Male Involvement In Reproductive Health Research Articles

\u201cI had to change my attitude\u201d: narratives of most significant change explore the experience of universal home visits to pregnant women and their spouses in Bauchi State, Nigeria

BackgroundUniversal home visits to pregnant women and their spouses in Bauchi State, northern Nigeria, discussed local evidence about maternal and child health risks actionable by households. The expected results chain for improved health behaviours resulting from the visits was based on the CASCADA model, which includes Conscious knowledge, Attitudes, Subjective norms, intention to Change, Agency to change, Discussion of options, and Action to change. Previous quantitative analysis confirmed the impact of the visits on maternal and child outcomes. To explore the mechanisms of the quantitative improvements, we analysed participants’ narratives of changes in their lives they attributed to the visits.MethodsLocal researchers collected stories of change from 23 women and 21 men in households who had received home visits, from eight male and eight female home visitors, and from four government officers attached to the home visits program. We used a deductive thematic analysis based on the CASCADA results chain to analyze stories from women and men in households, and an inductive thematic approach to analyze stories from home visitors and government officials.ResultsThe stories from the visited women and men illustrated all steps in the CASCADA results chain. Almost all stories described increases in knowledge. Stories also described marked changes in attitudes and positive deviations from harmful subjective norms. Most stories recounted a change in behaviour attributed to the home visits, and many went on to mention a beneficial outcome of the behaviour change. Men, as well as women, described significant changes. The home visitors’ stories described increases in knowledge, increased self-confidence and status in the community, and, among women, financial empowerment.ConclusionsThe narratives of change gave insights into likely mechanisms of impact of the home visits, at least in the Bauchi setting. The compatibility of our findings with the CASCADA results chain supports the use of this model in designing and analysing similar interventions in other settings. The indication that the home visits changed male engagement has broader relevance and contributes to the ongoing debate about how to increase male involvement in reproductive health.

Impact of home visits to pregnant women and their spouses on gender norms and dynamics in Bauchi State, Nigeria: Narratives from visited men and women.

Background:Maternal and newborn child health are priority concerns in Bauchi State, northern Nigeria. Increased male involvement in reproductive health is recommended by the World Health Organization. A trial of a program of universal home visits to pregnant women and their spouses, with an intention to increase male involvement in pregnancy and childbirth, showed improvements in actionable risk factors and in maternal morbidity. We used a narrative technique to explore experiences of the visits and their effect on gender roles and dynamics within the households.Methods:Trained fieldworkers collected narratives of change from 23 visited women and 21 visited men. After translation of the stories into English, we conducted an inductive thematic analysis to examine the impact of the visits on gender norms and dynamics.Results:The analysis indicated that the visits improved men’s support for antenatal care, immunization, and seeking help for danger signs, increased spousal communication, and led to changes in perceptions about gender violence and promoted non-violent gender relationships. However, although some stories described increased spousal communication, they did not mention that this translated into shared decision-making or increased autonomy for women. Many of the men’s stories described a continuing paternalistic, male-dominant position in decision-making.Conclusions:Few studies have examined the gender-transformative potential of interventions to promote male involvement in reproductive health; our analysis provides some initial insights into this.

Predictors of age at first child’s birth and contraceptive use among men in Uganda

Background: Globally, research on age at first child’s birth among men has been neglected especially in Africa. Consequently, little is known about its impact on male involvement in reproductive health. This paper examined the socio-demographic, economic and proximate predictors of age at first child’s birth among men aged 15-54 years in Uganda. Methods: We used the 2016 Uganda Demographic and Health Survey (UDHS) on a sample of 3,206 men aged 15-54 years who had a biological child. The outcome variable was age at first childbirth categorized as: below 17, 18-24 and 25 years and above (25+). Analysis was done using descriptive statistics, un-adjusted and adjusted multinomial regressions with significance level at 95%. Results: Median age at first child’s birth was 22 years (IQR = 20-25). The majority of men (62.4%) had fatherhood onset between 18 and 24 years. Only 5.2% had fatherhood onset at 17 years or earlier, increasing to 32.4% at 25+. Respondents whose first sexual encounter was before 18 years was 44.3% and 92.7% by 24+. Few respondents (44.1%) reported use of any contraceptive methods. Anglican religion (RRR=1.62; CI 1.06 – 2.46) or not having attended school (RRR=2.20; CI 1.02-4.71) were predictors of childbirth onset before 17 years. Age of sex debut at 18 years or higher (RRR= 2.09, CI 1.72 – 2.54) and secondary and above education (RRR = 1.76, CI 1.42-2.18) were predictors of fatherhood onset at 25+. Contraceptive use among men had no association with age at first child’s birth. Conclusion: These findings are important for strategic allocation of resources to curb early onset of fatherhood among adolescent and young men under the age of 25 years. They highlight the need for gender-sensitive interventions targeting men for behavioral change, participation in Sexual and Reproductive Health Rights (SRHR) programming and improved access to services delivery.

