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Men, Family Planning and Reproductive Health

Men, Family Planning and Reproductive Health. Richard Lord. Men’s Share of Responsibility for Family Planning. What percentage of worldwide contraceptive use involves male methods? . Is this percentage increasing or decreasing? . Jane Turner.

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Men, Family Planning and Reproductive Health

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  1. Men, Family Planning and Reproductive Health Richard Lord

  2. Men’s Share of Responsibility for Family Planning • What percentage of worldwide contraceptive use involves male methods? • Is this percentage increasing ordecreasing? Jane Turner

  3. Male Methods: 26% of Global Contraceptive Use Femalesterilization Withdrawal andAbstinence: 12% Male methods: 33% Other female methods 5% 26% Vasectomy: 7% 22% 14% Condoms: 7% IUD Oral contraceptives Source: United Nations, 1998.

  4. Use of Male Methods Declining as Proportion of Overall Use 1987 1998 Global use ofmale methods Global use ofvasectomy Global use ofcondoms Source: United Nations, 1987, 1998.

  5. Gender Imbalance: Knowledge/Use of Sterilization Use of Sterilization in 10 Countries with Highest Levels of Vasectomy Australia Belgium Canada China Republic of Korea Nepal Netherlands New Zealand United Kingdom United States Female Sterilization Vasectomy Percent of Married Couples of Reproductive Age Source: United Nations, 1998.

  6. Why Involve Menin Family Planning? • Male responsibility in reproductive health issues is essential to decreasing HIV/AIDS and other STIs • Men play dominant role in decision-making • Global contraceptive use has reached a plateau • Funds for family planning have declined

  7. Husband Disapproval Major Factor in Unmet Need • 3 of 7 pregnancies in the world are unintended • Contraceptive use and continuationare higher when husband and wife agree Photo?? USAgency for International Development Sources: Bongaarts, Stud Fam Plann 1995;26(2).

  8. Couple Counseling Resultsin Better Continuation Rates Percentage of couples contracepting after 12 months One-year contraceptive continuation twice as high when husband counseled with wife (Ethiopia) 33% 17% Husbandinvolved incounseling Husband NOTinvolved incounseling Source: Terefe, Am J Public Health 1993;83(11).

  9. Beryl Goldberg Barriers to Men’s Use of Contraception • Lack of accurate information • Provider bias against male methods • Limited access to services

  10. Barriers to Men’s Useof Contraception (cont.) • Lack of provider training • Men’s misunderstanding of correct use • Limited range of male methods S. Khalaf/Family Health International

  11. Why Some MenChoose Vasectomy • Simpler, safer and less expensive than female sterilization • Love for wife and concern for her health • Desire to take responsibility in family planning • Greater sexual enjoyment by eliminating worries about unwanted pregnancy

  12. Condoms: Dual Protection Against Pregnancy and STIs • Can be highly effective in protecting against pregnancy AND preventing HIV/STIs • Should be promoted in family planning, HIV prevention, and other programs

  13. Men’s Public Approvalversus Private Use • Men report high knowledge and support of contraception even where use is low • Public approval different than private use • Programs need to change attitudes and practices • desire for more children • belief that religion prohibits use • desire for control over wife Sources: Drennan, Popul Rep 1998;J(46); Wilkinson, Man-Myths, AVSC International, 1998.

  14. Creative Outreach Efforts Reach Men in Community • Sports events • Workplaces • Small businesses • Truck stops • Military bases • Media R. Witlin/World Bank

  15. Community Education Successfully Involves Men Honduras: • Agricultural agents and community volunteers reached farmers with reproductive health and family planning information • Interactive materials for low-literacy clients stressed importance of birth spacing for child health • Family planning increased from 37 to 55%

  16. Clinic-basedStrategies for Men • Stand-alone male clinics • Separate hours/entrances for men • Integrated services • Male or female counselors Debbie Rogow

  17. Men Respond Positively to Broad Reproductive Health Services • Family planning • STI/HIV prevention and treatment • Infertility • Sexual dysfunctions • Reproductive cancers Photo?? W. Graham/World Bank

  18. Involving Men in Family Planning Can Promote Gender Equity Women want their partners involved: • To support their own contraceptive use • To share responsibility for contraception and protecting health • To increase men’s understanding of reproductive health issues

  19. Assure That Women’s Reproductive Health Needs Remain Primary Focus • Encouraging men to take control of fertility can disempower women • In Zimbabwe, men who wanted sole responsibility for decision-making rose from 27 to 37% • Positioning men as responsible and caring can be productive Source: Kim, Involving Men in Family Planning, Johns Hopkins CCP, 1996.

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