Her body, their rules: How Maasai men call shots on family planning

Growing up in a Maasai community, Ezekiel Lesiau, now 25, says conversations about sexual and reproductive health were largely absent from his childhood. Like many boys raised in traditional settings, he learnt about cultural expectations, marriage and family responsibilities long before he understood contraception, HIV/AIDs prevention or reproductive health rights.

It was only after joining college that Lesiau began to understand that he could make choices about his relationships or reproductive health.

“When growing up, we never knew anything outside our traditions, such as getting married at a young age to a girl chosen by our fathers. But when I went to college, I learnt that I could actually choose my own woman. I learnt about my sexual and reproductive health and the choices I could make,” he says.

But the knowledge he acquired in college was not enough to change the expectations waiting for him back home in Mashuru village, Kajiado County.

One of them was to marry a woman chosen by his family. But that was not the only thing that was to be done on his behalf. When the wife became pregnant, he says, he could not take her to hospital for antenatal care because his family believed more in traditional medicine and practices than modern healthcare. Taking her to hospital was against his cultural beliefs.

After having two children, he says he would have wanted his wife to use modern family planning methods. But that decision, too, was closely tied to the traditions and expectations of his community.

“My wife really wanted to undertake contraception, but I could not allow it because I had to seek permission from my community elders. And if we were to go ahead and take without their approval, chances are curses will follow us, and we might not be able to get more children in the future, or something bad might happen,” Lesiau reveals.

“So for now, we are not using any contraceptive method,” he notes, while taking note of how Maasai elders have a say in major family decisions, including how many children their sons will have or the number of wives they will marry; until they are dead.

For Geoffrey Kitende, a 28-year-old father of two, traces back the culturally bound decision-making for individual lives to growing up with the limited information in his community.

He says he was raised to believe that modern medicine could be harmful, while discussions about HIV, condoms and family planning were largely missing from his upbringing.

“Imagine growing up knowing HIV/AIDS is just a disease that is caused by curses and not knowing anything about condoms. We were made to believe if you sleep around, the spirits of those women will hunt you down, only to realise later that the spirit they were referring to was actually HIV,” he says.

It was through education that Kitende began to understand sexual and reproductive health, including the role of condoms and contraceptives.

“I learnt about condoms and family planning at college. Education really helped us be aware of sexual matters,” he says.

After getting married and having two children, Kitende and his wife decided they wanted to use a long-term contraceptive method. They were still building their lives, with Kitende pursuing his education and his wife hoping to return to school.

He says they felt having another child at that stage would make it harder to achieve their plans, particularly given the economic demands of raising a family.

“We had plans for the future. I was still in school, and she also wanted to go back to school. We felt that for us to achieve those dreams, it was important not to get pregnant again. That is why we wanted a long-term family plan,” he says.

But their decision was not entirely theirs to make, at least according to the expectations of the wider family.

Kitende says he felt obliged to inform the elders about their plans, only for the proposal to be met with strong opposition.

“I had to ask for permission, or rather inform our elders, of our plans to undertake family planning. As you can imagine, that was not received well. They vehemently opposed the move, saying it would bring a curse,” he says.

Among the beliefs he encountered was that family planning could cause infertility and prevent the woman from getting pregnant again.

Faced with the resistance, Kitende and his wife, however, decided “it was their choice to make, not his father’s or grandfathers’ as they eventually proceeded with their plans without the elders' approval.

“After all, it was my family we were talking about,” he says.

But not all young men are willing to reconsider the beliefs they have inherited from their forefathers.

At 24, Parmari Antonica, who has two wives, says he does not support his wives using contraceptives. He associates family planning with infidelity, arguing that a woman who uses contraception may be planning to cheat on her husband.

“I cannot allow any of my two wives to undertake family planning. I make decisions concerning reproductive health, and they must consult me,” he says.

Antonica, a father of four, believes men, including community elders, have a bigger say when it comes to the sexual and reproductive health of a woman.

“For us Maasai, that responsibility lies with our community elders and us as the husband,” he notes.

“Using a contraceptive means we are just safe from pregnancy and not diseases. And that’s why none of my wives can undertake any family planning. We can get as many children as possible or try traditional methods, but not modern contraceptives.”

His account reflects a reality in some Maasai households, where reproductive health decisions are largely considered a man's responsibility, with women expected to seek their elders' and husbands' approval before undertaking any contraceptives.