Factors influencing male participation in reproductive health: a qualitative study.

IntroductionMale involvement in reproductive health is an essential component in promoting maternal and family health. In Nepal, men are not actively engaged in most maternal and child health (MCH) services nor in other reproductive health programs. There is a need to know about the understanding of key professionals in such practices. This study explores gendered perspectives among teachers and health professionals to understand the factors contributing to male involvement in reproductive health.MethodsThe data were collected through two focus group discussions (FGDs) and seven key informant interviews (KIIs). FGDs were held among male teachers of selected schools, and KIIs were conducted with health professionals of the health post of Bungamati, Lalitpur. An unstructured interview guide was used to explore their experiences and perceptions. All KIIs and FGDs were recorded, translated and transcribed verbatim.ResultsFindings show limited male involvement in reproductive health. Participants reported several hindering and challenging factors such as sociocultural and psychological norms, lack of education, and misinformation and dominance of female as health care providers in many MCH clinics. Perceived motivating factors included positive attitude in men, literacy and awareness, inclusion of reproductive health in school curriculum and certain incentives. Participants also recommended a range of strategies for increasing men’s involvement in reproductive health in Nepal.ConclusionMen’s education and attitude, knowledge and awareness, sociocultural factors, psychological factors, health system factors, and policies play important roles in male involvement in reproductive health. Programs on effective implementation of men involvement in reproductive health initiatives should address the barriers and challenges to men’s supportive activities. This study also suggests increasing literacy of reproductive health among men that enhances their positivity and motivates them to participate in reproductive health services.

Male involvement in antenatal and natal care practices of their partners – a community-based study in rural area of North Karnataka

Introduction: Male involvement, an all-encompassing term which refers to the various ways in which men relate to reproductive health problems and programmes, reproductive rights and reproductive behaviour. Objective: To assess the level of male involvement in the antenatal and natal care practices of women residing in Gadag. Methodology: A cross sectional study conducted in rural areas of Gadag. 100 Male partners of parous women formed the study group. They were interviewed regarding the reproductive profile of their partners and their level of knowledge and involvement in the Antenatal and natal health care utilisation. Perceptions regarding male involvement in reproductive health were also assessed. Results: 81% male partner accompanied their wives for at least one antenatal visit. Only 41% were aware of the complications which can occur during pregnancy, anemia being the most commonly known complication. 50% confessed that they could not spend quality time with their partners during pregnancy due to work and other restrictions. With reference to the autonomy regarding decision making about vital events, the participants were given freedom only about the age of their marriage. Other decisions regarding use of family planning, antenatal care, newborn care, immunisation of child was taken by the elders in the family. Traditional male roles were cited as the most common reason for low male participation. Conclusion: In addition to the benefits for women and children, male involvement has potential benefits for men. Thus, programmes should be implemented based on the understanding of gender dynamics, on how decisions are made and implemented, on the changing needs of both genders and their interaction.

Attendance of male partners to different reproductive health services in Shinyanga District, North western Tanzania

