Abstract: Background: Men’s reproductive health directly affects the partner’s reproductive health. Men also may serve as gatekeepers to women’s access to reproductive health services. “Male involvement” in reproductive health and family planning programmes is not just promoting the use of male methods of contraception, but men’s supportive roles in their families. Objectives: 1. To know the attitudes of men regarding the family planning and women’s health. 2. To know the involvement and participation of men in maternity, delivery, post-natal care and family planning. 3. To study the treatment seeking behaviour of men for the reproductive health. problems. Methods: The study was conducted on the auto-rickshaw drivers in the Hoskote town. Total 96 married men were interviewed using a well-designed and pretested questionnaire. The aspects covered are awareness and practices related to RTIs/STIs/HIV/AIDS, family planning, antenatal care and treatment seeking behaviour for the reproductive health problems. Results: Majority (62.50%) of the men did not help their wives seek antenatal care. Only few 7(7.29%) were aware of parameters of antenatal care. There were 44 (45.83%) men who reported the symptoms of reproductive tract infections (RTIs). Among the men suffering from RTIs, only 32(72.73%) took treatment. Only 6(6.25%) people were aware of the all family planning methods. There were 39 (40.63%) participants having extramarital sexual relations with prostitutes or other females, of which 25(64.10%) people do not use condoms while engaging in the high risk sexual encounters. There were 34 (35.42%) men not aware of HIV/AIDS. Conclusion: Antenatal care and family planning are considered the primary responsibility of the women. Also majority of the men in the study group have high risk sexual behaviour. The awareness regarding HIV/AIDS is low.
Key Words: Men’s involvement; Reproductive health; Contraception; Antenatal care.
Introduction:
In recent years, many family planning and other reproductive health programs have become interested in the topic of men and reproductive health. These programs recognize that men’s reproductive health directly affects that of their partner’s health. Men play key roles in supporting women’s and children’s health, preventing unwanted pregnancies, slowing the transmission of sexually transmitted infections, making pregnancy and delivery safer, reducing gender-based violence and also have distinctive reproductive health needs of their own.(1) It is shown in some studies that men also may serve as gatekeepers to women’s access to reproductive health services.(2) However, reproductive health programs have traditionally focused on women. The exclusion of men from such programs considerably undermine it’s own effectiveness.As men are dominant decision maker in the society, they exert a strong influence over their partners, determining the timing and conditions of sexual relations, family’s social well-being and access to health care. Their distance from reproductive health programs debarred female from their sexual rights coupled with lesser utilization of reproductive health services. As a matter of fact, not only male, but also a large proportion of ill health suffered by females. Such gender inequalities in access to health care create a wide gap between facilities available and its utilization and pose a challenge to reproductive health services to overcome the deficiency.(3) Traditionally, health care providers and researchers in the field of reproductive health have focused almost exclusively on women when planning programmes and services, especially with regard to family planning, prevention of unwanted pregnancy and of unsafe abortion, and promotion of safe motherhood. In recent years, efforts have been made in many countries to broaden men’s responsibility for their own reproductive health as well as that of their partners. Measures are also being taken to improve gender relations by promoting men’s understanding of their familial and social roles in family planning and sexual and reproductive health issues. The Cairo International Conference on Population and Development (ICPD) Programme of Action (1994), urged that: "… special efforts should be made to emphasize men's shared responsibility and promote their active involvement in responsible parenthood, sexual and reproductive behaviour including family planning; prenatal, maternal child health; prevention of sexually transmitted diseases, including HIV; prevention of unwanted and high-risk pregnancies; shared control and contribution to family income, children's education, health and nutrition; recognition and promotion of the equal value of children of both sexes. Male responsibilities in family life must be included in the education of children from the earliest ages. Special emphasis should be placed on the prevention of violence against women and children".
