The Challenge of Sexual Reproductive Health in Sierra Leone: Gendered Perceptions of Family Planning

ABSTRACT Background/Introduction In Sierra Leone, persistent challenges in sexual and reproductive health (SRH), including high maternal mortality, poor maternal health outcomes, and gender inequality, underscore the critical importance of family planning. Despite progress, with contraceptive use among married women rising from 8% (2008) to 21% (2019), barriers related to knowledge and cultural norms remain. This study explored the family‐planning perceptions of mothers and fathers, using a short film as a discussion stimulus. Methods We conducted 11 focus group discussions following the screening of a health‐promotion short film. Participants included 35 mothers and 21 fathers from the Bombali District. Discussions were analyzed using thematic analysis to identify gender‐based perspectives. Results Mothers predominantly expressed positive views, emphasizing the benefits of family planning for self‐advocacy and control, child well‐being, and health. In contrast, fathers primarily focused on concerns about contraceptive side effects and the impact on partner relationships. A notable theme among fathers was criticism of providing family planning to adolescent girls, based on fears it would promote promiscuity. Conclusions The stark contrast in perspectives underscores the need for family‐planning programs that are tailored to address gender‐specific concerns and that promote constructive communication amongst couples. The film effectively elicited nuanced discussions, suggesting that narrative‐based media are valuable tools for qualitative research and health promotion. These findings provide key insights for refining SRH interventions in Sierra Leone and similar contexts.