Background: Male involvement in reproductive health (RH) services in Africa has been associated with improved maternal and child health outcomes. The objective of this study was to determine the prevalence and factors affecting male partner attendance to available reproductive health services in Shinyanga district, north-western Tanzania.Methods: A house to house survey using a structured questionnaire was conducted among randomly selected married men. Additional in-depth interviews were conducted among married men found attending RH services. Factors that motivates the uptake of locally available RH services together with their partners were explored.Results: A total of 204 men participated in the study, 94.4 % (193/204) of them reported to have ever attended the RH service with their female partners at least once whereas 50.6% (103/204) of them attended at least thrice. Three quarters (154/204) attended HIV counselling and testing (VCT) and 63% (129/204) attended antenatal services (ANC). Reported attendance to sexually transmitted infections (STIs/STDs), prevention of HIV transmission from mother to child (PMTCT), and reproductive health cancer services were all less than 13%. The male partners age group (25-34 years; χ2=9.347, df =3 p-value < 0.001), female partner invitation to HR services (χ2= 29.901, df=1, p-value <0.001) and having less than 2 children (χ2= 6.201, df= 2, p-value < 0.05) were associated with higher RH service attendance. Only 20% (4/20) of married men attended RH because they expected better health outcomes in their presence whilst majority attended because they were summoned or just happen to be at the clinic for other purposes.Conclusion: The male attendance to RH services together with their female partners’ in rural Shinyanga was mainly focused ANC and VCT. Most of men attended because were verbally invited by their partners. Education on couple communication empowerment among women attending RH clinics could sustainably improve attendance to all RH services.

Factors associated with male involvement in reproductive care in Bangladesh

BackgroundMen’s active involvement in reproductive healthcare has shown to be positively associated with maternal and child health outcomes. Bangladesh has made appreciable progress in its pursuance of maternal mortality related goals in the framework of the MDGs. However, there remains a lot to be accomplished to realise the long-term goals for which active participation of male counterparts in reproductive care is crucial. Therefore, the objective of the present study was to investigate factors associated with male involvement in reproductive health among Bangladeshi men.MethodsWe used data from Bangladesh Demographic and Health Survey (BDHS) conducted in 2011. Study participants were 1196 married men, aged between 15 and 69 years and living in both urban and rural households. Level of male involvement (outcome variable) was measured based on the responses on knowledge, awareness and practice regarding reproductive health. Chi-square tests and multivariable logistic regression models were performed for data analysis.ResultsOut of 1196 participants, only 40% were found to be active about partners’ reproductive healthcare. Chi-square test showed significant association between active involvement and ever hearing about family planning (FP) in television, learning about FP through community health events, community health workers and poster/billboard. Results from logistic regression analysis revealed that type of residency [p = 0.004, AOR = 0.666, 95% CI = 0.504–0.879], literacy [secondary/higher education- p = 0.006. AOR = 0.579, 95% CI = 0.165–0.509], learning about family planning from Newspaper [p < 0.001. AOR = 1.952, 95% CI = 1.429–2.664], and television [p = 0.017. AOR = 1.514 95% CI = 1.298–1.886], and having been communicated about family planning by community health workers [p = 0.017. AOR = 1.946, 95% CI = 1.129–3.356] were significantly associated with active involvement of men in reproductive health issues.ConclusionsLevel of male involvement was associated with schooling experience, type of residency and exposure to electronic media. National health policy programs aimed at promoting male involvement in reproductive care should focus on improving knowledge and awareness of reproductive health though community health education programs with a special focus in the rural areas.

Development of model to facilitate male involvement in the reproductive health context by the registered nurses

The purpose of this article is to describe the process followed in the development of the model of facilitating male partner involvement in reproductive health (RH) context by the nurses. Namibia is one of the African countries affected by cultural and socio-economic influences that have persuaded gender roles in a way that hinders male-partner involvement in RH context. This phenomenon make difficult for the nurses to facilitate their involvement.The research methods were done in four phases. Phase 1 entitled concepts analysis. Phase one was done into two steps namely step1 - concepts identification and step 2 - concepts definition. During concept identification, qualitative, exploratory, descriptive design was followed. The target population included male and female partners attending health facilities and all nurse managers (registered nurses in charge) that provided RH services in the health facility in a northern region in Namibia. Individual interviews and focus were conducted until data saturation occurred. During the research three fundamental principles such as respect person, beneficence and justice were adhered. Tech’s eight steps of descriptive data analysis were used. Three (3) main categories, six (6) categories and twelve (12) subcategories were identified using open coding and conceptualization. The main concepts of the model were identified and classified using a survey list of Dickoff, James, Wiedenba (Dickoff,James, Wiedenbach, 1968; Mckenna, 2006). Phase 2 dealt with the creation of interrelationship statements between concepts identified in step 1. In phase 3 focuses with the description of the model using strategies proposed by (Chinn &amp; Kramer, 1991). In phase 4, the description of guidelines and evaluation for the model was also done. The applied the principle of trustworthiness through developing dependability, credibility, transferability and confirmability in all four phases.A model was developed based on a theory generated approach. The model consist of five phase namely, situational analysis in the external environment (community) and internal environment (health facilities); establishment of partnership (male and female partner and Nurses), management process, maintaining the conducive environment and control &amp; terminus/ outcome phase. It was concluded that facilitation of Male involvement in RH care context is needed. Further the recommendations were made to implement a model within the current health care framework in which reproductive health is provided.

