MALE INVOLVEMENT IN REPRODUCTIVE HEALTH Dr. Babar T. Shaikh Health Systems Division Department of Community Health Sciences Aga Khan University Karachi-Pakistan

Learning Objectives: Comprehend the meanings of ‘Male Involvement in RH. Recognize the role of men in RH. Understand the strategies to ensure the men’s participation in RH matters. Discuss the implications of men’s involvement in RH.

REPRODUCTIVE HEALTH: MEN’S PARTICIPATION Men: Full partners and advocates for good reproductive health reaching men is a winning strategy to encourage sexual responsibility to foster men’s support of their partners’ contraceptive choices to address the reproductive health care of couples

New Perspectives Recognize: Men play dominant roles in decisions Men are more interested in family planning than assumed Need communication and services directed specifically to them Understanding-and influencing-the balance of power Couples who talk to each other reach better, healthier decisions

Goals Provides male support for female actions related to reproduction and respect for women’s reproductive and sexual rights Increases access to male contraceptive methods Improves male and female reproductive health Promotes responsible and healthy reproductive and sexual behavior in young men Involves men with their spouses during counseling and other FP/RH information

The reasons for attention to men: spread of HIV/AIDS and STDs ill effects of men’s risky sexual behaviour on the health of women and children men approve of family planning men make decisions that affect women and men’s health awareness that gender affects sexual behaviour, reproductive decision-making, and reproductive health demands from women for more involvement

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

The ICPD Programme of Action urges all countries to provide men, as well as women, with reproductive health care that is “accessible, affordable, acceptable and convenient” The ICPD Programme of Action encourages reproductive health care programmes to move away from considering men and women separately and to adopt a more holistic approach that includes men and focuses on couples

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

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

Terms used for Involvement of men in RH men’s participation men’s responsibility male motivation male involvement men as partners men and reproductive health A complex process of social and behavioural change

Policies and programmes encourage: Men to take more responsibility for their sexual behaviour men’s access to reproductive health information and services communication with their partners reproductive health care needs of couples

A promising strategy to: slow the spread of HIV/AIDS and other STDs prevent unintended pregnancies reduce unmet need for family planning foster safe motherhood practice responsible fatherhood stop abuse of women

Men and Contraception Men’s participation is crucial to avoid unintended pregnancies. Of the 175 million pregnancies each year, about 75 million are unintended, (UNFPA) An estimated 100 million married women have unmet need for family planning Surveys exist only for married women.

Safe motherhood: Men’s Role Men play many key roles Their decisions and actions make a difference during: pregnancy delivery the postpartum period

During pregnancy- by ensuring: Good Nutrition Plenty of rest Timely referral

Helping pregnant women stay healthy ensure proper antenatal and early care provide transportation provide funds to pay for visits learn about the symptoms of pregnancy complications

During the Non-Pregnant Interval Period Planning their families limit births space at least two years apart support contraceptive use accompany their partners for services communicate with each other to meet needs

During delivery, arranging for skilled care A trained attendant present during childbirth can mean the difference between life and death. Men can help by arranging for a trained attendant to be available for the delivery and by paying for the services. They also can arrange ahead of time for transportation and can buy supplies, if necessary.

During the postpartum period men can help with household chores can encourage breastfeeding can begin using contraception

Men can be responsible fathers by: becoming more involved in their children’s healthy, physical and emotional development ensuring that their children receive all of the needed immunizations helping in children’s day to day care

Factors Limiting Male Involvement Primary health center (PHC) programs not geared to meet men’s needs Limited contraceptive options for men Rumors and misconceptions Unfavorable social and cultural climate Priorities to women and child care services Provider’s bias against male involvement Lack of information and knowledge Limited communication between spouses about FP needs PHC service providers are mostly female

Men need more info on: contraception reproductive physiology sexuality pregnancy STDs other reproductive health care

How to involve them? How can programmes communicate effectively with men? How can reproductive health care providers best increase men’s participation? How can programmes encourage more men to care about reproductive health?

Some solutions Design IEC materials, communication programmes and services, focus gender equality. RH information and services should focus the couple rather than the individual. Remove myths about condom and vasectomy. Service providers to be sensitized for men’s reproductive health needs. In RH health clinics, a constellation health services may increase the male clientele.

Some solutions contd…. Separate clinic for males. Improved services at existing clinics. Workplace services. Community-based services. Commercial and social marketing. Increase contraceptive choice for men. Train providers about male FP/RH needs.