MALE INVOLVEMENT IN MALE INVOLVEMENT IN REPRODUCTIVE REPRODUCTIVE

HEALTHHEALTH

Dr. Babar T. ShaikhDr. Babar T. Shaikh

Health Systems DivisionHealth Systems Division

Department of Community Health Department of Community Health SciencesSciences

Aga Khan UniversityAga Khan University

Karachi-PakistanKarachi-Pakistan

Learning Objectives:Learning Objectives:

Comprehend the meanings of Comprehend the meanings of ‘Male Involvement in RH.‘Male Involvement in RH.

Recognize the role of men in RH.Recognize the role of men in RH. Understand the strategies to Understand the strategies to

ensure the men’s participation ensure the men’s participation in RH matters. in RH matters.

Discuss the implications of Discuss the implications of men’s involvement in RH. men’s involvement in RH.

REPRODUCTIVE HEALTH: REPRODUCTIVE HEALTH: MEN’S PARTICIPATIONMEN’S PARTICIPATION

Men: Full partners and advocates for Men: Full partners and advocates for good reproductive healthgood reproductive health

reaching men is a winning strategyreaching men is a winning strategy to encourage sexual responsibilityto encourage sexual responsibility to foster men’s support of their to foster men’s support of their

partners’ contraceptive choicespartners’ contraceptive choices to address the reproductive health care to address the reproductive health care

of couples of couples

New PerspectivesNew PerspectivesRecognize:Recognize: Men play dominant roles in decisions Men play dominant roles in decisions Men are more interested in family planning Men are more interested in family planning

than assumedthan assumed Need communication and services directed Need communication and services directed

specifically to themspecifically to them Understanding-and influencing-the balance Understanding-and influencing-the balance

of powerof power Couples who talk to each other reach Couples who talk to each other reach

better, healthier decisionsbetter, healthier decisions

GoalsGoals Provides male support for female actions Provides male support for female actions

related to reproduction and respect for related to reproduction and respect for women’s reproductive and sexual rightswomen’s reproductive and sexual rights

Increases access to male contraceptive Increases access to male contraceptive methods methods

Improves male and female reproductive healthImproves male and female reproductive health Promotes responsible and healthy reproductive Promotes responsible and healthy reproductive

and sexual behavior in young menand sexual behavior in young men Involves men with their spouses during Involves men with their spouses during

counseling and other FP/RH informationcounseling and other FP/RH information

The reasons for attention to men:The reasons for attention to men: spread of HIV/AIDS and STDsspread of HIV/AIDS and STDs ill effects of men’s risky sexual behaviour on the ill effects of men’s risky sexual behaviour on the

health of women and childrenhealth of women and children men approve of family planningmen approve of family planning men make decisions that affect women and men make decisions that affect women and

men’s health men’s health awareness that gender affects sexual behaviour, awareness that gender affects sexual behaviour,

reproductive decision-making, and reproductive reproductive decision-making, and reproductive healthhealth

demands from women for more involvementdemands from women for more involvement

At the 1994 International At the 1994 International Conference on Population and Conference on Population and Development (ICPD), held in Cairo, Development (ICPD), held in Cairo, representatives from more than representatives from more than 180 countries formally recognized 180 countries formally recognized the importance of men to women’s the importance of men to women’s reproductive health and also reproductive health and also recognized the importance of recognized the importance of men’s own reproductive health. men’s own reproductive health.

In Cairo…In Cairo…

The ICPD Programme of Action urges all The ICPD Programme of Action urges all countries to provide men, as well as women, with countries to provide men, as well as women, with reproductive health care that is “accessible, reproductive health care that is “accessible, affordable, acceptable and convenient”affordable, acceptable and convenient”

The ICPD Programme of Action encourages The ICPD Programme of Action encourages reproductive health care programmes to move reproductive health care programmes to move away from considering men and women separately away from considering men and women separately and to adopt a more holistic approach that and to adopt a more holistic approach that includes men and focuses on couplesincludes men and focuses on couples

The ICPD also draws The ICPD also draws attention to the unfairness attention to the unfairness inherent in many men’s and inherent in many men’s and women’s gender roles, women’s gender roles, calling for men to take more calling for men to take more responsibility for household responsibility for household work and child-rearingwork and child-rearing

The 1995 United Nations The 1995 United Nations Fourth World Conference on Fourth World Conference on Women, held in Beijing, Women, held in Beijing, encourages men to take steps encourages men to take steps toward achieving gender toward achieving gender equality and better equality and better reproductive health. reproductive health.