Interventions for male involvement in pregnancy and labour: A systematic review

Male involvement in pregnancy and labour care has been shown to improve maternal and newborn outcomes. Nevertheless, it continues to be low, especially in low income countries. Several interventions have been suggested for supporting male involvement in reproductive health and maternity care, but no assessment has been made in terms of their effectiveness. The objective of this review was to summarise and evaluate the current evidence related to male partner involvement in maternal health. Three databases were searched electronically. This review included two randomised controlled trials and two observational studies. Two interventions emerged from the review: facility-based couple health education and workplace-based health education. These interventions showed positive outcomes regarding the presence of partners during antenatal visits, postpartum visits, childbirth, and the initiation of breastfeeding within one hour of birth among others. More rigorous research is needed into strategies for, and the effect of, including men in maternal and newborn health.

Assessment of Husbands’ Participation on Birth Preparedness and Complication Readiness in Enderta Woreda, Tigray Region, Ethiopia, 2012

Background: Male involvement in reproductive health has been promoted as a promising new strategy for improving maternal and child health. The promotion of husband participation in the process of antenatal care and in preparations for the delivery is very important. Objective: To assess husband participation on birth preparedness and complication readiness in Enderta Woreda, Tigray region, Ethiopia, 2012. Methods: A community based cross-sectional study was conducted among 376 husbands whose wives was delivered within the last 12 months preceding the study in Enderta Woreda northern part of Ethiopia from August to September 2012. Multi stage stratified sampling technique with Probabilities proportional to size was used. Study subjects again were selected by systematic random sampling technique from 10 randomly selected kebelle’s in the Woreda. Data was collected using structured interview questionnaire and entered, cleaned and analyzed using SPPS version 16.0 statically package software. Result: The study revealed that about 60.4% husbands had good practice and participated on birth preparedness. And regarding the husbands complication readiness practice in the labor and delivery, 193 (51.30%) of the respondents were reported that their wives were delivered by skilled birth attendant and the role of those husbands, 174(46.30%) were told their wife to get skilled birth attendant, 152(42.00%) were informed to health facility for their place of childbirth, 99(26.30%) were accompanied their wife to labor room, and 59 (15.70%) had gave money for health services and transportation. In addition, 75(19.90%) of all respondents perceived the actual complications faced for their wives during that delivery. The respondents major source of information about birth preparedness and complication readiness where, 43.6% heard from health care providers, 23% from Radio/television, and 21.3% discussion with different peoples. Conclusion and recommendation: Husbands have good practice in birth preparedness, but poor participation in complication readiness of maternity care. The community should be informed husbands to participate in complication readiness, generate income for the normal maternal health care and considering complications in pregnancy, labor and after labor, education for the female youth and promotion of facility birth, health education about husbands’ birth preparedness of wife and other studies to be conducted on the husband involvement in maternal health care service.

Male Partners Involvement in Maternal ANC Care: The View of Women Attending ANC in Hararipublic Health Institutions, Eastern Ethiopia

