On a recent trip to Malawi, I visited the rural community of Matapila outside of the capital, Lilongwe, where a theater group was performing a series of short plays on how couples negotiate sex and make decisions about if and when to have children. After the plays, during a Q&A session, an older man stood up and elicited chuckles from the audience when he asked, “What about men?”

He continued, “Family planning is all for the women. All the education is taught to women and all of the methods are for women, but what about us? We want to be involved with family planning, too.”

That so many people in the audience found the man’s comments amusing was telling. In Malawi, information and education on contraception and family planning is largely geared toward women. Often, these services are offered in spaces that are largely seen as women-only sections of health clinics during prenatal, postpartum, or pediatric visits. Despite the audience’s laughter, the man’s question, “What about men?” is a serious one.

The question made me think back to a scene a fellow colleague in Malawi had described to me. She told me she witnessed a young couple ride up to the clinic on a bicycle, and soon after the clinic guard approached them. The couple explained to the guard that they were there for a doctor’s appointment about family planning. The guard immediately directed the young man to park the bike by the fence and wait outside for his wife. Although the man had said he wanted to go in with his wife, he followed the guard’s instructions. When describing this scene to me, my colleague explained that even if the man had chosen not to follow the guard’s instructions, he would have faced other objections. This man most likely would have been teased by other women in the clinic for attending a “woman’s appointment.”

Walking back to the car that evening after the performance had wrapped up, I told Deliwe Malema, IntraHealth’s Malawi country program director, this story. I asked her what she thought about the role men play in making family planning decisions, and how men in Malawi can be more engaged and informed. She said, “In Malawi, the use of family planning has come a long way.” In fact, in Malawi, the contraceptive prevalence rate for modern methods has increased from 7% in 1992 to 28% in 2004. “But,” she continued, “the perception that family planning is a woman’s topic is still strong throughout Malawi.” Changing the perception of family planning as a women’s issue more widely requires that all the health clinic staff—down to the guard outside the clinic—understand and approach family planning as an issue for women, men, and couples.

In recent years, some initiatives have been started to encourage greater participation from both members of a couple by offering incentives to those couples who attend family planning appointments together. There are also projects that offer education and information about family planning to men in health clinics that they attend. This is critical work because while many men continue to have fears that using contraception will decrease libido or affect their or their partners’ health negatively in other ways, yet, men are key to any success in increasing the acceptance and use of family planning. Not only are men important actors in decisions about family planning, but when men are kept informed about family planning, they are enabled to be supportive partners and actively support healthier decisions about family planning.