How men in Amasaman are reshaping family planning and why their involvement could transform reproductive health across the region
In the bustling communities of Amasaman, just outside Ghana's capital city of Accra, a quiet revolution is unfolding in how families plan their futures. While contraceptives have traditionally been viewed as a woman's responsibility, a growing body of research reveals that men are increasingly becoming active participants in birth control decisions—a shift that could transform reproductive health outcomes across the region 1 .
The 1994 Cairo International Conference on Population Development first sounded the call for men's inclusion in reproductive health programs, but for decades, policy and research largely overlooked men's crucial role in family planning success 1 . Today, in communities like Amasaman, researchers are discovering that men are not just passive bystanders but influential decision-makers whose knowledge, attitudes, and support significantly determine whether contraceptives are used effectively 4 8 .
This article explores the groundbreaking research uncovering how adult men in Amasaman and similar Ghanaian communities navigate birth control options, the surprising factors that influence their decisions, and what this means for the future of family health in Ghana.
When researchers surveyed 300 men across 39 rural, semi-rural, and urban communities in the Amasaman Area Council, they uncovered a complex picture of contraceptive awareness. While knowledge of birth control methods was reasonably high, the sources of information and depth of understanding varied significantly 1 .
Friends and peers emerged as the primary information source about birth control products, highlighting the powerful role of informal social networks in shaping reproductive health decisions 1 . This word-of-mouth knowledge transmission often fills gaps left by more formal health education channels.
To understand the factors influencing contraceptive use among adult males in Amasaman, researchers employed a scientific random sampling survey of 300 men aged 18 and above from 39 diverse communities during November and December 2019 1 .
The study used rigorous statistical methods to ensure representativeness. Based on a pilot survey conducted earlier in June 2019 which found that 95% of adult males were aware of at least one birth control product, researchers calculated an optimal sample size of 292 participants to achieve a 95% confidence level with a maximum standard error of 0.025. This was rounded up to 300 to account for potential non-response 1 .
The Amasaman study yielded several crucial insights that challenge common assumptions about men and family planning:
The research demonstrated that awareness strongly predicted use, particularly for men with lower formal education levels. When men with limited schooling gained knowledge about contraceptive options, they were significantly more likely to use them, suggesting that targeted information campaigns could dramatically increase participation among socially disadvantaged groups 1 .
Perhaps one of the most striking findings was the clear link between economic welfare and contraceptive use. Men with higher family sizes who had ever used (either currently or in the past) birth control products enjoyed better economic welfare, highlighting the potential economic benefits of family planning for larger households 1 .
While not explicitly detailed in the results, the model specification examining the interaction between male and spouse education suggests that couples' combined educational backgrounds create unique dynamics in contraceptive decision-making worth further exploration 1 .
Perhaps nowhere is the gap between knowledge and practice more evident than with vasectomy. Despite being a safe, simple, and effective method of family planning, vasectomy remains one of the least known and least used methods in Ghana, with a prevalence of less than 0.1% 3 7 .
Qualitative research reveals deep-seated cultural barriers to vasectomy acceptance. In focus group discussions across Ghana, many men expressed fears that vasectomy was synonymous with castration, would make them weak and sexually incapable, or was against God's will 3 7 . As one woman in Southern Ghana starkly warned her husband: "If you do vasectomy and come back here weak, I will divorce you" 7 .
These perceptions persist despite evidence that vasectomy is one of the most reliable family planning methods available with very low post-vasectomy pregnancy rates between 0-2% 7 . The procedure can be performed in low-resource settings and represents an important alternative to tubal ligation for women 7 .
When men actively participate in family planning decisions, the benefits extend far beyond contraceptive use. Research from rural Ghana shows that women whose partners support family planning are significantly more likely to use contraceptive methods themselves 4 .
A study in the Sissala East District of northern Ghana found that approximately 48% of men were involved in family planning service utilization, and this involvement was positively associated with having living children and being knowledgeable about family planning 4 . Women who reported that their spouses supported family planning method use were more likely to use a contraceptive method, and this likelihood increased when partners had some education 4 .
Higher likelihood of contraceptive use by women in rural Ghana 4
Increased modern contraceptive uptake in Ghana 2
72.8% of men approved of partner's family planning use in rural Ghana 4
75% of men discussed family planning with partners in rural Ghana 4
The research from Amasaman and similar communities paints a clear picture: men are willing to engage in family planning when given appropriate information, access, and support. The study in Amasaman revealed that despite knowledge gaps, men's involvement significantly influences contraceptive uptake and effectiveness 1 .
As Ghana continues to address its population growth challenges and their environmental and economic consequences, harnessing the potential of male involvement in family planning becomes increasingly urgent 1 . Recent data from the 2022 Ghana Demographic and Health Survey shows promising trends, with 16.6% of men using modern contraceptives and 4.3% using traditional methods, though 79.0% still use no method 2 .
Men using modern contraceptives
Men using traditional methods
Men using no contraceptive method
The path forward requires demystifying male contraceptive methods, addressing cultural misconceptions, and making services more accessible and male-friendly. As research in the Ho Municipality confirmed, affordability remains a critical barrier, with men who find modern contraceptives affordable being eight times more likely to use them 5 9 .
Ultimately, the experiences of men in Amasaman teach us that family planning success depends on moving beyond female-centered approaches to embrace shared responsibility and collaborative decision-making between partners. When men become active participants rather than passive observers, the entire family—and society—reaps the benefits.