Maleinvolvement in reproductive health has recently been promoted as a promising new strategy for improving maternal and child health. This is becausetheinvolvement of men in antenatal care can play a vital role in ensuring safe pregnancy, delivery and moral support to the women.However, little attention has been placed on male parnersinvolvement in maternity care in developing countries, including Ethiopia. Thus, the aim of this study was to assess male partners’ involvement in maternal ANC care and identify its associated factors among pregnant women attending their ANC in Harari Regional State of Ethiopia. Institutional based cross-sectional study was conducted among 385 randomly selected ANC attendees in Harari public health institutions from February to May 2011.Data were collected using interview based questions; which was then entered into Epidata and analyzed using SPSS. Odds ratio with 95% confidence interval was calculated to assess factors associated with male accompany at p<0.05. The result showed that only 19.7% of the women were found to be accompanied by their spouse during their recent visit to ANC. Being a housewife (AOR=2.6, 95% CI; (1.2, 5.8)), rural residents (AOR=2.7, 95% CI; (1.2, 6.0)) and women unsupportive of male involvement in maternal care (AOR= 3.5, 95% CI; (1.2, 10)) were more likely associated with unaccompanying male partners. The major reasons reported by women for not being accompanied by their male partnerswere: a pretext that males being preoccupied with work, lack of awareness on the possible complication during pregnancy, misconception that the ANC is the concern of women’s only, males’ feeling shame to accompany them on visit and lack of responsibility. In general, the involvement of male partners in maternal ANC service was found to be low in the study area. Empowering women to have open discussion with their partners about maternal health issues and creating awareness in utilizing ANC could improve male involvement in ANC in the region.

Men’s participation during pregnancy, childbirth and postpartum and

Background and aim Increasing global approach to men's participation in care and reproductive health programs, in the past 15 years, has created a need to research on men’s encouragement to take responsibility for their families’ health through Men's participation. Therefore, the aim the present study is to determine men's participation in reproductive health care programs during pregnancy, in health clinics affiliated to Shahid Behshti University of Medical Sciences. In 1388. Material & methods: This was a descriptive study on 400 cases that had at least one child under 2 years and familly file in health clinics coverage Shahid Beheshti University. Sampling was multi-stage cluster Nonrandomized and research instrument was a questionnaire Findings According to the findings of the study, the mean age of participant was (37/27±5/56). (60/2 Percent) had a child and pregnancy in (24/8 Percent) was scheduled. Generally (74/2 Percent) men demonstrated good cooperation and participation and (0/25) had relative participation (89/0Percent) men had good knowledge and (11/0 Percent) had relative knowledge. There was Significant relationship between participation and education (p<0/0001), If higher education participation was low. There was Significant relationship between participation and job involvement (p<0/004). There was highest participation (83/9 Percent) in men whose job was lndependent. Also between the term Marriage and Participation was found Significant relationship (p<0/0001). There was Significant relationship between kind of Pregnancy and participation (P<0/0001) if It was planned to increase participation. Conclusions: The results of this research imply good men , s participation during pregnancy and childbirth that showe good oppurtunity for education and counseling before pregnancy that is good oppurtunity for Training men by expert person can enhance men , s participation during pregnancy and childbirth. Keywords: men's participation, prenatal care, delivery *Corresponding Author: Sharareh Jannesari, Lecturer, Dept of Midwifery, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Science, Tehran, Iran. E-mail :shararehjannesari@gmail.com Alipoor B Sattari F (2010). [Male participation in prenatal care]. Behvarz Faslname. 19(2)40-41.(Persian) . http://www.magiran.com/temp/mag-pdf/272013/1586-20457240-B91.pdf„ -Carter M, Speizer I (2005). Salvadoran fathers´ attendance at prenatal care, delivery and postpartum care.Revista Panamericana Salud Publica. 18 (3) 149-156 -Dellmann T (2004). The best moment of my life: A literature review of father's experience of child birth. Australian Midwifery.17 (3) 20-26. http://www.journals.elsevierhealth.com/periodicals/ausmid/article/PIIS1448827204800142/abstract -Dragonas TG (1992).Greek fathers participation in labour and care of the infant. Scandinavian Journal of Caring Science.6 (3) 151-9. http://www.ncbi.nlm.nih.gov/pubmed/1439376 -Ghandi M (2009). [Male participation in maternal health]. Women´ s mahnameh.147 I 88. (Persian). http://www.magiran.com/magtoc.asp?mgID=1095& -Gruskin S Cottingham J Hilber AM et al (2008).Using human rights to improve maternal and neonatal health: history, connections and a proposed practical approach. Bulletin of the World Health Organization. http://www.who.int/bulletin/volumes/86/8/07-050500/en /print. html (Accessed on 30/05/2010). http://www.who.int/bulletin/volumes/86/8/07-050500/en/index.html Kinanee J Ezekiel-Hart J (2009) Men as partners in maternal health: Implications for reproductive health counselling in Rivers State, Nigeria. African Journal of Psychology and Counseling Vol. 1 (3), pp. 039–044. -Orji EO Adegbenro CO Moses OO etal (2007). Men´ s involvement in safe motherhood. Journal of Turkish- German Gynecology Association.8 (3) 240 -248. -Rahman MM (2009).Factors associated with delivery assistance: Dose differentials exist between Rural and Urban areas in Bangladesh? The Internet Journal of Family Practice 7(2)38-49 -Soul Sista. Inactive (2007). Men: Effective Partners for Safe Motherhood. http://www.nigeriavillagesquare.com/forum/lounge/11259-men-effective-partners-safe-motherhood.html -World Health Organization (2007). Maternal Mortality in 2005: Estimates Developed by UNICEF and UNFPA. Geneva: World Health Organization. http://www.who.int/whosis/mme_2005.pdfw -World Health Organization (2005). The World Health Report: 2005: Make Every Mother and Child Count, World Health Organization, Geneva, 2005 World Health Organization (2002). http://www.who.int/whr/2005/02_ contents_en.pdf -World Health Organization. Programming For Male Involvement in Reproductive Health. Report of the meeting of WHO Regional Advisers in Reproductive Health WHO /PAHO Washington DC, USA, 5–7 September 2001, World Health Organization, Geneva, http://whqlibdoc.who.int/hq/2002

