A sweeping review of over 150 scientific publications spanning nearly three decades has spotlighted critical gaps in how men’s involvement in family planning is understood and studied across 23 African nations. The research, led by a team of demographers, reproductive health experts, and population scientists, raises fresh questions about how health systems worldwide—including in Thailand—should rethink the role of men in shaping reproductive choices and outcomes. The findings suggest that involving men meaningfully in family planning discussions and programmes is not only essential for gender equity but also for the long-term success of reproductive health initiatives (The Conversation).
Traditionally, family planning in Africa and many parts of Asia, including Thailand, has been depicted as a domain chiefly managed by women. The imagery of women queuing at clinics, making decisions about contraception, and shouldering responsibility for family size is a familiar one from health campaigns and public discourse. However, as this new review clearly articulates, these perceptions overlook the crucial influence men exert—whether directly through decision-making or indirectly through cultural attitudes—on reproductive behaviour, fertility intentions, and contraceptive uptake.
The research team’s analysis, which covered studies published between 1996 and 2023, found that of all studies purporting to examine “male involvement” in family planning, only about 20% actually collected data from men. Most studies fell back on evaluating men’s approval of their partner’s contraceptive use, rather than delving into the fuller scope of male involvement: emotional support, shared decision-making, communication dynamics, and joint responsibility for reproductive health decisions. As one co-author noted: “Assessing male involvement without men’s perspectives is like painting a landscape with only half the colours—it cannot capture the true picture.”
This narrow focus has not only led to an incomplete understanding of men’s roles but has also affected the design of reproductive health policies and services. Across the African continent, family planning programmes centred almost exclusively on women have yielded impressive outcomes: from 2010 to 2020, under-five mortality fell by 35%, and maternal mortality by 28%. Yet, this female-centric approach, perpetuated in many non-African contexts as well, reinforces the notion that family planning is predominantly a woman’s issue. This, despite the reality in many households and communities where male partners exert significant influence—sometimes primary control—over decisions about family size, timing of childbearing, and even whether contraceptives are used at all.
In comparing these findings with the Thai context, it is notable that similar patterns persist here. Health education and contraceptive promotion often target women, and public messaging rarely features men as proactive partners in family planning. The National Statistical Office of Thailand, for instance, shows that while knowledge about contraception is relatively high, male engagement in reproductive health conversations and clinic visits remains low (NSO Thailand). This is despite the country’s long-standing reputation for successful family planning initiatives, marquee declines in fertility rates, and robust community health infrastructure. The limited inclusion of men in both campaigns and research could hinder further progress, especially in regions where traditional gender roles remain deeply rooted.
The African review underscores the need for a more participatory approach that brings both genders into the heart of family planning conversations. The authors argue that involving men is not about shifting the burden from women or diluting the success of maternal health gains. “True involvement,” the study stresses, “means recognising shared decision-making, mutual respect, and supportive partnerships as vital for sustained reproductive health.”
Moreover, the study reveals a troubling bias in the geographic and institutional focus of family planning research. Most studies were concentrated in just four African countries—Nigeria, Ethiopia, Uganda, and Kenya—leaving much of the continent underrepresented. In addition, over half of the most influential authors were affiliated with institutions outside Africa, raising concerns about the cultural relevance, equity, and sustainability of the knowledge base underpinning reproductive health policy.
This critique of research equity is highly relevant globally, including in Thailand, where academic partnerships and donor-driven projects may sometimes sideline local voices and context-specific understanding. Experts caution that for health policies and programmes to be effective, they must be anchored in inclusive, representative, and culturally attuned evidence.
There is, however, cause for optimism. The research points to a marked increase in studies examining male involvement since 2015, a sign that recognition of men’s pivotal role is growing. Examples from the African continent illustrate ways forward: in Senegal, community campaigns led to increased male support for contraceptive use; Tanzania saw a 71% attendance rate among men when invited to accompany their wives to clinics; Kenya’s male-only family planning clinics and Ghana’s father-focused outreach both translated into higher male participation rates.
Such interventions can be readily adapted to the Thai context. While Thailand’s network of village health volunteers and district health centres has rightly been lauded for engaging women in reproductive health, there is room to broaden this approach. For instance, male community leaders—or respected village figures—could be trained as peer educators, mirroring the successful “Male Motivator” project from Malawi. Health clinics could schedule male-only consultations or integrate men’s health topics (including reproductive health) into existing men’s groups or sporting events, building trust and reducing stigma.
Expert voices in Thailand support this direction. According to a reproductive health official from the Ministry of Public Health, “Broadening family planning to engage men directly is key to forging stronger, more equitable health systems. Men are not just gatekeepers or spectators—they are co-owners of family health choices.”
From a cultural perspective, it is important to address social norms that reinforce the idea of male virility being tied to fathering many children or dominating family planning choices. Thai popular media and traditional wisdom often valorise strong patriarchal roles. However, modern Thai society—particularly in urban areas—has seen a gradual shift towards partnership-based family structures. Buddhist teachings on mutual respect and shared responsibility can also provide a culturally resonant narrative promoting gender equality in reproductive health decisions.
Looking ahead, the African review outlines key recommendations with global relevance. Policymakers must update national strategies to treat men as active participants in family planning, not merely as passive supporters or barriers. Research agendas should incorporate men’s experiences and perspectives, including their own fertility intentions and attitudes toward reproductive health services. Healthcare professionals need tailored training to engage men effectively and without judgment, recognising the influence of local culture and gender dynamics.
Donors and international agencies, meanwhile, should make equitable research funding, regional diversity, and local leadership central criteria for programme support. The days of “parachute research,” where outside experts dominate studies in the Global South, are numbered if family planning agendas are to reflect the values and realities of those they intend to serve.
For Thailand, practical steps can be taken immediately. The Ministry of Public Health could pilot couple-based family planning consultations in high-fertility provinces or areas with strong traditional values. Awareness campaigns featuring respected male personalities or popular celebrities could help model positive male involvement and reshape public perceptions. Monitoring and evaluation systems should be updated to capture men’s attitudes, knowledge, and practices around reproductive health. Collaborations between Thai universities, local NGOs, and international partners could prioritise research led by Thai scholars, focusing on the diversity of experiences across different regions and ethnic communities.
Ultimately, achieving reproductive health equity in Thailand—and globally—means making room for both women’s and men’s voices. As the African study concludes: “Improving male involvement isn’t about choosing between men and women. It’s about designing health systems and research agendas that reflect the reality that reproductive health is a shared responsibility.” The lesson for Thailand is clear: the future of family planning belongs to all, and engaging men as full partners is essential for continued progress.
For Thai families, educators, and policymakers, now is the time to reset expectations. Begin conversations about reproductive health as a family concern. Men should feel encouraged to visit clinics, ask questions, and participate in shared decision-making. Community leaders can champion male engagement in family health, breaking down taboos and fostering new social norms. By embracing these changes, Thailand can not only sustain its success in family planning but also become a regional model for gender-equitable, inclusive reproductive health.
For further reading and a global perspective on this topic, review the full article at The Conversation, as well as resources from the National Statistical Office Thailand. To understand the broader implications, consult related literature available on PubMed and the World Health Organization’s regional office reports on family planning and gender equity.