Journal of Reproductive Health, Gender, and HIV in Africa | 21 March 2015
A Gender-Synchronised Intervention to Enhance Shared Decision-Making for Family Planning Among Refugee Couples in Nakivale Settlement, Uganda
M, s, K, i, m, S, m, i, t, h, ,, D, r, F, r, a, n, c, e, s, H, a, l, l, ,, N, a, k, a, t, o, M, b, a, b, a, z, i, ,, D, a, v, i, d, O, k, e, l, l, o
Abstract
In humanitarian settings, family planning decisions are often male-dominated, contributing to low contraceptive use. Gender-synchronised interventions engaging both partners may improve shared decision-making but are rarely evaluated in refugee contexts. This short report assessed the effect of a gender-synchronised, couple-based intervention on enhancing shared decision-making for family planning among refugee couples in Nakivale settlement, Uganda. A mixed-methods evaluation was conducted. Couples participated in facilitated dialogue sessions, held separately and jointly, addressing gender norms, communication, and family planning. Pre- and post-intervention surveys measured changes in shared decision-making, complemented by in-depth interviews exploring participants’ experiences. Post-intervention, the proportion of couples reporting joint, communicative decision-making on family planning increased markedly. Qualitative data revealed improved spousal communication and increased male willingness to discuss family planning, indicating a shift away from unilateral decision-making. The gender-synchronised intervention showed promise in shifting family planning decision-making dynamics among refugee couples towards more shared processes. Programmes aiming to improve family planning uptake in refugee settings should integrate gender-synchronised approaches that create safe spaces for couple dialogue. Further implementation research with robust designs is warranted. family planning, shared decision-making, gender-synchronised intervention, refugees, Uganda, humanitarian settings This report contributes practical evidence on implementing a couple-centred intervention in a complex humanitarian environment, highlighting the feasibility of addressing gender norms directly.