影响男性参与计划生育的因素:中国定性研究的发现

本项目于1993～1994年在中国开展。为达到研究的预期目的,在方法学方面采用定性研究技术,即通过集体访谈(FGDs)和个人深入访谈的方式来获取各类访谈对象的观念和行为方面的广泛信息,以探究影响男性参与的深层原因。访谈现场确定在四川、云南和吉林三省。本项目集体访谈对象类型主要包括避孕套使用者及其妻子,五年内男扎接受者及其妻子,采用女性方法的妇女及其丈夫等;个人访谈对象类型主要包括政策制定者、项目管理者、节育技术提供者和宗教领袖等。各省现场调查结束后,研究者使用统一拟定的提纲对集体访谈资料进行观点归类,并以个人访谈获取的关键信息加以补充,进而找出研究之主要发现。研究结果提示,影响男性参与计划生育的因素主要涉及政策与宣传、服务与技术、地理与文化和社会与心理等相互联系的诸多方面。根据主要发现提出的建议要点主要包括改善决策者男扎方面的知识,制定出有利于男性参与的鼓励性政策;加强避孕套提供过程的全面质量管理;进一步提高男扎服务质量并制定切实可行的规范;通过各种渠道宣传男扎知识,改进服务提供者的人际交流技巧,为广大群众提供咨询服务,进一步改善男性参与计划生育的意识并分担责任。

Male Participation in Family Planning in China: Findings from Qualitative Research.

This project was conducted from 1993 to 1994 in China. Before the implementation of the project, a review was done on the world' s as well as China' s experience in acceptability of male contraception. In order to find out in-depth reasons, information was collected through qualitative methodology including focus group discussion and in-depth individual interview in three provinces with highly different rates of male sterilization. Sichuan Province has the largest number of vasectomy, accounting for roughly one forth of the world' s total j oppositely, Jilin Province has the lowest rate of va-sectomy in whole China, approximately under one per thousand t Yunnan Province was chosen because it is a place with many minority nationalities, the vasectomy prevalence rate is about the average level. The condom prevalence rate there is about 2-3% in the three provinces. Participants recruited for focus group discussions include condom users and their wives, vasectomy acceptors within the past five years and their wives, women using contraceptives and their husbands, etc; individual interviewees mainly include policy makers, project managers, technical providers and religious leaders and so on When FGDs and interviews finished, a unified guides was used to classify information from the FGDs. The major findings are made on the basis of those information which is supplemented by important information from individual interviews.Vasectomy is popular in Sichuan Province. Policy makers there think that vasectomy is harmless, simple, economical and easy to recover. A network of male service has been set up in the whole province, vasectomy could be performed even in county and town/township level family planning clinics. Quality of service is valued by publicizing the experience of successful cases. Another reason is that Sichuan women are the major labors in their families. They are responsible for field work as well as house chores, therefore, their husbands are willing to take contraceptives. In Jilin Province, however, female sterilization has been very much developed. Due to the low level of agriculture mechaniza-tion in this province, farm work mainly relies on men' s power. Afraid of harming the pillar in their families and affecting their family life, women in Jilin usually take the responsibility of sterilization. In Jilin Province, there is hardly and publicity of vasectomy. It is told by many interviewees that they just know female sterilization not male one. Little knowledge leads to misconceptions among some people. Because they fear that the side effects of vasectomy will affect their sexual function, women are strongly opposed of this kind of contraception. This indicates that the acceptability is very low. Policy makers are very skeptical about this method as they are afraid of the problems caused by the side effects. In Yunnan Province, male sterilization service is provided in some county and town/township level family planning clinics. Besides knowledge, other factors also contribute to the underdevel-opment of vasectomy in Yunnan, like poor transportation condition and mountainous geography, which have made accessibility quite difficult. Apart from that, due to large number of minority nationalities , their different religious belief and national tradition also lead to a low rate of vasectomy prevalence. For instance, we were told by some participants of FGDs in areas inhabited by Bai nationality that, "if one takes vasectomy, he will not have any children even in his next life". Yet, when holding an interview with the Buddhism monk in charge in the place inhabited by Dai nationality, we know that vasectomy is not contradictory with the doctrines of Buddhism.Recommendations based on findings are targeted separately on policy makers, researchers and service providers, including improving policy makers' knowledge on male sterilization, formulating more policies encouraging male participation in family planning; improving the current mal sterilization techniques and conducting further study on the prevention of vasectomy