Are men clients, catalysts or controllers of family planning?

Background: Family planning (FP) has moved from being used as a tool for population control to promoting individuals' and couples' reproductive rights. The narrative surrounding FP focuses on how providing modern contraception empowers women to control their fertility and space their children. However, the role of men in the decision-making process of women's access, and use of FP services is under-examined. Although international health organisations insist that FP programmes ensure free choice for both men and women, most programmes primarily target women. This paper explores the role of men in FP programmes and services in the Global South. Methods: We conducted a qualitative study with 31 professionals from the international FP community, including academics, NGO workers, FP advocates, government officials, and international funding representatives. Interviews were conducted virtually and transcribed verbatim. Thematic analysis was applied to the dataset. Results: Participants did not have clear or consistent opinions about the role of men in FP service provision. Yet, all emphasised the need to prioritise women's reproductive health needs within FP programmes. Almost all reflected on men's role in the decision-making process around FP, emphasising how power dynamics between men and women in heterosexual relationships can limit women's autonomy. Some argued that men should have no role in FP programmes, as they were described as "controllers of" women's reproductive choices. Some participants reflected described men as "catalysts" and encouraged their engagement in programmes to support women in accessing, using, and continuing FP services. Others argued that men should be viewed as "clients" requiring FP services themselves. While different roles for men were discussed, no consensus emerged on a single approach. Participants also described tensions between women-centered policies at higher levels and the social norms impacting care at the community level. Conclusion: International organizations recommend targeting both men and women in FP programmes, but most programs continue to focus on women. These findings explore the roles men play in FP decision-making and identify barriers to engaging men in FP programmes. They highlight the need for culturally sensitive, gender transformative approaches to address gender norms and ensure reproductive rights for all.