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Reproductive Health and Family Planning
Some of the most innovative work since the ICPD has
aimed to involve men in protecting their partners’
reproductive health as well as their own. Through
their greater access to resources and power, men
often determine the timing and conditions of sexual
relations, family size and access to health care.
Reproductive health programmes are increasingly
being designed to counter the ways that gender
inequality limits women’s—and sometimes men’s—
access to health care.(57)
Prior to the ICPD, the population field tended to
focus almost exclusively on the fertility behaviour of
women, paying little attention to men’s roles in its
study of the macro dimensions and implications of
population growth and fertility rates.(58) As a consequence,
basic family planning programmes served
women almost exclusively.
ATTITUDES TOWARD INFORMATION AND SERVICES.
Research has long shown that men want to know
more about reproductive health and want to support
their partners more actively.
Men’s desire to limit their family size often makes
it possible for women who want to use contraception
to do so. Research on male attitudes and practices,
including a 17-country analysis of Demographic and
Health Survey data collected on husbands during the
1990s,(59) suggests that views of men and women on
contraception and family size are much closer than
many in the field once believed. (60) Men generally want
more and better information and access to services.(61)
Those aged 15-24 want fewer children than men 25-34,
who in turn want fewer than men in their 50s.(62)
When programmes exclude men, they undermine
their own effectiveness. Men’s reproductive health
directly affects that of their partners, a reality that the
AIDS pandemic has brought sharply into focus. Treating
sexually transmitted infections in women makes little
sense unless the partners who infected them are also
treated and involved in prevention education.
INCLUDING MEN IN REPRODUCTIVE HEALTH. In virtually
every country, and in thousands of governmental and
NGO programmes, creative ways are being found to
draw men into reproductive health programmes.
Men have responded positively to these efforts.
All countries replying to the 2003 UNFPA global
survey reported taking measures to promote male
contraceptive methods. Education campaigns on men
supporting women have been carried out in all of the
Central Asian countries and in most countries in Asia
and the Pacific, Africa and the Caribbean. More than
half of the Caribbean countries reported developing
plans to encourage more male involvement in reproductive
health.
DIVERSE APPROACHES TO “MALE INVOLVEMENT”.
Programmes developed in recent years have taken different
approaches to involving men in reproductive
health. One approach focuses on men as obstacles to
women’s contraceptive use and as an untapped group
of potential users themselves.(63)
A second group of programmes emphasize the need
to provide men with sexual and reproductive health
care, remedying their traditional exclusion from such
services.(64) Programmes can improve men’s access to
sexual and reproductive health services by making
existing services more receptive: welcoming men, both as clients
and as supportive partners or fathers,
retraining staff, providing information and services
for men, hiring and training male counsellors, and
even altering clinic décor. In trying to make men
welcome, programmes need to recruit and train male
health workers, who can be important advocates and
role models for healthful behaviours and supportive
partnerships.
WORKING TO CHANGE GENDER NORMS. A third
approach focuses on men as supportive partners of
women and seeks opportunities to address the ways that
social positions constrain the sexual and reproductive
roles of women and men. Some programmes explicitly
address inequitable gender norms that harm the health
of both men and women. They work to educate men
about the ways in which control over family resources,
violence at home, or views of male or female sexuality,
for example, can inhibit good reproductive health.
Programmes such as Mobilizing Young Men to Care
in South Africa, the Better Life Options Programme
for Boys in India, the Men Can Stop Rape’s “Strength
Campaign” in the United States, the Conscientizing
Male Adolescents Programme in Nigeria, and Cantera
in Central America seek to transform the values that
underlie harmful behaviours.(65) They have shown that
encouraging men to discuss their beliefs leads them to
question harmful elements of traditional masculinity
and that men welcome the opportunity to do things
differently.
Some programmes promote communication and
respect between men and women on reproductive
health issues, and aim to build the negotiating skills
of both sexes. Many efforts focus on young and
unmarried men whose ideas about gender roles
and sexuality are still evolving.(66) From Costa Rica to
Kenya to the Philippines, programmes are working
with young men to address their sexual health choices
and to develop their skills. The Mathare Youth Sports
Association in Kenya, for example, has established a
peer education programme for HIV prevention.(67) The
Brazilian NGO, ECOS, emphasizes the links between
masculinity, fatherhood and health.(68)
Working with men in leadership positions who
can influence other men and advocate for women’s
health is another important strategy.
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