A Gender-Synchronised Intervention to Enhance Shared Decision-Making for Family Planning Among Refugee Couples in Nakivale Settlement, Uganda

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.