Involving Men – family planning
While men share responsibility for reproductive health, lack of attention to them in the past has conveyed a message that family planning is not their concern. The more that programs can reach men, the healthier the consequences will be–for men, women, and children.
Communication and Decision-Making
Men are more interested in family planning than is usually assumed (58). Today, family planning programs increasingly are focusing on involving men. Yet much remains to be done to turn interest into healthy behavior.
In particular, encouraging men to discuss reproductive health, including family planning, with their partners and to share responsibility for reproductive decisions is a good health care strategy. Also, in the era of HIV/AIDS, it is urgent for men’s own protection and that of their partners that programs address the problem of sexual risk-taking.
Men play powerful–even dominant–roles in reproductive decisions. Without considering their partners’ wishes or the health consequences for themselves or their partners, however, their actions can have unhealthy and even dangerous results. In contrast, couples who talk to each other about family planning and reproductive health reach healthier decisions. For example, they are more likely to use contraception and use it effectively (17, 50, 127).
Surveys show that many husbands and wives do not know each others’ views about family planning (61, 163, 190). When men and women do not know their partners’ fertility desires, family planning attitudes, or contraceptive preferences, the consequences can include unintended pregnancies and unsafe abortions (20, 88, 100, 150, 198).
Men’s attitudes and behavior. Men’s contraceptive use is lower than might be expected, given their levels of knowledge and approval of family planning, according to surveys of men in developing countries, mostly in sub-Saharan Africa.
For example, between one-quarter and two-thirds of these men say that they do not want to have more children, but neither they nor their wives are using contraception (61). By comparison, in countries surveyed about one-fifth of married women say they do not want to become pregnant but are not using any method of contraception (189).
Use of contraceptive methods that involve men’s cooperation–condoms, vasectomy, withdrawal, and periodic abstinence–amounts to about one-third of all contraceptive use among married couples. Nevertheless, the two most effective male methods–condoms and vasectomy–are among the least used of all methods (225). One reason for the apparent gap between men’s attitudes and their contraceptive behavior is that, while men may be aware of modern contraception, they often know little about it (85).
With more information and encouragement, more men would be able to play positive roles in reproductive health. For example, a husband can help his wife have safe pregnancies and give birth to healthy babies if he becomes better informed about maternal and child health (208). Reproductive health care programs can help men play supportive roles during pregnancy and delivery (220) and during breastfeeding (208). Increasing men’s participation can be a promising strategy for achieving good reproductive health for all.
Encouraging Healthier Sexual Behavior
Most men, and particularly sexually active unmarried men, have a lot to learn to become responsible sex partners. Most need to know more about preventing pregnancy and about avoiding and preventing HIV/AIDS and other STIs. In some countries only a minority of never-married men who have heard of AIDS know that condoms prevent AIDS (74).
Even when men know that unprotected sex is risky, many still take the risk (158). Yet among men there is much demand for condoms that family planning can meet. In sub-Saharan countries surveyed 7% to 50% of unmarried men report using condoms. In Latin America condom use reported by unmarried men ranges from 27% to 64%. Few data on sexually active unmarried men are available elsewhere (58).
Often, unmarried men are less able than married men to obtain information about safer sexual behavior (40). Embarrassment and reluctant providers may stand in the way of obtaining condoms (74).
Family planning programs can address many of the obstacles that men face to learning about and adopting safer sexual behavior. For example, programs have organized community activities and meetings where men can discuss their concerns about sexual behavior comfortably and openly (111).
Young men are particularly difficult to reach, but some youth programs have found that peer educators in particular can provide information and counseling about healthy behavior (58). By reaching men of all ages now, family planning programs can do more for the health of all people.
COPYRIGHT 1999 Department of Health
COPYRIGHT 2004 Gale Group