The above challenge calls for more intense efforts to foster partnerships between men and women which help men identify with the magnitude and range of reproductive illnesses which affect women .(4) “Male involvement” in reproductive health and family planning programmes is not just promoting the use of male methods of contraception, but men’s supportive roles in their families, communities and workplaces to promote gender equity, girls’ education, women’s empowerment and sharing of child rearing and caring.(5)
Objectives of this study:
1. To know the attitudes of men regarding the family size preferences, family planning and women’s health.
2. To know the involvement and participation of men in maternity, delivery, post-natal care and family planning.
3. To study the treatment seeking behaviour of men for the reproductive health problems.
Materials and Methods:
The study was conducted on the auto-rickshaw drivers in the Hoskote town. Only married men having children were interviewed using a well-designed and pretested questionnaire. Total 96 men participated in the study. The men’s involvement in reproductive health has been studied by examining their supportive role to wives and concern for their own health problems. The aspects covered are awareness and practices related to RTIs/STIs/HIV/AIDS, family planning, antenatal care and treatment seeking behaviour for the reproductive health problems.
Results:
Total of 96 auto-rickshaw drivers participated in the study. Most of them were educated up to secondary school and belonging to the class III and IV of the Modified B. G. Prasad’s classification of socioeconomic status.
There were 8(8.33%) respondents who reported that their wives deliveries were home deliveries. The distribution of respondents according to the parameters of men’s involvement in reproductive health is shown in Table 1.
Majority (62.50%) of the men did not help their wives seek antenatal care. Only few 7(7.29%) were aware of parameters of antenatal care.
There were 44 (45.83%) men who reported the symptoms of reproductive tract infections (RTIs). The distribution of respondents according to symptoms of reproductive tract infections is shown in Table 2.
Among the men suffering from RTIs, only 32(72.73%) took treatment. The rest were not bothered about their own health. Among the men who sought treatment, 14 (43.75%) men took treatment in PHCs, 8 (25%) in private hospitals, and 10 (31.25%) men went to quacks. Even though most of them preferred government services , they reported the attitude of govt. doctors was apathetic.
Among the study group 45 (46.88%) men reported that the wife also suffers from the RTI symptoms but only 28(62.22%) men actually helped their wife seek treatment.
Only 6(6.25%) people were aware of the all family planning methods. Not a single man reported of vasectomy done or willingness to do it. There were 22(22.92%) men who reported that their wife has undergone previous abortions due to unwanted pregnancies.
In 12 (12.50%) men the wives have undergone tubectomy. In the remaining group, only 26 (27.08%) men were using condoms occasionally while having sex with the wife. There were 24 (25%) men having 3 or more children. This shows the unmet need for contraception.
There were 39 (40.63%) participants having extramarital sexual relations with prostitutes or other females, of which 25(64.10%) people do not use condoms while engaging in the high risk sexual encounters.
There were 34 (35.42%) men not aware of HIV/AIDS. Also most of them who are aware of it, have no proper information about its transmission and prevention.
Discussion:
In the study, the men’s participation in the antenatal care is less. Only few were aware of parameters of antenatal care. Similarly, in a study by KB Saha et al, only 12% men helped their wife avail antenatal care. (6) Men consider pregnancy and its care as a woman’s affair and she is only the sole responsible for the all consequences. Accompanying the wife to the hospital for visits is not considered as the husband’s role. This shows their negligible participation in antenatal care.
There were 45.83% of men who reporting the symptoms of reproductive tract infections RTIs. Urethral discharge was the commonest symptom. Around one third of the men did not take any treatment. Among the study group, 46.88% of the men reported that the wife also suffers from the RTI symptoms but only few actually helped their wife seek treatment. Similarly in the study by KB Saha et al, only 12 % of the men got the wife treated.(6)
The awareness about all the family planning methods was very low. Most of them knew only condoms and tubectomy as the family planning measure. Only few men use condoms occasionally. The men’s involvement in the family planning is very minimal. This may be due to the lack of knowledge of various family planning measures. Also, due to the myths pertaining to the male sterilization, ultimately the responsibility lies on the female partner either to do sterilization or land up with unwanted pregnancies. Contraception use and effectiveness depends on the male involvement. Usually in India men are the decision makers in the family and they may have significant influence over women’s contraceptive choice and decisions.
Almost half of the participants were having extramarital sexual relations mostly with the prostitutes and only about one third of them were using condoms while engaging in sex. This shows that these men and indirectly the female partners are at risk of sexually transmitted infections and HIV/AIDS.
RTIs were reported more in the men having extramarital sexual relations. ( p < 0.001) Similarly in a study by Kate M Dunn et al, men having extramarital sex and men having sex with prostitutes were more likely to RTIs than men not having extramarital sex.(7)
Conclusion:
Antenatal care and family planning are considered the primary responsibility of the women. Also majority of the men in the study group have high risk sexual behaviour. The awareness regarding HIV/AIDS is low.
Recommendations:
• Educate the young men about the sexual responsibilities.
• Involve men in the maternal care.
• Train the medical personnel in counselling the couple for the reproductive health.
• Design and implement IEC strategy about the reproduct - ive health issues and their role.
Acknowledgements:
We sincerely acknowledge the management of MVJ Medical College, Bangalore, for their support for this work. We are grateful to the group who participated and extended their full cooperation in the study. We would like to thank our field team and the local health workers who helped in this work.
References:
1. PAI (Population Action International). Men: partners in reproductive health. 2001. Available at: http://209.68.15.158/Publications/Reports/A_World_of_D ifference/Men_Partners_in_Reproductive_Health.shtml . Accessed on Feb 10th 2012.
2. Greene ME, Mehta M, Pulerwitz J, Wulf D, Bankole A, Singh S. Involving Men in Reproductive Health: Contri - butions to Development, Background paper to the report Public Choices, Private Decisions: Sexual and Reproduct - ive Health and the Millennium Development Goals. Available at http://www.unmillenniumproject.org/docu - ments/Greene_et_al-final.pdf. Accessed on Feb 12th 2012.
3. Saha KB, Singh N, Jain DC, Saha UC. Men’s Involve - ment in Reproductive Health: A study among the Khair - war Tribe of Central India. Proceeding of National Sym - posium on Tribal Health. pp 265-273.
4. Programming for male involvement in reproductive health. Report of the meeting of WHO Regional Advisers in Reproductive Health WHO/PAHO, Washington DC, USA 5-7 September 2001.
5. A study of involvement of men in reproductive health in Jammu & Kashmir-India. Paper submitted for presenta - tion in the 2010 Annual Meeting of the Population Asso - ciation of America Dallas-Texas (USA) 15-17 April, 2010.
6. Saha KB, Singh N, Jain DC, Saha UC, Roy J. Men’s in - volvement in reproductive health among scheduled tribe: experience from Khairwars, Central India. Rural and Re - mote Health 2007;7:605.
Key Words: Men’s involvement; Reproductive health; Contraception; Antenatal care.
Introduction:
In recent years, many family planning and other reproductive health programs have become interested in the topic of men and reproductive health. These programs recognize that men’s reproductive health directly affects that of their partner’s health. Men play key roles in supporting women’s and children’s health, preventing unwanted pregnancies, slowing the transmission of sexually transmitted infections, making pregnancy and delivery safer, reducing gender-based violence and also have distinctive reproductive health needs of their own.(1) It is shown in some studies that men also may serve as gatekeepers to women’s access to reproductive health services.(2) However, reproductive health programs have traditionally focused on women. The exclusion of men from such programs considerably undermine it’s own effectiveness.As men are dominant decision maker in the society, they exert a strong influence over their partners, determining the timing and conditions of sexual relations, family’s social well-being and access to health care. Their distance from reproductive health programs debarred female from their sexual rights coupled with lesser utilization of reproductive health services. As a matter of fact, not only male, but also a large proportion of ill health suffered by females. Such gender inequalities in access to health care create a wide gap between facilities available and its utilization and pose a challenge to reproductive health services to overcome the deficiency.(3) Traditionally, health care providers and researchers in the field of reproductive health have focused almost exclusively on women when planning programmes and services, especially with regard to family planning, prevention of unwanted pregnancy and of unsafe abortion, and promotion of safe motherhood. In recent years, efforts have been made in many countries to broaden men’s responsibility for their own reproductive health as well as that of their partners. Measures are also being taken to improve gender relations by promoting men’s understanding of their familial and social roles in family planning and sexual and reproductive health issues. The Cairo International Conference on Population and Development (ICPD) Programme of Action (1994), urged that: "… special efforts should be made to emphasize men's shared responsibility and promote their active involvement in responsible parenthood, sexual and reproductive behaviour including family planning; prenatal, maternal child health; prevention of sexually transmitted diseases, including HIV; prevention of unwanted and high-risk pregnancies; shared control and contribution to family income, children's education, health and nutrition; recognition and promotion of the equal value of children of both sexes. Male responsibilities in family life must be included in the education of children from the earliest ages. Special emphasis should be placed on the prevention of violence against women and children".
The above challenge calls for more intense efforts to foster partnerships between men and women which help men identify with the magnitude and range of reproductive illnesses which affect women .(4) “Male involvement” in reproductive health and family planning programmes is not just promoting the use of male methods of contraception, but men’s supportive roles in their families, communities and workplaces to promote gender equity, girls’ education, women’s empowerment and sharing of child rearing and caring.(5)
Objectives of this study:
1. To know the attitudes of men regarding the family size preferences, family planning and women’s health.
2. To know the involvement and participation of men in maternity, delivery, post-natal care and family planning.
3. To study the treatment seeking behaviour of men for the reproductive health problems.
Materials and Methods:
The study was conducted on the auto-rickshaw drivers in the Hoskote town. Only married men having children were interviewed using a well-designed and pretested questionnaire. Total 96 men participated in the study. The men’s involvement in reproductive health has been studied by examining their supportive role to wives and concern for their own health problems. The aspects covered are awareness and practices related to RTIs/STIs/HIV/AIDS, family planning, antenatal care and treatment seeking behaviour for the reproductive health problems.
Results:
Total of 96 auto-rickshaw drivers participated in the study. Most of them were educated up to secondary school and belonging to the class III and IV of the Modified B. G. Prasad’s classification of socioeconomic status.
There were 8(8.33%) respondents who reported that their wives deliveries were home deliveries. The distribution of respondents according to the parameters of men’s involvement in reproductive health is shown in Table 1.
Majority (62.50%) of the men did not help their wives seek antenatal care. Only few 7(7.29%) were aware of parameters of antenatal care.
There were 44 (45.83%) men who reported the symptoms of reproductive tract infections (RTIs). The distribution of respondents according to symptoms of reproductive tract infections is shown in Table 2.
Among the men suffering from RTIs, only 32(72.73%) took treatment. The rest were not bothered about their own health. Among the men who sought treatment, 14 (43.75%) men took treatment in PHCs, 8 (25%) in private hospitals, and 10 (31.25%) men went to quacks. Even though most of them preferred government services , they reported the attitude of govt. doctors was apathetic.
Among the study group 45 (46.88%) men reported that the wife also suffers from the RTI symptoms but only 28(62.22%) men actually helped their wife seek treatment.
Only 6(6.25%) people were aware of the all family planning methods. Not a single man reported of vasectomy done or willingness to do it. There were 22(22.92%) men who reported that their wife has undergone previous abortions due to unwanted pregnancies.
In 12 (12.50%) men the wives have undergone tubectomy. In the remaining group, only 26 (27.08%) men were using condoms occasionally while having sex with the wife. There were 24 (25%) men having 3 or more children. This shows the unmet need for contraception.
There were 39 (40.63%) participants having extramarital sexual relations with prostitutes or other females, of which 25(64.10%) people do not use condoms while engaging in the high risk sexual encounters.
There were 34 (35.42%) men not aware of HIV/AIDS. Also most of them who are aware of it, have no proper information about its transmission and prevention.
Discussion:
In the study, the men’s participation in the antenatal care is less. Only few were aware of parameters of antenatal care. Similarly, in a study by KB Saha et al, only 12% men helped their wife avail antenatal care. (6) Men consider pregnancy and its care as a woman’s affair and she is only the sole responsible for the all consequences. Accompanying the wife to the hospital for visits is not considered as the husband’s role. This shows their negligible participation in antenatal care.
There were 45.83% of men who reporting the symptoms of reproductive tract infections RTIs. Urethral discharge was the commonest symptom. Around one third of the men did not take any treatment. Among the study group, 46.88% of the men reported that the wife also suffers from the RTI symptoms but only few actually helped their wife seek treatment. Similarly in the study by KB Saha et al, only 12 % of the men got the wife treated.(6)
The awareness about all the family planning methods was very low. Most of them knew only condoms and tubectomy as the family planning measure. Only few men use condoms occasionally. The men’s involvement in the family planning is very minimal. This may be due to the lack of knowledge of various family planning measures. Also, due to the myths pertaining to the male sterilization, ultimately the responsibility lies on the female partner either to do sterilization or land up with unwanted pregnancies. Contraception use and effectiveness depends on the male involvement. Usually in India men are the decision makers in the family and they may have significant influence over women’s contraceptive choice and decisions.
Almost half of the participants were having extramarital sexual relations mostly with the prostitutes and only about one third of them were using condoms while engaging in sex. This shows that these men and indirectly the female partners are at risk of sexually transmitted infections and HIV/AIDS.
RTIs were reported more in the men having extramarital sexual relations. ( p < 0.001) Similarly in a study by Kate M Dunn et al, men having extramarital sex and men having sex with prostitutes were more likely to RTIs than men not having extramarital sex.(7)
Conclusion:
Antenatal care and family planning are considered the primary responsibility of the women. Also majority of the men in the study group have high risk sexual behaviour. The awareness regarding HIV/AIDS is low.
Recommendations:
• Educate the young men about the sexual responsibilities.
• Involve men in the maternal care.
• Train the medical personnel in counselling the couple for the reproductive health.
• Design and implement IEC strategy about the reproduct - ive health issues and their role.
Acknowledgements:
We sincerely acknowledge the management of MVJ Medical College, Bangalore, for their support for this work. We are grateful to the group who participated and extended their full cooperation in the study. We would like to thank our field team and the local health workers who helped in this work.
References:
1. PAI (Population Action International). Men: partners in reproductive health. 2001. Available at: http://209.68.15.158/Publications/Reports/A_World_of_D ifference/Men_Partners_in_Reproductive_Health.shtml . Accessed on Feb 10th 2012.
2. Greene ME, Mehta M, Pulerwitz J, Wulf D, Bankole A, Singh S. Involving Men in Reproductive Health: Contri - butions to Development, Background paper to the report Public Choices, Private Decisions: Sexual and Reproduct - ive Health and the Millennium Development Goals. Available at http://www.unmillenniumproject.org/docu - ments/Greene_et_al-final.pdf. Accessed on Feb 12th 2012.
3. Saha KB, Singh N, Jain DC, Saha UC. Men’s Involve - ment in Reproductive Health: A study among the Khair - war Tribe of Central India. Proceeding of National Sym - posium on Tribal Health. pp 265-273.
4. Programming for male involvement in reproductive health. Report of the meeting of WHO Regional Advisers in Reproductive Health WHO/PAHO, