Men and Reproductive Health Programs: Influencing Gender Norms Prepared by
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Review of LiteratureFor many years, reproductive health programs simply did not address men,11 in part because women’s centrality to reproduction was taken for granted (an assumption that itself reflects social norms) and in part because so little was known about men. Recent years have provided much useful information about men. A 1999 review by the Panos Institute provided extensive evidence on the special role that men were playing in spreading HIV and linked men’s behaviors to underlying gender norms.12 A comprehensive analysis of men’s reproductive health needs worldwide by the Alan Guttmacher Institute provides much-needed information about men, though it does not strongly address the ways in which gender norms constrain reproductive health for both men and women.13 Over the past decade, numerous programs involving men have been developed and documented. These programs involve men in safer motherhood, offer diagnosis and treatment of sexually transmitted infections, develop men’s parenting skills, encourage men’s support of women when they seek services, and provide basic information and counseling, among the range of their offerings. The wide universe of programs can be glimpsed in the pages of several important reviews. For example, a United Nations Population Fund review effectively divides male involvement efforts into those that promote family planning, serve men’s needs, or attempt to address gender inequity, but does not dwell on evaluation efforts.14 A UNICEF review similarly includes a wide variety of programs, some of which attempt to change social norms. But whether these programs have been evaluated is not discussed for the most part.15 Inspirational, life-changing, informative: these words can describe nearly the entire myriad of programs designed to change gender norms. Unfortunately, “evaluated” and “demonstrably effective” are not on that list of descriptors. Several promising programs that are widely recognized as being innovative and influential in their work to change perceptions of gender roles have not been evaluated in ways that would make their replication possible. For example, Fathers Inc., in Jamaica, is a training and support program that teaches and encourages men to nurture their roles as fathers and to assume the position of a gender-equitable role model for their children and communities. PAPAI works with adolescent fathers in Brazil, stimulating public discussion on the importance of young men’s participation in sexuality, reproduction, and parenthood. The organization creates a space for young fathers, who are an invisible and undervalued group, where they are appreciated and challenged to assume greater responsibility by developing their parenting skills and expanding their concepts of gender, rights, and citizenship.16 In Mexico, the Male Collective for Equitable Relationships (CORAIC) supports creative, emotional, and respectful constructions of masculinity through programs focused on nurturing men as fathers and preventing gender-based violence. It also galvanizes community support to address these issues politically.17 Salud y Género, based in Mexico, sensitizes men to the detriments of socialized masculinity, especially violence, and how they affect both men and women. The organization emphasizes working with men facing social and economic issues in all-male or mixed-gender groups. The Society for Integrated Development of Himalayas focuses instead on achieving social justice through educational programs with youth and network-building between commensurately empowered men and women. In the Dominican Republic, the Catholic Institute for International Relations has conducted gender workshops to explore and address the social and cultural processes that enable gender-based violence. The institute has also been involved in similar efforts in Haiti, facilitating discussions analyzing cultural impediments and enablers that affect the power balance between men and women that in turn influence issues of gender and development.18 The Botswana National Youth Council works with youth broadly by addressing their needs and anxieties about male sexuality, including intimate partner relations, through a program focused on preventing HIV infection. Thandizani, a Zambian nongovernmental organization, engages communities in meaningful dialogue on the interconnectedness of gender, sexuality, and vulnerability to HIV in order to stimulate change in community norms.19 The University of Edinburgh has worked with the Meru ethnic group in Kenya, providing education on gender issues to men undergoing the initiation rite of circumcision.20 These are just a few of the worthwhile programs affecting the lives of men of all ages in different contexts. Unfortunately, it cannot be stated definitively whether the above-mentioned programs have been effective enough to be expanded or replicated in other settings. Influencing deeply entrenched social norms, such as those addressing gender, is not easy, but clearly, it has already been done. One-hundred years ago, women in the United States could not vote, and very few went to college or worked outside the home. Women’s emancipation, like all great social changes, was in part due to organized efforts and in part due to economic and other forces. Given the worrying state of reproductive health throughout the world, including HIV/AIDS, we do not have 100 years to wait. Good programs—given sufficient reach—can accelerate the pace of progress. The programs described here meet the criteria of successfully challenging gender norms as well as improving reproductive health behaviors as outlined in the Framework for Men in Reproductive Health programs.21 Adoption of the highest criterion—that which changes socially defined male-female roles for the better—will avoid problems of some male involvement programs that have unintentionally reduced women’s autonomy or increased violence in their efforts to recruit men to use family planning.22 The following review describes evaluated programs in developing countries specifically designed to address social norms related to gender roles. It explains the methods each employed to achieve this goal and presents findings from various kinds of evaluations conducted to assess their efficacy. |