Transcript Document

Male Involvement: A
Practical Overview
Repositioning
Family Planning
in West Africa
Repositionnement
de la Planification
Familiale en
Afrique de l’Ouest
Levent Cagatay, M.D.
Lissette C. Bernal Verbel,
M.I.A.
The ACQUIRE Project
New York, New York
Sponsored by: U.S. Agency for International Development (USAID), World Health Organization (WHO),
Action for West Africa Region Project - Reproductive Health (AWARE-RH), Advance Africa, the POLICY Project
Presentation Overview
1. Background
2. Why involve men?
3. A Global Mandate
4. MAP Program
5. A Framework for
Working with Men
6. Country Highlights
Why Should We Involve Men?
“Although African men play an important
role in childbearing decisions and are
crucial to efforts to prevent sexually
transmitted infections (STIs), family
planning programs have for the most part
ignored their needs.”
Source: Rosen, James E. and Shanti R. Conly. Africa’s Population Challenge: Accelerating
Progress in Reproductive Health. Population Action International. Washington, DC: 1998.
Why Should We Involve Men?
(con’t.)
“Failure to target men
in reproductive health
interventions has
weakened the impact
of reproductive health
programs”
Source: Mbizvo, M.T. and Bassett, M.T. “Reproductive health and AIDS prevention
in sub-Saharan Africa: The case for increased male participation.” Health Policy and
Planning 11 (1): 84-92, March 1996
Men Often Play a Critical
Role in Women’s Health
• Men tend to be the primary decisionmakers regarding many reproductive health
decisions such as the use of family
planning or the access to a skilled provider
during delivery
• Men often have control over access to
resources
Involving Men Helps Women
• Men can play a constructive role in
contraception and childrearing
• Partners who can discuss and jointly
make reproductive health decisions
can make better, more informed, and
healthier decisions
Women Welcome Men Into the
Reproductive Health Arena
• Studies have shown that
women want their
partner to accompany
them to family planning
appointments and would
like their partner to be
present during family
planning counseling
sessions.
Source: Danielson, R, Roy, K., and De Vargas, T. “Women’s Perceptions—Providers’
Challenges: CEMOPLAF clients on partner participation in reproductive health services,”
Population Council Summary Report, New York, 1998
Men Need Services Too
• Need for health
care as
individuals
• Access to
reproductive
health is a human
right
Men as Partners, Men as Allies
• Men who are informed about
reproductive health issues and/or are
involved in reproductive health decision
making can serve as important role
models in the community and with
young men
A Global Mandate
“Special efforts should be made to emphasize men's
shared responsibility and promote their active involvement
in responsible parenthood, sexual and reproductive
behaviour, including family planning; maternal and child
health; prevention of STIs, including HIV; .... shared
control and contribution to family income, children's
education, health and nutrition; and recognition .... of the
equal value of children of both sexes. Male responsibilities
in family life must be included in the education of children
from the earliest ages. Special emphasis should be placed
on the prevention of violence against women and children”
(United Nations, 1994).”
- Cairo Plan of Action
MAP Approaches
• Linking Clinics and Communities:
The Supply/Demand Model
• Working with Men: Addressing Gender
Issues that Lead to Negative RH
Outcomes
MAP Strategy in Guinea:
Using a Supply & Demand
Framework to Meet Needs
• Build capacity at
the two sites
through training
• Create awareness
about importance of
male involvement
• Develop a
supportive
environment for
male clients
• Encourage the use
of these services
SUPPLY SIDE ACTIVITIES:
Building Capacity at the Site Level
• Trained 30 staff members
at two sites
• Whole Site Approach
• Themes
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Sexuality
Anatomy & Physiology
FP & RH
STIs & HIV
Sexual Dysfunction
Management and Cost
Considerations
DEMAND SIDE ACTIVITIES:
Developing a Supportive
Environment for Men’s Services
• Designated area & staff to
provide men’s RH services
• IEC messages geared to
men
• Specific RH services for
men
• Community outreach to
men
• Better linkages between
staff at the sites
Results From Guinea
• Increased staff comfort, interest, and commitment to
meeting men’s RH needs
• Increase in the numbers of couples that come in
together for consultations and treatment.
• Decrease in repeat cases of STI infection among
women (as their partners also receive treatment)
• Increased community knowledge, better attitudes,
and improved practices regarding RH
• Increased linkages between the community and the
service delivery sites
Quotes From Guinea
One provider:
• Helped me to communicate with clients including men…
before, I was very timid.
Another provider:
• Before I only knew about women’s reproductive health.
Now, I know more about men’s RH health. I encourage
female clients to bring in their husbands and young men
to learn about male RH during counseling.”
Quotes From Guinea
One male client:
• In the past, family heads have been giving their daughters
in marriage before age 18. This poses many dangers for
the daughters’ health …as a result, there have been
concrete cases where families have decided to abstain
from this custom
One imam:
• During prayer time, we advise all the men, women, and
youth of the importance of going to Boulbinet Health
Center. At Boulbinet, they can receive care at a much
lower cost – and people are very happy about this
MAP Strategy in South Africa:
Men Taking a Stand For Gender Equity and
Positive Male Involvement in RH and
Against Men’s Violence Against Women
MAP in South Africa in Context
HIV/AIDS:
• At the end of 2001, five
million South Africans were
living with HIV/AIDS: 2.7
million women, 2 million men
and 250,000 children.
Violence Against Women
• South Africa has the world’s
highest per capita rate of
violence against women.
Unemployment
• Nearly 40% --Country with
highest disparities between
rich and poor
Evolution of MAP Priority Issues
1. Violence Against Women
2. Gender Equity
3. High Risk Sexual Practices and HIV/AIDS
Prevention
4. Male Support for Female Reproductive
Health Decisions
5. Information on Male and Female
Reproductive Health
6. Men & PMTCT
7. HIV/AIDS Care & Support/HB Care
Program Description
Technical assistance with
focus on:
• Workshops
• TOT & facilitation skills
development
• Social Norm change
• Community Mobilization
• Organizational Buy in
and change
• Coalition Building
• Strengthening Capacity
within Private, Public
and NGO sectors.
Selected Activities for MAP
Participants Post Workshop
• Act upon specific commitments made during the workshop
to end violent and abusive behavior & prevent HIV/AIDS
• Hold informal discussions with peers in the community &
take a stand for gender equity and against violence.
• Distribute condoms, using opportunity to talk about gender
related issues.
• Encourage men to access VCT services
• Use picture codes to prompt discussions in the community
• Mentor a young man in the community.
• Conduct outreach for future MAP workshops
• Develop theatre pieces to be performed in the community