Key Social Norms Take-aways Husbands’ attitudes toward family planning and contraceptive use are strongly associated with whether they participate in reproductive decision-making and support their wives’ contraceptive use. The discussion emphasizes that favorable attitudes occur across social groups and that media exposure may help shape attitudes toward shared responsibility for family planning. Programs could leverage positively engaged husbands, including those from marginalized communities, to promote family planning acceptance. However, the authors note that existing societal norms around contraceptive use were not directly measured and should be examined in future research.

Objectives To assess husbands’ involvement in family planning—defined as involvement in decisions about family size and support for wives’ contraceptive use—and identify demographic, socioeconomic, attitudinal, and program-related factors associated with this involvement among married couples in Uttar Pradesh, India.

Methods This community-based cross-sectional study included 1,258 couples from Aligarh and Fatehpur districts. Husbands’ involvement was measured through reported discussion and decision-making about family size, birth spacing, and contraceptive use. Attitudes toward family planning, contraceptive use, and supporting wives’ contraceptive use were assessed; latent class analysis classified husbands according to family planning and supportive attitudes, while contraceptive attitudes were measured with a 13-item scale. Exposure to family planning messages through frontline health workers and media was also assessed. Analyses included bivariate and multivariable logistic regression, including interactions between attitudes and media exposure.

Results Approximately 65% of husbands participated in decisions about family size and 56% supported their wives’ contraceptive use. Positive attitudes and media exposure were particularly important: compared with husbands with negative attitudes and no media exposure, husbands with both positive attitudes and media exposure had over four times the odds of involvement in family-size decision-making (adjusted odds ratio=4.18, 95% confidence interval: 2.96–5.88) and nearly four times the odds of supporting wives’ contraceptive use (adjusted odds ratio=3.98, 95% confidence interval: 2.82–5.61). Media exposure was associated with greater involvement even among husbands with negative attitudes.

Conclusions Male involvement in family planning extends beyond men’s contraceptive use to equitable decision-making and support for women’s reproductive choices. The authors recommend strategic media approaches and engagement of husbands with favorable attitudes across social and religious groups to strengthen men’s supportive participation in family planning, while noting that the cross-sectional design prevents causal conclusions about whether media exposure changes attitudes or involvement.