Evidence shows that engaging men in health across the life span can effectively improve health and equity outcomes, particularly for women and children. For the past 12 years, global approaches to engage men in gender equity have focused mainly on men’s role as being supportive for their partners’ family planning and sexual and reproductive health (FP/SRH). This has left a gap in evidence and practice around engaging men as clients and service users in their own right, including providing high-quality and accessible male-friendly health services. A greater focus is required within global and national policy, research, programs, and services to scale up, institutionalize, and standardize approaches to engaging men in health initiatives to support the health of their partners and children as well as their own health.
What are examples of ways to engage men in health?
Strategies to engage men use a gender transformative approach; work at personal, social, structural, and cultural levels; consider specific life course stages; and are inclusive of all races, ethnicities, sexual orientations, gender identities, abilities, geography, wealth status, immigrant status, and other characteristics.
Here are a few examples of effective programs and strategies to engage men:
- Supporting contraceptive use and family planning
- Shared responsibilities for healthy sexuality and reproduction
- Greater involvement during maternity care
- Improvement of maternal, newborn, and child health
- Prevention of mother-to-child transmission of HIV
- Advocacy for sexual and reproductive rights for all
- Prevention of STIs, HIV, unintended pregnancy
- Prevention of reproductive system cancers
- Prevention and management of infertility and male sexual dysfunction
- Promotion of men’s sexual health and broader well-being.
What does a gender transformation mean?
First described by Dr. Geeta Rao Gupta in the context of the HIV/AIDS epidemic, a gender-transformative approach is one “that addresses the causes of gender-based health inequities through approaches that challenge and redress harmful and unequal gender norms, roles, and power relations that privilege men over women.” Men contribute to the harmful consequences of gender inequity, also harming their own and other men’s health in addition to the health of their partners as a result of narrow and constraining definitions of what it means to be a man.
Benefits for using gender transformative approaches
Gender transformative approaches can benefit men by increasing our understanding of masculinity and socially acceptable ways that being a man is expressed in a given culture or society. Engaging men is critical to achieve gender equity by challenging inequitable power dynamics and disrupting harmful gender norms that can undermine women’s FP/SRH outcomes, rights, and autonomy.
Indicators to measure men’s engagement in gender equity
Specific indicators are underdeveloped in this field. The majority of work in this area has focused on engaging men in FP/SRH that considers men as supportive partners, addressing men’s own needs, and men as agents of change. This is a framework presented in a recent review by Adamou et al (2019) that synthesized the current literature and made recommendations for key indicators for monitoring and evaluation of male engagement in FP/SRH that can be used as an example to document and expand upon male engagement at individual, community or facility, and structural levels:
Men as partners
- Percent of men who support the use of modern contraception for themselves or their partners (outcome)
- Percent of men who share in the decision making of FP/SRH issues with their spouse or sexual partner (outcome)
- Percent of men who disagree that contraception is a woman’s business and a man should not have to worry about it (outcome)
- Evidence of engagement of men in FP/SRH incorporated in national health standards or policies (outcome)
Men as clients
- Percent distribution of contraceptive methods currently used by men or their sexual partners (outcome)
- Percent of men who have ever used any male FP/SRH method or FP/SRH method that requires male cooperation (outcome)
- Men’s condom use at last sex (outcome)
Community or facility level
- Number/percent of vasectomy referrals (output)
- Number/percent of facilities that offer vasectomy services (output)
- Number of FP/SRH providers trained on male-specific FP/SRH (output)
- Number of vasectomies performed (outcome)
- Inclusion of vasectomy in FP/SRH guidelines/ strategies, regulations, or policies (outcome)
Men as agents of change
- Attitudes towards gender norms (GEM Scale) (impact)
Community or facility level
- Number of providers trained on gender equity and sensitivity (output)
- Number of national level programs/ policies/advocacy campaigns that address gender equity (outcome)
Use of these types of indicators are a vital tool to measure male engagement in gender equity in national policies and programs. We need to collect and analyze this type of data so that we can measure and track male engagement activities at individual, community or facility, and structural levels that improve health outcomes for women, men, and children.