Encouraging contraceptive uptake by motivating men to communicate about family planning: The Malawi Male Motivator project

Objectives: We examined the effect of a peer-delivered educational intervention, the Malawi Male Motivator intervention, on couples' contraceptive uptake. We based the intervention design on the information-motivation- behavioral skills (IMB) model. Methods: In 2008 we recruited 400 men from Malawi's Mangochi province who reported not using any method of contraception. We randomized them into an intervention arm and a control arm, and administered surveys on contraceptive use at baseline and after the intervention. We also conducted in-depth interviews with a subset of intervention participants. Results: After the intervention, contraceptive use increased significantly within both arms (P<.01), and this increase was significantly greater in the intervention arm than it was in the control arm (P<.01). Quantitative and qualitative data indicated that increased ease and frequency of communication within couples were the only significant predictors of uptake (P<.01). Conclusions: Our findings indicate that men facilitated contraceptive use for their partners. Although the IMB model does not fully explain our findings, our results show that the intervention's content and its training in communication skills are essential mechanisms for successfully enabling men to help couples use a contraceptive.