Men's involvement in family planning service utilization among married men in Kondala district, western Ethiopia: a community-based comparative cross-sectional study

Background: Men involvement is one of the important factors in family planning (FP) service utilization. Their limitation in the family planning program causes a decrease in service utilization as well as the discontinuation of the method which eventually leads to failure of the program. Family planning uptake is low but there is no enough study conducted on the parameters of husband involvement in Ethiopia. Hence, this study focused to assess men's involvement in family planning service utilization in Kondala district, western Ethiopia. Methods: Community based comparative cross-sectional study design was employed in urban and rural kebeles of kondala district using quantitative and qualitative data collection tools. The multi-stage sampling method was employed to select 370 participants from each of the four urban and eight rural kebeles. Logistic regression analysis was used to identify variables that affect husbands' involvement in FP service utilization. Statistical significance was declared at p-value of < 0.05 with 95% confidence interval (CI) and strength of association was reported by odds ratio (OR). Results: The study showed that 203(55.6%) men from urban and 178(48.8%) from rural were involved in FP service utilization. The median age of the respondents was 36 +/- 8.5 years (IQR: 27.5-44.5) in urban and 35 years (IQR: 25-45) in rural parts. Respondents who had four and above current children (AOR = 3.25, 95%CI = 1.51-7.02) in urban and (AOR = 4.20, 95%CI = 1.80-9.79) in rural were positively associated with men's involvement in FP service utilization. In the urban setting, being government employee (AOR = 2.58, 95%CI = 1.25-5.33), wishing less than two children (AOR = 3.08, 95%CI = 1.80-5.24) and having a better attitude towards FP methods (AOR = 1.86, 95%CI = 1.16-2.99) were positively associated with FP service utilization. While good educational background (AOR = 2.13, 95%CI = 1.02-4.44), short distance from home to health facility (AOR = 2.29, 95%CI = 1.24-4.19) and having better knowledge (AOR = 4.49, 95%CI = 2.72-7.38) were positively associated with men involvement in FP service utilization in the rural area. Conclusion: Low involvement of men in family planning service utilization was reported in both settings. Factors associated with husbands' involvement were varied between the two setups, except for the current number of children. Future FP program should incorporate infrastructure associated with the health facility, knowledge, and attitudinal factors.