2015) upper-middle 16,858 2.5 22 0.664 (113th)
India (Fleming, 2018) lower-middle 1,396,387 2.1 17 0.629 (135th)
Tanzania (Mmbaga, 2017)
(Waidler, 2022)
lower-middle 61,704 4.8 37 0.719 (64th)
Malawi (Shattuck, 2011) low 19,377 4.0 33 0.632 (132nd)
Table 4. Summary of Findings.

From: Evaluating the Effectiveness of Educational Interventions in Family Planning for Men in Developing Countries: A Systematic Review

Outcome Publication Impact of intervention p-value
Knowledge Waidler, 2022 Knowledge regarding contraceptives p ≥ 0.05
Knowledge regarding modern contraceptives p ≥ 0.05
Schuler, 2015 Family planning knowledge* p < 0.001
Shattuck, 2011 Family planning knowledge p < 0.05
Attitude Mmbaga, 2017 Action plan to delay sex p = 0.614
Action plan to use a condom p = 0.0876
Shattuck, 2011 Family planning attitude p ≥ 0.05
Self-efficacy p ≥ 0.05
General communication p ≥ 0.05
Communication frequency* p < 0.05
Practice Waidler, 2022 Used a condom during last sexual encounter p ≥ 0.05
Currently using contraceptives (among sexually active) p ≥ 0.05
Currently using modern contraceptives (among sexually active) p ≥ 0.05
Mmbaga, 2017 Sexual initiation* p = 0.043
Condom use* p = 0.004
Shattuck, 2011 Contraceptive uptake* p < 0.05
Gender Dynamics Fleming, 2018 Sex ideology p ≥ 0.05
Equitable attitudes toward household decision-making* p < 0.01 (9 months)
p ≥ 0.05 (18 months)
Schuler, 2015 Sexual attitudes* p = 0.002
Shattuck, 2011 Sexual norms p ≥ 0.05
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