men, family planning and reproductive health richard lord
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Men, Family Planning and Men, Family Planning and Reproductive HealthReproductive Health
Richard Lord
Men’s Share of Responsibility Men’s Share of Responsibility for Family Planningfor Family Planning
What percentage of What percentage of worldwide contraceptive worldwide contraceptive use involves male use involves male methods? methods?
Jane Turner
Is this percentage Is this percentage increasing orincreasing ordecreasing? decreasing?
Male Methods: 26% of Global Male Methods: 26% of Global Contraceptive UseContraceptive Use
FemaleFemalesterilizationsterilization
MaleMalemethods:methods:
22%
Other femaleOther femalemethodsmethods
Oral contraceptivesOral contraceptives
Source: United Nations, 1998.
Withdrawal Withdrawal andandAbstinence: 12%Abstinence: 12%
IUDIUD
5%
33%
26%
14%
Vasectomy: 7%Vasectomy: 7%
Condoms: 7%Condoms: 7%
Use of Male Methods Declining as Use of Male Methods Declining as Proportion of Overall UseProportion of Overall Use
Source: United Nations, 1987, 1998.
0
5
10
15
20
25
30
35
40
Global use ofmale methods
Global use ofvasectomy
Global use ofcondoms
1987
1998
Gender Imbalance: Gender Imbalance: Knowledge/Use of SterilizationKnowledge/Use of Sterilization
Australia
Belgium
Canada
China
Republic of Korea
Nepal
Netherlands
New Zealand
United Kingdom
United States
Source: United Nations, 1998.
Use of Sterilization in 10 Countries with Highest Levels of Vasectomy
Female Sterilization
Vasectomy
Percent of Married Couples of Reproductive Age
0 10 20 30 40
Why Involve MenWhy Involve Menin Family Planning?in Family Planning?
Male responsibility in reproductive health Male responsibility in reproductive health issues is essential to decreasing HIV/AIDS issues is essential to decreasing HIV/AIDS and other STIsand other STIs
Men play dominant role in decision-makingMen play dominant role in decision-making Global contraceptive use has reached Global contraceptive use has reached
a plateau a plateau Funds for family planning have declinedFunds for family planning have declined
Husband Disapproval Husband Disapproval Major Factor in Unmet NeedMajor Factor in Unmet Need
Sources: Bongaarts, Stud Fam Plann 1995;26(2).
USAgency for International Development
Photo??
Contraceptive use Contraceptive use and continuationand continuationare higher when are higher when husband and wife husband and wife agree agree
3 of 7 pregnancies in the world are 3 of 7 pregnancies in the world are unintended unintended
Couple Counseling ResultsCouple Counseling Resultsin Better Continuation Ratesin Better Continuation Rates
Source: Terefe, Am J Public Health 1993;83(11).
One-year One-year contraceptive contraceptive continuation continuation twice as high twice as high when husband when husband counseled with counseled with wife wife (Ethiopia)(Ethiopia)Husband
involved incounseling
Husband NOTinvolved incounseling
Percentage of couplescontracepting after 12 months
0
5
10
15
20
25
30
35
33%33%
17%17%
Barriers to Men’s Use of Barriers to Men’s Use of ContraceptionContraception
Lack of accurate informationLack of accurate information Provider bias Provider bias
against male against male methodsmethods
Limited access Limited access to services to services
Beryl Goldberg
Barriers to Men’s UseBarriers to Men’s Useof Contraception of Contraception (cont.)(cont.)
Lack of provider training Lack of provider training Men’s misunderstanding Men’s misunderstanding
of correct useof correct use Limited range of male Limited range of male
methodsmethodsS. Khalaf/Family Health International
Why Some MenWhy Some MenChoose VasectomyChoose Vasectomy
Simpler, safer and less expensive than Simpler, safer and less expensive than female sterilization female sterilization
Love for wife and concern for her healthLove for wife and concern for her health Desire to take responsibility in family Desire to take responsibility in family
planningplanning Greater sexual enjoyment by eliminating Greater sexual enjoyment by eliminating
worries about unwanted pregnancyworries about unwanted pregnancy
Condoms: Dual Protection Condoms: Dual Protection Against Pregnancy and STIsAgainst Pregnancy and STIs
Can be highly effective Can be highly effective in protecting against in protecting against pregnancy AND pregnancy AND preventing HIV/STIspreventing HIV/STIs
Should be promoted in Should be promoted in family planning, HIV family planning, HIV prevention, and other prevention, and other programsprograms
Men’s Public ApprovalMen’s Public Approvalversus Private Useversus Private Use
Men report high knowledge and support Men report high knowledge and support of contraception even where use is low of contraception even where use is low
Public approval different than private usePublic approval different than private use Programs need to change attitudes and Programs need to change attitudes and
practicespractices desire for more childrendesire for more children belief that religion prohibits usebelief that religion prohibits use desire for control over wifedesire for control over wife
Sources: Drennan, Popul Rep 1998;J(46); Wilkinson, Man-Myths, AVSC International, 1998.
Creative Outreach Efforts Creative Outreach Efforts Reach Men in CommunityReach Men in Community
Sports eventsSports events WorkplacesWorkplaces Small businessesSmall businesses Truck stops Truck stops Military basesMilitary bases Media Media
R. Witlin/World Bank
Community Education Community Education Successfully Involves MenSuccessfully Involves Men
Agricultural agents and community Agricultural agents and community volunteers reached farmers with reproductive volunteers reached farmers with reproductive health and family planning information health and family planning information
Interactive materials for low-literacy clients Interactive materials for low-literacy clients stressed importance of birth spacing for child stressed importance of birth spacing for child health health
Family planning increased from 37 to 55% Family planning increased from 37 to 55%
Honduras:Honduras:
Clinic-basedClinic-basedStrategies for MenStrategies for Men
Stand-alone Stand-alone male clinics male clinics
Separate Separate hours/entrances hours/entrances for men for men
Integrated servicesIntegrated services Male or female Male or female
counselorscounselors Debbie Rogow
Men Respond Positively to Broad Men Respond Positively to Broad Reproductive Health ServicesReproductive Health Services
Family planningFamily planning STI/HIV prevention STI/HIV prevention
and treatmentand treatment InfertilityInfertility Sexual dysfunctions Sexual dysfunctions Reproductive cancersReproductive cancers
W. Graham/World Bank
Photo??
Involving Men in Family Planning Can Involving Men in Family Planning Can Promote Gender EquityPromote Gender Equity
Women want their partners involved:Women want their partners involved: To support their own contraceptive useTo support their own contraceptive use To share responsibility for contraception To share responsibility for contraception
and protecting healthand protecting health To increase men’s understanding of To increase men’s understanding of
reproductive health issuesreproductive health issues
Encouraging men to take control of fertility Encouraging men to take control of fertility can disempower womencan disempower women
In Zimbabwe, men who wanted sole In Zimbabwe, men who wanted sole responsibility for decision-making responsibility for decision-making rose from 27 to 37%rose from 27 to 37%
Positioning men as responsible and caring Positioning men as responsible and caring can be productivecan be productive
Source: Kim, Involving Men in Family Planning, Johns Hopkins CCP, 1996.
Assure That Women’s Reproductive Assure That Women’s Reproductive Health Needs Remain Primary FocusHealth Needs Remain Primary Focus
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