Gender Differences in Perceived Benefits of and Barriers to Use of Modern Contraceptive Methods in Rural Malawi

CONTEXT: Despite the extensive literature on women's perceptions about contraceptive methods, distinctions between specific methods have rarely been investigated, men have often been excluded and comparable data for contraceptive users and nonusers have typically not been collected. The lack of such information may limit family planning programs' effectiveness. METHODS: Cross-sectional survey data from 7,162 women and 621 men were used to examine perceived barriers to and facilitators of use of contraceptive methods (the pill, injectable, subdermal implant, IUD and male condoms). Conditional logit regression analysis was used to examine associations between 13 method-specific perceptions and respondents' preference to use the male condom, injectable or implant among a subsample of 603 women and 295 men. RESULTS: Men's and women's perceptions differed the most with regard to side effects, sexual pleasure and partner support. The likelihood that a woman preferred to use a method was positively associated with her perception that it does not have side effects, has a desired influence on menstruation, has no impact on conceiving a future pregnancy, is easy to use covertly and was recommended by a friend (odds ratios, 1.3-1.7). The likelihood that a man preferred a method was positively associated with his perception that it has a desired influence on his partner's menstruation (1.7) and that his partner is very supportive of its use (2.1). CONCLUSIONS: Family planning programs and health care providers should engage with both women and men to counteract misperceptions or negative beliefs about contraceptive methods, and should work to provide accurate information to couples.