Factors Influencing Modern Contraceptive Use among Men in Maritime Region of Togo

Abstract

Background: High birth rate is the main cause of dramatic demographic changes in Sub-Saharan African countries, including Togo. Due mainly to low contraceptive use, the fertility rate in Togo was 4.5 births per woman in 2016 and was deemed a public health issue. Only 37.2% of the demand for women modern contraceptives in Togo is fulfilled, resulting in prevalence of 20-40% of modern contraceptives and leading to illegal and risky abortions. Men's systematic use of contraceptive methods is less common than women's methods; with vasectomy being only adopted by less than one percent. This research aimed to explore factors related to modern contraceptives use among men in two southern districts of Togo. Method: A community-based cross-sectional survey was conducted using a mixed-method approach among 311 men, aged 15-54 years, living in urban and rural areas of Togo. Quantitative data was collected using self-administrated questionnaire. To assess qualitative data, eight men grouped in two teams were involved in focus group discussions and in-depth interviews. These were audio-recorded and transcribed verbatim into English. QSR NVivo 12 Software was used to identify recurrent themes from the transcribed data. Stata software version 15.0 was used to analyze the quantitative data. Results: The median age of the participants was 29 years old. Of the 311 respondents, 72.7% knew of at least one male contraceptive: 69.8% and 14.1% mentioned condom and vasectomy respectively, 46.6% were using condoms and 0.3% were under vasectomy. Marital status, educational level of sexual partners, number of sexual partners, perception of the utility of male contraceptives were found to be highly significant (p< 0.001) factors for male contraceptive use. The study showed that men use contraceptives to prevent unwanted pregnancies and secure their partners' well-being. Conclusion: Men in this study cited condoms as the only safe male contraceptive. They have limited knowledge on vasectomy and other male contraceptives. The results of this study could provide direction for policymaking and the design of interventions by policy makers and other stakeholders.