Exploration, adaptation, and pilot testing of a male-engaged group family planning intervention in Nakivale Refugee Settlement, Uganda

This project aims to enhance family planning among refugees in the Nakivale refugee settlement in Uganda by involving men and promoting joint decision-making within couples. Uganda, hosting over 1.62 million refugees, faces challenges where unstable conditions raise the need for effective contraceptive use to avoid unintended pregnancies. Although there have been global advances, sub-Saharan Africa, including Uganda’s refugee populations, has one of the lowest contraceptive uptake rates. This project addresses the gap in male involvement in family planning, which is crucial for promoting women's health and achieving equitable reproductive health outcomes.

Guided by the Interdependence Model of Couple Communal Coping and Behavior Change by Lewis and colleagues, the project team is currently conducting an exploratory qualitative study in Nakivale. This study gathers insights on men’s involvement and couple dynamics in family planning through interviews and focus group discussions with African refugee men, women, religious leaders, healthcare providers, and settlement commanders. With additional support through the CGHE Impact Accelerator Grant, the team will implement a quantitative survey to understand the desires, availability, and utilization of family planning methods, and the factors influencing male involvement. Subsequently, community consultations will be conducted to adapt two evidence-based interventions for the local context: a couple-based sexual and reproductive health counseling program and a group antenatal care program using picture cards for low literacy populations.

This three-phased study will: 1) Quantitatively and qualitatively assess the family planning context among African refugee men and women in Nakivale; 2) Adapt existing interventions through community consultations to develop a male-engaged family planning program; and 3) Pilot test the intervention focusing on feasibility and acceptability. The pilot will involve six to eight sessions, initially targeting men and later including their female partners.

The outcome is a tailored, culturally relevant, male-engaged family planning intervention designed to foster joint decision-making and increase contraceptive use within the Nakivale refugee community. This initiative aims to empower both men and women, promoting equitable family planning decisions and improving overall health and well-being. By emphasizing community involvement and using a mixed-methods approach, this project aligns with the principles of the Empowering Women and Communities (EWC) challenge group and aspires to contribute to health equity and sustainable family planning practices in refugee settings.