A multi-sectoral approach to male involvement in family planning and reproductive health focusing on optimal birth spacing American Public Health Association 133 rd Annual Meeting Philadelphia, Pennsylvania 2005 Manal Eid, B.A., M.A.

Session Objectives: Present TAHSEEN ’ s approaches for engaging men in FP/RH issues, with specific emphasis on OBSI Present TAHSEEN ’ s approaches for engaging men in FP/RH issues, with specific emphasis on OBSI Share results of the interventions promoting male involvement in FP/RH Share results of the interventions promoting male involvement in FP/RH

TAHSEEN Integrated Model Improving quality of care Community mobilization Contributing to long-term sustainability

TAHSEEN ’ s Rationale for Involving Men in FP/RH Decision makers and opinion leaders Decision makers and opinion leaders Working with men: Working with men: Impacts not only men themselves, but also the entire family, and community Impacts not only men themselves, but also the entire family, and community Changes deeply-rooted beliefs and norms Changes deeply-rooted beliefs and norms Peer-to-peer effect Peer-to-peer effect

How does TAHSEEN Involve Men in FP/RH Advocacy for male involvement in FP/RH issues Advocacy for male involvement in FP/RH issues Training on gender and rights, medical aspects of FP/RH issues, couple communication Training on gender and rights, medical aspects of FP/RH issues, couple communication Community Mobilization through outreach programs, plays, puppet shows, seminars, IPC … etc. Community Mobilization through outreach programs, plays, puppet shows, seminars, IPC … etc.

What is OBSI? Optimal Birth Spacing Interval (OBSI) is the ideal time period between births Optimal Birth Spacing Interval (OBSI) is the ideal time period between births Evidence to date suggests that a 3-5 year interval between consecutive births is being associated with the most favorable outcomes for pregnancies, infants, children and mothers Evidence to date suggests that a 3-5 year interval between consecutive births is being associated with the most favorable outcomes for pregnancies, infants, children and mothers ( Rutstein 2003, Agudelo 2002, Population Report 2002)

TAHSEEN ’ s Male Involvement Models Religious leaders Religious leaders Literacy facilitators Literacy facilitators Agricultural/irrigation extension workers Agricultural/irrigation extension workers Peer educators Peer educators Community leaders Community leaders Mothakaf sokany (population outreach workers) Mothakaf sokany (population outreach workers) Media professionals Media professionals Transportation workers Transportation workers

Involving Religious Leaders – Why? Considered to be “ the soul of the village and trustworthy ” Considered to be “ the soul of the village and trustworthy ” Reach a large proportion of the population through their weekly sermons Reach a large proportion of the population through their weekly sermons Opinion and attitude shapers Opinion and attitude shapers

Improvement of Religious Leaders' OBSI Knowledge Beni Suef, Fayoum and Minia Governorates

Involving Literacy Facilitators – Why? 36.4% of Egyptian males are illiterate* 36.4% of Egyptian males are illiterate* Egypt has a strong national literacy program Egypt has a strong national literacy program Illiterate men have never been reached with FP/RH messages Illiterate men have never been reached with FP/RH messages *UNDP HDR 2003

OBSI Knowledge for Literacy Students

Involving Agricultural Extension Workers (AEW) – Why? 57.9% of Egypt ’ s population is rural* 57.9% of Egypt ’ s population is rural* AEW reach approximately 40,000 farmers/month AEW reach approximately 40,000 farmers/month Existing strong and widespread outreach program for farmers Existing strong and widespread outreach program for farmers AEW have direct personal communication linkages with farmers AEW have direct personal communication linkages with farmers *UNDP 2002 POSAR

OBSI Knowledge of Farmers (N=1000)

39% Increase Source: Five Prototype Clinics in Mina Governorate FP Method Users Impact on practice

Improved couple communication Source: Household Survey in Minia, Fayoum and Beni Suef, July 2005 all women n=1000, low-parity women (n=pre 214 and post 266) Women discussing FP with their husbands

Lessons Learned Government/policy support is crucial Government/policy support is crucial Building on already existing strong networks within local communities increased the program ’ s success Building on already existing strong networks within local communities increased the program ’ s success Comprehensive integrated approach vs. single intervention Comprehensive integrated approach vs. single intervention Skilled male facilitators are critical Skilled male facilitators are critical Focus on gender relations is crucial Focus on gender relations is crucial

Challenges Sustainability Sustainability Developing partnership and trust with male champions Developing partnership and trust with male champions Developing a cadre of skilled intermediaries Developing a cadre of skilled intermediaries

Conclusion Adopting a multi-sectoral approach to involving men and providing them with the same messages builds the supportive environment that is needed to improve the RH knowledge and practice of the community at large.

Thank you