Abstract
Background Male participation in contraceptive decision-making is increasingly recognised as a key determinant
of reproductive health outcomes in sub-Saharan Africa (SSA). Yet, the pathways through which men’s education
and media exposure shape male-reported contraceptive behaviour remain under-examined. This study strengthens
the public health perspective by highlighting how male engagement contributes to improved reproductive health and
supports progress toward Sustainable Development Goal (SDG) 3 on ensuring healthy lives.
Methods A cross-sectional analysis was conducted using harmonised IPUMS-DHS datasets for 22,265 men aged
15–59 years in Nigeria, Uganda, and South Africa. Survey weights were applied in all descriptive and multivariable
analyses. Logistic regression models assessed the associations between education, exposure to newspapers/radio/
television, and male-reported modern contraceptive use.
Results Overall, 25.7% of men reported current use of modern contraception. Higher educational attainment was
strongly associated with use (aOR for higher education = 4.47; 95% CI: 3.68–5.43). Exposure to newspapers (aOR =
1.13), radio (aOR = 1.27), and television (aOR = 1.24) independently increased the likelihood of use. Substantial crosscountry
variations were observed, with South African men being over six times more likely to report contraceptive use
than Nigerian men after adjusting for all covariates.
Conclusion Despite the positive influence of male education and media exposure, many well-educated men remain
non-users, indicating a persistent behavioural gap with significant implications for public health systems. Strengthening
male-focused reproductive health interventions and expanding culturally responsive media messaging are essential to
reducing unintended pregnancies, lowering maternal morbidity, and advancing SDG 3 targets in SSA.