Semen Loss and Sexual Anxiety Among Young Unmarried Men: Being Young and Vulnerable in Rural India

Premarital sex remains stigmatized even as the unmarried period of life is lengthening in India. This paper examines how young unmarried men in rural central India conceptualize and understand their sexual health and vulnerability. The data is qualitative, derived from four focus group discussions (N = 38 persons) of young unmarried males that were carried out in conjunction with a larger study on male involvement in reproductive health in the central Indian state of Madhya Pradesh in 2005. Young, unmarried rural men experience a wide range of functional situations which are culturally defined as health problems, such as “weakness,” thought to be caused by masturbation, nocturnal ejaculations, and the loss of semen. Despite constraints on communication on sexuality with married men, young unmarried men largely share with them the culturally hegemonic notion of semen loss as a health hazard. All four discussions pointed to the negative image of psycho-physiological changes related to maturation and further, to the belief that the reproductive functions of men can render them vulnerable and even harm them. Sexual anxiety in young men may in part reflect young men’s socially dependent and insecure life situation and social suffering. Young, unmarried rural men see marriage as the only release from sexual health problems although temporary relief is sought from private health care providers. In the future, men’s unmarried life stage is bound to lengthen in rural India, and consequently sexual health prior to the commencement of active intercourse should receive more attention in public health services and sex education.

Promoting male involvement in family planning in Vietnam and India: HealthBridge experience

In many developing countries, gender inequality contributes to the continued problem of unwanted pregnancies and unmet contraception needs. The majority of family planning programmes in Asia target only women; however, women's lack of decision-making power, even with regard to their own health, hinders their ability to practise family planning. This article describes successes and lessons learned in India and Vietnam from a HealthBridge programme which facilitated male involvement in reproductive health, particularly in family planning and in the use of male-centred contraception. The experience shows that, given the right role models and enabling environments, men are willing to be more fully and positively engaged in reproductive health matters.

Male involvement in reproductive health: a management perspective

The present study outlines the perceptions of participants on male involvement in reproductive health (RH) from a management perspective. Namibia is one of the African countries affected by cultural and socio-economic influences that have persuaded gender roles in a way that hinders male-partner involvement in RH. A qualitative, exploratory, descriptive design was followed. The target population included all male and female partners attending a health facility and all nurse managers (registered nurses in charge) that provided RH services in the health facility in a northern region in Namibia. Individual interviews were conducted until data saturation occurred. The results indicate that the management principles, policy and legislation, as well as resources to facilitate male involvement in RH, were indicated as barriers for nurse managers to facilitate male involvement. Male involvement in RH care is needed for an interpersonal and interactive partnership. Recommendations are made to establish a partnership within the current health care framework in which reproductive health is provided.

Factors that influence male involvement in sexual and reproductive health in western Kenya: a qualitative study.

