| Male
Involvement and Responsibility The ICPD Programme of Action
recognizes that men need to take responsibility for their own sexual behaviour as well as
respect and support the rights and health of their partners. Family planning programmes
have generally ignored men, and have been de-signed to maintain gender norms dictating
that reproduction and fertility control are women’s responsibility.60
A study in Bolivia found that men were not as negative towards family planning as women
thought. In fact, men’s knowledge of family planning methods was slightly higher than
women’s, but couples did not always communicate about family size. In a study in
Mali, the findings were not so positive: men in a focus-group discussion there were
unanimous that women had no right to use family planning without their husbands’
permission.61
While 36 countries reported measures to broaden or promote male involvement in sexual
and reproductive health,62 the situation
in Nicaragua is fairly typical. That country’s national health plan does not mention
male responsibility for family planning and makes no provision for reproductive health
services for men. In the Philippines, male reproductive health is one of the 10 components
of the reproductive health package, but very little has been done so far. In Nepal, the
programme is targeted primarily at women. Although the policy is for men and women to
share the responsibility for family planning, the proportion of vasectomy acceptors, for
example, has been steadily declining.
BOX 19
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Teach Men about the Benefits of Family Planning
A prospective study of new contraceptive users in Mali, conducted as part of Family
Health International’s Women’s Studies Project, has shown how important it is to
involve men as partners in promoting reproductive health.
Legally, Malian women do not need spousal consent to obtain contraception. However,
husbands are statutory heads of the household, and their decisions about family planning
use are critical to women’s contraceptive practices. Programmes should therefore
consider ways to educate men about the benefits of family planning, including the use of
male peer education groups. In addition, policy makers may want to rethink laws that make
the husband the final arbiter in decisions about women’s health. For women whose
husbands disapprove of family planning, providers should offer special counselling to help
the woman resolve conflicts and make decisions that are best for them.
Source: B. Barnett and J. Stein. 1998. Women’s Voices, Women’s Lives:
The Impact of Family Planning. Research Triangle Park, N.C.: Family Health International. |
In Mexico, although providers generally understand the reproductive
health concept, it continues to be seen as a "women’s" programme. Little
effort has been made to make the services more attractive to men or to involve men as
partners.
In Morocco, married women of reproductive age are the main target and there is no clear
strategy to address men. This is a serious problem in rural areas where some women may be
best approached through their partners. To a large extent programme implementers and
service providers in Uganda have ignored the role of men. Since the ICPD, some efforts are
being made to reach men, including approaches aimed at addressing the effects of
sociocultural attitudes and practices, as well as gender-based violence, on the sexual
health and reproductive rights of Ugandan women and girls. Among the countries that do
have reproductive health activities for men, advocacy campaigns have been the most common
activities. Since the ICPD, there appears to have been some increase in men’s use of
condoms and vasectomy and some expansion of male STD services.
In a few countries, NGOs especially are developing innovative approaches to support the
involvement of males in pregnancy and childcare, and to encourage them to develop
relationships based on equality and mutual respect. For example, in Mexico, a group of
midwives have trained community health workers to teach men that pregnancy and birth is a
family affair and not just "women’s business".
An international "Men as Partners" Initiative is developing a reproductive
health curricula to train providers and sensitize workers to the needs of men as clients.63 Some countries have strengthened
legislation that supports men’s roles in the family, especially concerning child
support.
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