The influence of men and elders is particularly strong where family planning is viewed not merely as a personal health decision, but as an issue tied to family lineage, marriage, fertility and the continuity of the community.

Emily Sapuk, a community health promoter, says elders have considerable influence over Maasai women's reproductive health and other aspects of their lives.

“If a pregnant woman is about to deliver and experiences difficulties, it is the elders who will decide whether she should be rushed to hospital or not. It is our culture, and we have to abide by it,” she says.

She notes that the majority of Maa women who are on family planning use contraceptives without their husbands' knowledge, fearing opposition or rejection.

“We have seen men forcefully removing family planning from their wives' bodies simply because they do not want them to use contraceptives,” Sapuk says.

 “As a Maasai woman, I would want to one day see a fellow woman have a say in her health and not wait for the elders or husband to decide for her,” she says.

The data behind reproductive health choices

Although national surveys do not provide statistics specifically for the Maasai community, the Kenya Demographic and Health Survey (KDHS) 2022 offers an indication of contraceptive use in Kajiado County, which has a significant Maasai population.

The survey found that 57.3 per cent of currently married women aged 15 to 49 in Kajiado were using modern contraceptive methods, while 36.1 per cent were not using any method.

Sophie Kimeu, from Engawan Community-Based Organisation (CBO), which creates awareness about sexual and reproductive health in Kajiado, says that despite the numbers looking promising, the open uptake of family planning remains a challenge, mainly due to the patriarchal influence in household decisions.

“Most of the contraceptive uptake is in the town areas, and not in the villages,” she says.

Kimeu says their efforts to educate women about family planning in Maasai communities often require them to first seek the support of elders and other community gatekeepers.

“We have to talk to the men and convince them to allow us to engage their women,” she says.

Also, reaching men with information is difficult because of cultural expectations governing who can address whom in community gatherings.

Kimeu says women working in community health programmes cannot always engage male elders directly, while younger men who may be more open to family planning are often unable to challenge the views of older men.

“We cannot use men to engage their fellow men because they, too, are influenced by culture and are mostly against family planning. The young men who are a bit enlightened cannot stand before their elders because culture only allows people of the same age set to speak in a gathering,” she says.

This creates another barrier for women seeking greater control over their reproductive health, as those expected to provide information and challenge misconceptions must first navigate the same cultural structures that limit women's participation.

Changing attitudes without erasing culture

To change how Maasai men perceive sexual and reproductive health, the National Council for Population and Development (KNCPD) says there is a need for attitude change without erasing the community's cultural perception.

Acting Director General at KNCPD Lucy Kimondo says the aim should not be to eliminate Maa culture, which is an important source of community cohesion, but to distinguish traditions that strengthen communities from those that harm health, violate rights or undermine the wellbeing of women and children.

Instead, the Council advocates for dialogue involving elders, women leaders, young people, health professionals and other respected community figures to identify practices that support community wellbeing and reconsider those that may harm health or undermine women's rights.

“We can use trusted local voices, including trained peer educators, to communicate accurate information in Maa and other familiar languages. The goal is to ensure that no young person has to rely on rumours when making decisions that affect their health and future,” Kimondo says.

Kimondo notes that changing deeply held beliefs requires more than simply providing information. She says community engagement must be sustained, locally driven and supported by practical examples and credible voices.

“Traditional forums, school-based education, local-language radio, digital platforms and partnerships with healthcare providers can all contribute to changing attitudes,” the council says.

The council also identifies cultural expectations, limited access to accurate information, stigma and misconceptions about family planning as barriers that discourage men from participating in reproductive health discussions.

It says engaging men requires taking conversations to spaces where they already gather and trust, including meetings led by elders, community and religious leaders, schools and local barazas.

“Men should be partners in decision-making, not merely observers,” Kimondo says, adding that reproductive health should be presented as a shared responsibility that protects families and improves maternal and child health.

But the council says empowering women must remain central to efforts to improve reproductive health uptake, as women need access to accurate information, affordable and quality services, education and economic opportunities. She notes that they should also be able to make informed decisions about contraception, pregnancy and childbirth without coercion or fear.

“Engaging men constructively is important, but it must never undermine a woman's right to make informed decisions about her own body,” the council says.