This study explored factors that influence male involvement in reproductive health in western Kenya. Qualitative study design was used. From December 2008 to February 2009, data were collected via in-depth interviews and focus group discussions (FGDs) at three provinces of western Kenya. Twelve in-depth interviews and eight FGDs were conducted. Five participants in in-depth interviews were female, seven were male. Four of the FGDs had all-male participants, four all-female. The factors that influence male involvement in reproductive health emerged in two themes, namely gender norms and the traditional approaches used to implement reproductive health and family planning programs. Any strategy taken to involve men in reproductive health must therefore consider addressing these two factors. A review of the traditional approaches of implementing reproductive health is necessary to make them more male-friendly.

Male involvement in reproductive health among scheduled tribe: experience from Khairwars of central India

Indian tribal men's lack of participation in reproductive health not only damages their own health, but also contributes to the reproductive ill health of their female partners and children. In India the involvement of men in such matters is a new concept. There is a paucity of data particularly on Scheduled tribesmen's knowledge and the extent of their participation in reproductive health. This inhibits planning. The present study aims to understand the involvement of Scheduled tribesmen in reproductive health and the barriers to their involvement by generating a database from the Khairwar tribe of Central India. A door-to-door survey on knowledge, attitude and practice relating to aspects of reproductive health was conducted by canvassing a pre-designed interview schedule among 15-40 year old, currently married Khairwar males in the Sidhi district of Madhya Pradesh, India. As far as reproductive morbidity is concerned, only 17% of the respondents had heard of HIV/AIDS, and most had no proper knowledge of its transmission. Although 74% of the respondents had heard about reproductive tract infections, the majority of them were unaware of the mechanism of transmission and seriousness of the problem. The duel role of condoms, both as a method of family planning and a protective measure against sexually transmitted infections, was also unknown to them. Approximately 59% of the males were aware of family planning but only 13% were using any method (mostly female sterilization) at the time of survey. Their view on the ideal number of children (3.56) exceeded the actual number of children born and living. High infant and child mortality influenced their preference for higher fertility. Very few among them (29%) had knowledge of antenatal care. They expressed faulty knowledge, myths and unhelpful attitudes towards sexual health matters. The study revealed the male Scheduled tribe population's lack of knowledge and misinformation regarding male sexual health issues, the gender inequality in Indian society, and a lack of male-oriented reproductive health services, all of which deter men from sharing the responsibility.

Homens e abortamento espontâneo: narrativas das experiências compartilhadas

Maior envolvimento masculino na saúde reprodutiva é um desafio da atualidade; em âmbito nacional e internacional existem recomendações para desenvolver pesquisas sob a perspectiva masculina. Objetivo: Compreender a experiência de homens que compartilharam do processo de abortamento espontâneo de suas parceiras. Método: Utilizou-se a abordagem qualitativa e a análise da narrativa foi o método empregado. Foram identificadas as similaridades nas experiências de nove homens entrevistados, que permitiram elaborar as seguintes categorias descritivas: Vivenciando a notícia da gravidez; identificando as possíveis causas do abortamento; expressando sentimentos relativos à experiência do abortamento; tomando atitudes em decorrência do abortamento; ponderando sobre a experiência vivida. Conclusão: Homens que compartilham da experiência do abortamento espontâneo requerem sensibilidade e envolvimento dos profissionais que os assistem, expressaram o desejo do acolhimento, o recebimento de suporte emocional e informações completas e precisas sobre o conjunto do processo.

Men's experiences of vasectomy in the Brazilian Public Health Service

Vasectomy was legalized in Brazil in 1996 and is freely available in some public health institutions. Nevertheless, the prevalence of vasectomy is less than 4.4%, demonstrating how rarely this contraceptive resource is used. The promotion of greater male involvement in reproductive health was one of the recommendations of the Cairo International Conference of Population and Development (ICPD). To describe the experiences of a group of men who had had vasectomy. The thematic oral history method was used. Twenty men vasectomized in a Sao Paolo State Health Service Clinic were interviewed. Each tape-recorded narrative was analysed through transcription, textualization, and transcreation, a process used to transform the oral history into written narrative form. From each narrative a 'vital tone' was extracted, revealing the essence of the individual experience. All the data were analysed under an inductive and interpretative process. The similarities among histories were identified, and submitted to a process of reduction in order to develop descriptive categories. The following descriptive categories were developed from the men's experiences: Misconceptions regarding vasectomy that were overcome after hearing positive results expressed by other men; Vasectomy was the last solution for a couple's troubles related to contraceptive methods; Satisfaction related to professional support received during the process of searching for a method and deciding upon vasectomy; Satisfaction was the main feeling expressed following vasectomy and they recommended this contraceptive method to other men; Men's behaviours towards postvasectomy control was divergent despite the professional guidance. An integrated public policy is required to promote male involvement in reproductive health. Family planning programmes must be meaningful socioculturally and the inclusion of men in these programmes is recommended. The use of anonymized videotaped narratives or the recruitment of the men themselves during counselling about this method would be helpful for the resolution of reservations related to vasectomy. All the interviewed men expressed satisfaction with vasectomy and this feeling was mainly based on the certainty of the preservation of sexual performance. A third of those invited for interview did not attend.