In In Beijing…Beijing…

Terms used for Terms used for Involvement of men in RHInvolvement of men in RH

men’s participationmen’s participation men’s responsibilitymen’s responsibility male motivationmale motivation male involvementmale involvement men as partners men as partners men and reproductive healthmen and reproductive health

A complex process of social and behavioural A complex process of social and behavioural changechange

Policies and programmes Policies and programmes encourage:encourage:

Men to take more responsibility Men to take more responsibility for their sexual behaviourfor their sexual behaviour

men’s access to reproductive men’s access to reproductive health information and serviceshealth information and services

communication with their partnerscommunication with their partners reproductive health care needs of reproductive health care needs of

couplescouples

A promising strategy A promising strategy to:to:

slow the spread of HIV/AIDS and other slow the spread of HIV/AIDS and other STDsSTDs

prevent unintended pregnanciesprevent unintended pregnancies

reduce unmet need for family planningreduce unmet need for family planning

foster safe motherhoodfoster safe motherhood

practice responsible fatherhoodpractice responsible fatherhood

stop abuse of womenstop abuse of women

Men and ContraceptionMen and Contraception Men’s participation is crucial to avoid Men’s participation is crucial to avoid

unintended pregnancies. Of the 175 unintended pregnancies. Of the 175 million pregnancies each year, about million pregnancies each year, about 75 million are unintended, (UNFPA)75 million are unintended, (UNFPA)

An estimated 100 million married An estimated 100 million married women have unmet need for family women have unmet need for family planningplanning

Surveys exist only for married women.Surveys exist only for married women.

Safe motherhood: Safe motherhood: Men’s RoleMen’s Role

Men play many key rolesMen play many key roles Their decisions and actions Their decisions and actions

make a difference during:make a difference during:

• pregnancypregnancy• deliverydelivery• the postpartum periodthe postpartum period

During During pregnancy- pregnancy- by ensuring:by ensuring:

Good NutritionGood Nutrition Plenty of restPlenty of rest Timely referralTimely referral

Helping pregnant Helping pregnant women stay healthywomen stay healthy

ensure proper antenatal and early careensure proper antenatal and early care

provide transportationprovide transportation

provide funds to pay for visitsprovide funds to pay for visits

learn about the symptoms of learn about the symptoms of

pregnancy complicationspregnancy complications

During the Non-During the Non-Pregnant Interval Pregnant Interval PeriodPeriodPlanning their families Planning their families

limit birthslimit births space at least two years apartspace at least two years apart support contraceptive usesupport contraceptive use accompany their partners for accompany their partners for

servicesservices communicate with each other to communicate with each other to

meet needs meet needs

During delivery, During delivery, arranging for skilled care arranging for skilled care

A trained attendant present duringA trained attendant present during

childbirth can mean the difference childbirth can mean the difference

between life and death. between life and death. Men can help by arranging for a trained Men can help by arranging for a trained

attendant to be available for the attendant to be available for the delivery and by paying for the services. delivery and by paying for the services.

They also can arrange ahead of time for They also can arrange ahead of time for transportation and can buy supplies, if transportation and can buy supplies, if necessary.necessary.

During the postpartum During the postpartum periodperiod

men can help with household choresmen can help with household chores can encourage breastfeedingcan encourage breastfeeding can begin using contraceptioncan begin using contraception

Men can be responsible Men can be responsible fathers by:fathers by:

becoming more involved in their becoming more involved in their children’s healthy, physical and children’s healthy, physical and emotional developmentemotional development

ensuring that their children ensuring that their children receive all of the needed receive all of the needed immunizationsimmunizations

helping in children’s day to day helping in children’s day to day carecare

Factors Limiting Male Factors Limiting Male InvolvementInvolvement

Primary health center (PHC) programs not geared to meet men’s Primary health center (PHC) programs not geared to meet men’s needsneeds

Limited contraceptive options for menLimited contraceptive options for men

Rumors and misconceptionsRumors and misconceptions

Unfavorable social and cultural climateUnfavorable social and cultural climate

Priorities to women and child care servicesPriorities to women and child care services

Provider’s bias against male involvementProvider’s bias against male involvement

Lack of information and knowledgeLack of information and knowledge

Limited communication between spouses about FP needsLimited communication between spouses about FP needs

PHC service providers are mostly femalePHC service providers are mostly female

contraceptioncontraception reproductive physiology reproductive physiology sexualitysexuality pregnancypregnancy STDsSTDs other reproductive health other reproductive health

carecare

Men need more info on:Men need more info on:

How can programmes communicate How can programmes communicate effectively with men?effectively with men?

How can reproductive health care How can reproductive health care providers best increase men’s providers best increase men’s participation?participation?

How can programmes encourage more How can programmes encourage more men to care about reproductive health?men to care about reproductive health?

How to involve them?How to involve them?

Design IEC materials, communication programmes and services, Design IEC materials, communication programmes and services,

focus gender equality. focus gender equality.

RH information and services should focus the couple rather than RH information and services should focus the couple rather than

the individual. the individual.

Remove myths about condom and vasectomy.Remove myths about condom and vasectomy.

Service providers to be sensitized for men’s reproductive health Service providers to be sensitized for men’s reproductive health

needs. needs.

In RH health clinics, a constellation health services may increase In RH health clinics, a constellation health services may increase

the male clientele.the male clientele.

Some Some solutionssolutions

Separate clinic for males.Separate clinic for males.

Improved services at existing clinics.Improved services at existing clinics.

Workplace services.Workplace services.

Community-based services.Community-based services.

Commercial and social marketing.Commercial and social marketing.

Increase contraceptive choice for men.Increase contraceptive choice for men.

Train providers about male FP/RH needs.Train providers about male FP/RH needs.

Some solutionsSome solutions contd….contd….