American Public Health Association 133 rd Annual Meeting Philadelphia, Pennsylvania 2005

1. A multi-sectoral approach to male involvement in family planning and reproductive health focusing on optimal birth spacing American Public Health Association 133rd Annual Meeting Philadelphia, Pennsylvania 2005 Manal Eid, B.A., M.A.

2. Session Objectives: • Present TAHSEEN’s approaches for engaging men in FP/RH issues, with specific emphasis on OBSI • Share results of the interventions promoting male involvement in FP/RH

3. TAHSEEN Integrated Model Improving quality of care Contributing to long-term sustainability Community mobilization

4. TAHSEEN’s Rationale for Involving Men in FP/RH • Decision makers and opinion leaders • Working with men: • Impacts not only men themselves, but also the entire family, and community • Changes deeply-rooted beliefs and norms • Peer-to-peer effect

6. How does TAHSEEN Involve Men in FP/RH • Advocacy for male involvement in FP/RH issues • Training on gender and rights, medical aspects of FP/RH issues, couple communication • Community Mobilization through outreach programs, plays, puppet shows, seminars, IPC…etc.

7. What is OBSI? • Optimal Birth Spacing Interval (OBSI) is the ideal time period between births • Evidence to date suggests that a 3-5 year interval between consecutive births is being associated with the most favorable outcomes for pregnancies, infants, children and mothers (Rutstein 2003, Agudelo 2002, Population Report 2002)

8. TAHSEEN’s Male Involvement Models • Religious leaders • Literacy facilitators • Agricultural/irrigation extension workers • Peer educators • Community leaders • Mothakaf sokany (population outreach workers) • Media professionals • Transportation workers

9. Involving Religious Leaders – Why? • Considered to be “the soul of the village and trustworthy ” • Reach a large proportion of the population through their weekly sermons • Opinion and attitude shapers

10. Improvement of Religious Leaders' OBSI Knowledge Beni Suef, Fayoum and Minia Governorates

12. Involving Literacy Facilitators – Why? • 36.4% of Egyptian males are illiterate* • Egypt has a strong national literacy program • Illiterate men have never been reached with FP/RH messages *UNDP HDR 2003

13. OBSI Knowledge for Literacy Students

15. Involving Agricultural Extension Workers (AEW) –Why? • 57.9% of Egypt’s population is rural* • AEW reach approximately 40,000 farmers/month • Existing strong and widespread outreach program for farmers • AEW have direct personal communication linkages with farmers *UNDP 2002 POSAR

16. OBSI Knowledge of Farmers (N=1000)

18. Impact on practice FP Method Users 39% Increase Source: Five Prototype Clinics in Mina Governorate

19. Improved couple communication Women discussing FP with their husbands Source: Household Survey in Minia, Fayoum and Beni Suef, July 2005 all women n=1000, low-parity women (n=pre 214 and post 266)

20. Lessons Learned • Government/policy support is crucial • Building on already existing strong networks within local communities increased the program’s success • Comprehensive integrated approach vs. single intervention • Skilled male facilitators are critical • Focus on gender relations is crucial

21. Challenges • Sustainability • Developing partnership and trust with male champions • Developing a cadre of skilled intermediaries

22. Conclusion Adopting a multi-sectoral approach to involving men and providing them with the same messages builds the supportive environment that is needed to improve the RH knowledge and practice of the community at large.

23. Thank you