[gender-aids] Issuesof Men's Reproductive Health

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Men in Bangladesh, India, and Pakistan: Reproductive Health Issues  
Population Council/News Release 
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NEW YORK (October 20, 1999) - The reproductive health of women can hinge
on the support and participation of their male partners, yet the
involvement of men in the reproductive health decision making process
has only recently been given serious attention. A new Population Council
book, Men in Bangladesh, India, and Pakistan: Reproductive Health
Issues, explores the practical and conceptual meaning of male
involvement. The book includes a discussion of progress made in
addressing gender reproductive health issues in current and past
national health programs, as well as analyses of experimental programs
aimed at expanding the participation of men in their own families'
reproductive health and family planning. The book, by Nancy Piet-Pelon,
Ubaidur Rob, and M.E. Khan, also recommends ways to improve the quality
of reproductive health services for both men and women. 

"Men are now seen as more than simply users of contraception or carriers
of sexually transmitted infections (STIs); their roles as partners,
fathers, decisionmakers, community leaders, service providers, and
potential clients are now highlighted," the authors say. "There is a
general agreement that improving men's health will have a positive
influence on improving women's health. But Bangladesh, India, and
Pakistan have not determined how to achieve this improvement most
effectively. Nor have they fully determined what services are essential
for men."  

In the three countries profiled, program managers and service providers
continue to view men's services too narrowly, the authors maintain.
"Despite an increasing rhetoric that men's programs are important,
little has been done to improve men's programs," they note. For
instance, in each of the three countries, men who suffer from STIs have
three choices: go to traditional practitioners; go to specialized-and
stigmatizing-clinics, or go without treatment. Quality services that
provide all elements of STI information, diagnosis and treatment of the
client and his partner are available in very limited circumstances. 

According to the authors, several factors have hindered the development
of men's programs. There tends to be a lack of vision, with the managers
of national family planning and health programs equating men's programs
with vasectomy services. Many program managers believe that vasectomies
would increase contraceptive prevalence and provide a safe alternative
to female sterilization, but this extremely narrow definition ignores
all the reproductive health services that men require to improve both
their health status and that of their partners, the authors note. 

Men's reproductive health services must extend beyond family planning.
Setting up parallel services for men is probably not appropriate and is
certainly financially daunting, yet at the same time, establishing men's
services in clinics and with workers who have traditionally focused on
women and children has disadvantages. These clinics, particularly at the
primary health care or community level, have been safe environments for
women to attend and discuss their health problems. That environmental
safety must be protected. The workers are women-focused; to refocus on
couples will require extensive retraining. 

Furthermore, STIs have not gained focused attention in national
programs. None of the countries has aggressively publicized the
behaviors that lead to HIV/AIDS, nor have they drawn the necessary
connections between other STIs and HIV/AIDS. There is a critical need
for information that clearly spells out to men and their partners the
consequences and potential risks of all sexual behavior. 

The authors suggest several ways to improve reproductive health care
services for men and women. "We must constantly remind ourselves that
family planning alone is not going to achieve the improved reproductive
health status we envision for all. Community health workers,
particularly those who provide family planning services at the household
level, need to be retrained on the reproductive health agenda," the
authors suggest, adding that the goal of all national programs should be
to encourage joint decision making among couples.  

The authors also emphasize that men's reproductive health programs
should begin during adolescence, to provide information that will allow
young people to make informed choices, obtain services when appropriate,
and to learn about issues such as gender equity before marriage.  Nancy
Piet-Pelon is a Population Council consultant. Ubaidur Rob is the
Country Director and M.E. Khan is Regional Advisor for Asia and Near
East countries in the Population Council's Bangladesh office in Dhaka. 

To obtain a copy of Men in Bangladesh, India, and Pakistan: Reproductive
Health Issues contact: 

In India: Hindustan Publishing Corporation, 4805/24 Bharat Ram Road,
Darya Ganj, New Delhi-110002, India;  Tel: 91-11-3254401.
In Bangladesh: Karshaf Publishers (Pvt.) Ltd., 25 Central Road,
Dhanmondi, Dhaka, Bangladesh;Tel: 8802-864291 or 8802-502414. 

Source: Population Council February 1, 2002 http://www.popcouncil.org


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