Partner in choice: Why male allyship is contraception's missing piece

Whether at a clinic in Kisumu, around a sitting room in Garissa, or across a pharmacy counter in Mombasa, contraception is often overwhelmingly considered a woman’s business. Consultation rooms fill daily with women arriving alone to discuss options, switch methods, or manage side effects. When a man does step through the door, most times he isn’t seeking counselling himself but is in fact merely accompanying his partner as an observer. While it takes two to have a child, contraception conversations in our country rarely take place with men for them to plan with shared intentionality and responsibility.

I once attended to a young woman who arrived at the clinic alone, asking to switch methods due to side effects. When asked if her partner knew, she shook her head, noting that discussing it at home would lead to frustration rather than understanding. In clinical practice, this reality appears daily. Too often, male influence becomes an added barrier in contraceptive access.

The lived experience of contraception

Contraception remains difficult to discuss openly in many Kenyan homes, where myths about infertility, suspicions of infidelity, and religious misconceptions turn routine health decisions into sources of tension. In Kenya, some partners oppose contraception entirely, driving 1 in 10 women to use methods covertly. This secrecy exposes women to gender-based violence and obstructs quality healthcare. Furthermore, because men frequently control domestic budgets, they can also refuse to pay out-of-pocket costs for care, which leaves many women wanting but unable to access contraceptives.

Men who understand reproductive health basics help change this dynamic. A partner who discusses side effects and costs without judgment reduces isolation, preventing early discontinuation or covert use. According to the 2022 Kenya Demographic and Health Survey (KDHS), one in three new contraceptive users stops within the year, and about a quarter of the time this happens due to health concerns or side effects. The mental load of contraceptive access, which includes the emotional and logistical labour of researching options, weighing choices, managing side effects, arranging finances, and navigating stigma from the healthcare system, frequently rests only with the woman, which is isolating and can result in them enduring discomfort or abandoning contraception altogether. Studies demonstrate that when men learn about family planning and attend counselling with their partner, women are more likely to be able to access preferred contraceptives and less likely to discontinue use prematurely. For men who are thinking of contraceptives, there are options including vasectomies and spermicides; however, these rates in Kenya sit well below 1%, suppressed by widespread myths regarding masculinity and virility.

For this year’s World Contraception Day, the Kenyan Ministry of Health’s theme, “My Contraception, My Choice, My Future,” prompted us to introspect and ask ourselves about the role of men in making that choice easier or harder to exercise.

From individual effort to institutional change

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Male allyship can be practical. We have seen partners pay for transport or other costs, travel with their wives to another facility when a preferred method is unavailable, and help find alternative care when a woman encounters judgement or poor treatment.

Men can also challenge disrespectful treatment directly, rather than leaving the woman receiving care to carry that burden alone. These actions may seem simple, but they shift contraception away from being something women are expected to manage almost entirely by themselves.

However, this dialogue must extend beyond the domestic sphere. Men can challenge peer stigma by speaking openly about family planning and shared responsibility. After all, cultural taboos are harder to sustain when men stop reinforcing them. Kenyan men are deeply committed to their families and want to support their spouses, but they often lack guidance. Shifting these dynamics requires accountability from both individuals and health institutions.

A vital first step is for clinicians to practice radical clinical transparency by fully unpacking potential side effects, lifestyle impacts, financial realities, and shared responsibilities. This enables patients and partners to make decisions rooted in mutual trust.

The health system has responsibilities of its own. County health departments and national supply agencies must address stockouts and reduce out-of-pocket costs that interrupt access. Health leaders should also equip providers to engage men constructively, encourage couple counselling where women want it, and create clinical environments where men can participate as informed partners rather than decision-makers.

True male allyship requires more than passive approval. It means sharing information, financial costs, practical burdens, and responsibility while fiercely respecting a woman’s autonomy. A man does not need to decide for her, but instead, he needs to help create the conditions where she can make an informed choice and access the method she wants with ease.

While Dr Hope Simiyu is a health communication consultant and the founder and host of the A Dose of Health podcast, Dr Joe Njagi is an advanced laparoscopic surgeon, gynaecologist, and endometriosis specialist