Factors associated with refugee men's involvement in family planning in Nyarugugu camop, Kasulu District Tanzania

Refugees are a marginalized group at high risk for poor health outcomes due to their displacement and vulnerable state. Reproductive health in refugee camps has become an issue of public health concern within the last two decades, but refugee men's involvement in family planning remains a neglected area of study. In refugee camps around the world, the use of contraceptives is frequently low while crude birth rates remain high. A cross- sectional study of 454 married Congolese refugee men was conducted during June of 2010 in Nyarugusu camp in Kasulu District within Kigoma Region using face-to-face interviews with a standard questionnaire. Additionally, 5 focus group discussions were carried out, 3 with refugee men and 2 with refugee women. Finally, key informant interviews were completed with 10 health providers from the Tanzanian Red Cross Society. Results from the questionnaires show that 35.2% of the refugee men reported that they or their wives had ever used family planning methods while in the camp, while condom use as a means of family planning stood at 4.4% among respondents. Strong cultural barriers to family planning approval and use were evident from both men and women. Perceived benefits from humanitarian agencies for having large families within the camp influence the use of family planning and the desired family size. Having employment in Nyarugusu was found to be a predictor of ever having used family planning in the camp (OR=1.92, 95%CI: 1.16-3.18). Those who discussed family planning with their wives were significantly more likely to have ever used family planning during their time as a refugee (OR=42.88, 95%CI: 15.26-120.54). Those who did not see any benefit or incentives to having a large family in the camp were also more likely to have ever used family planning in the camp (OR=1.77, 95%CI: 1.10-2.86). The main provider-related barriers to men's involvement in family planning included the lack of pertinent campaigns targeting men and the lack of in-service training for staff regarding family planning. Overall, gender sensitizations, men-specific family planning campaigns, and revision of certain camp policies should be promoted. Further research should be undertaken to better understand this neglected area of study