Exploring influence and knowledge on family planning among internally displaced men: a qualitative exploration of attitudes, norms and beliefs in Twic, South Sudan.

introductionEngaging men in family planning (FP) is widely recognised to be important for improving FP uptake as men are the primary household decision makers. In South Sudan, a setting where long-term conflict has impacted the health system, men's influence on FP decision-making their knowledge of FP remains challenging, shaped by tradition and gender norms.

methodsThis qualitative study among internally displaced men and service providers in Twic county of South Sudan aimed to explore the attitudes, behaviours and norms related to FP among men, so as to identify potential strategies to improve FP uptake. It is based on focus group discussions with men in two camps and interviews with service providers.

findingsOur study finds that despite the longstanding norm of child spacing in South Sudan, modern contraceptive methods are not seen as acceptable methods of spacing. We also find the existence of a strong norm around the importance of having a larger family size. While men do often lead FP decision-making, in some cases women do engage in decision-making about FP. Our study highlights how men's exclusion from programming and discussions around FP is a key challenge, however the broader issue in IDP camps is economic instability, which means that for these men, FP is not a priority. DISCUSSION AND

conclusionsOur research emphasises the importance of buy-in from community leaders, FP activities that reach across communities (including those in hard-to-reach areas), engagement with children and youth and engagement with faith leaders. We suggest peer-to-peer activities and radio as promising modalities to engage these groups.