men abnegating their responsibility
for a share in the family's reproductive
and sexual health care?
"Women point their fingers at men and say, 'We are willing to use family
planning, but these people prevent us from doing so."
Emmanuel Sabakati has heard this lament often while counselling
couples on family planning.
Sabakati is project director of the Man to Man Programme in Malawi,
designed to address the critical role of men in family planning.
studies show that men are concerned for women's reproductive health, and
are willing to participate in making decisions, according to The
State of World Population 1997 report by the UNFPA.
The problem may be the communication: husband and wife may want the
same thing, but they don't tell each other.
The result can be a bigger family than either really wanted.
and wife communication about reproductive health, including family
planning, has been improving over the past few decades, the report notes.
However, a large minority of men still consider sexual and
reproductive health to be exclusively women's concern - so they don't
men often impede women's efforts at family planning, as the women in
Sabakati's clinic charge.
Dr Everald Hosein co-ordinates the University of the West Indies'
Caribbean Population and Family Health Programming in Port of Spain,
Trinidad and Tobago.
He says that almost every method of contraception a woman might
choose can be opposed by her partner for one reason another.
For example, some men
complain that condoms and intra-uterine devices interfere with
their sexual pleasure.
One woman told Hosein, "My man doesn't want me to use the
pill; he says it will make me fat."
reports that men are frequently insensitive to women's reproductive and
sexual health needs.
In many cultures, misunderstandings and myths about female
sexuality and reproductive systems persist - though there are indications
that male attitudes towards a range of taboos (including concerns about
menstruation and 'cleanliness') are changing.
and men should be taught about responsible sexuality and parenthood, the
They need to understand the risks women face from pregnancy and
childbirth, and from multiple partners, harmful traditional practices and
initiation too early on in life.
Women's reproductive and sexual health requires the mutual concern
and investment of both partners.
to Man was foundered in response to these needs.
Says Sabakati, "It is important to target males because they
are the heads of families, and therefore they should know about family
Participants are taught about various methods of contraception,
particularly those men can use.
"When men are motivated to seek methods suitable for them,
they choose between vasectomy or condoms," notes Sabakati.
"All choices are strictly voluntary.
If they use condoms, we supply them.
If they choose vasectomy, we assist them in arranging it."
Those who undergo a vasectomy are usually in their late 30s or
he was a boy in Zimbabwe, Joseph Mabuto received family and life
The experience "gave a new dimension to my life", he
a scout leader, Mabuto advises teenage scouts about family and
"My scouts are always coming to me to ask about sexuality,
maturity, peer pressure and the like," he says.
Chief Scout Commissioner, Ignatius Kajenga, points out that the whole
society benefits from providing family life education to boys.
"The boys disseminate the information their family and
We teach them about sexuality, sexual health, sexually transmitted
diseases including Aids, and family planning." Most courses are conducted in local languages.
is an important aspect of the education," Kajenga says.
"Eventually it is incumbent upon the boys themselves to make
up their mind on what types of families they are going to have."
He adds that boys are glad to receive information on sexuality and
reproduction, as such subjects are generally taboo with parents.
barriers also underscore the important role that men play in family
planning, according to the report.
Fourteen countries require a woman to get her husband's consent
before she can receive any contraceptive services.
This has the effect of denying services to unmarried women,
including adolescents and the divorced or widowed, as well as to women who
wish to delay or limit births but who cannot persuade their husbands.
An additional 60 countries require spousal authorisation for
Spousal consent restrictions often apply to only women, the report
the report finds signs of improvement, especially at the grassroots.
In the Philippines, a new centre for men is experimenting with
innovative ways to involve men in reproductive health programmes.
In Indonesia, the government plans to expand its counselling
programme to include training materials on male participation in family
planning and reproductive health.
In Ghana, seminars and plays have been organised for both male and
female audiences to generate discussions on partners' joint responsibility
in the use of family planning, parenting and family life.
Noor Al Hussien Foundation in Jordan has launched a two-year nation-wide
motivational campaign with "Family Health is a Joint Responsibility of
Both Spouses" as its slogan.
The campaign, began in April 1996, includes a wide range of
activities: puppet shows, seminars, a mobile science exhibition,
counselling and interactive educational theatre.
Special activities are intended to sensitise men about their
responsibilities in family planning and reproductive health.
to reach men are eliciting a response.
"When I read in the paper about the vasectomy, I was very much
interested because I wanted to give relief to my wife," said Aaron
Kumwenda, a client at the Man the Man project in Malawi.
"Having borne four children, she was tired, I thought.
As the head of the family, I had to do it."
Mazengera, who underwent the same procedures after deciding with his wife
that they had reached their desired family size, notes that male
responsibility does not end with a vasectomy: "Now
what we have to do is develop our family."