Male Involvement in Bangladesh's Reproductive Health Programme: A Status Report

Male Involvement in Bangladesh's Reproductive Health Programme:A Status Report Tehmina Ghafur Introduction The issue of men's involvement in reproductive health services emanates from the underlying inequalities and inequities in the established gender-specific roles and responsibilities of men and women. Gendering of the roles and responsibilities tends to disengage men from core areas at the family and societal level (e.g., general health and nutrition, reproductive health, child care). Disengagement excludes men from participating and sharing responsibility in core areas of their life. Such exclusion is thought to be a major source of many gender-specific inequalities and inequities. Since its inception in the 1960s, the family planning programme (FPP) has primarily ignored men (Drennan, M., 1998). Since women bear the risk of pregnancy and child birth, FPP have assumed women have the greatest stake in protecting themselves against unwanted pregnancy. In the 1980s FPP started giving limited attention to men through workplace programmes and condom social marketing (Drennan, M., 1998). Focus of male involvement was then limited to promotion of male contraceptives. Population planners promoted men's participation as family planning method acceptors in order to ensure sustained use of contraceptive methods. On the other hand, feminists promoted men's inclusion in the FPP with the hope that such inclusion would lead to a situation where men would shoulder the responsibility of contraception. In the 1990s, the concept of male involvement was intensified in the wake of the HIV/AIDS pandemic. It was understood that the dominance of men in every sphere of life demanded the inclusion of men in sexual and reproductive health programmes (RHPs). Efforts to include men in RHPs were intensified during the 1990s. Intensified efforts to include men in RHP were taken in the wake of rising apprehension about HIV/AIDS and other STIs; increasing reports and information on ill effects on women and children resulting from some men's risky sexual behaviour; growing recognition that in many societies men make critical decisions that affect the reproductive health of women; and an increasing awareness that gendered roles affect sexual behaviour, reproductive decision making, and reproductive health in many ways (Drennan, M., 1998). In 1994, the International Conference on Population and Development (ICPD) gave momentum to the concept of male involvement in RHP. After ICPD, male involvement in RHP gained popularity in many countries. The concept of "male involvement" that resulted from ICPD was wide-ranging, with the intention of addressing gender inequality and inequity in all aspects of reproductive health. The Platform of Action of the Fourth World Conference on Women, in 1995, [End Page 70] followed the same tone with regard to the role of men in promoting reproductive health. Initiatives taken by many countries to incorporate and promote male involvement in reproductive health, however, failed to grasp the profundity and spirit of the concept of involving men in many ways. Only recently has the issue of male involvement received due attention in RHP and policies in Bangladesh. However, this prioritization of male involvement has been conceived from a very narrow perspective. Such a narrow conceptualization is likely to have serious implications for the health of both men and women. In this report, male involvement initiatives in Bangladesh, both past and present, are critically examined, and the prospect of fully involving men in RHP in Bangladesh is explored. The report is based on review and analysis of the male involvement approach and associated initiatives by the RHP of the government of Bangladesh. Male Involvement Initiatives in the RHP of Bangladesh The RHP of Bangladesh has its legacy in the family planning programme of the 70s and 80s. The family planning programme (FPP) had remarkable success with respect to bringing down fertility level from 6.3 births per woman in 1975 to 3 births per woman in 2004 (NIPORT, 2004). Over the last three decades, use of any method of contraceptive by married women has increased from 8 to 58 percent and use of modern methods of contraceptives by married women has increased almost tenfold, from 5 to 47 percent (NIPORT, 2004). One of the major reasons for the success of the FPP in reducing fertility was its women-centered-door-to...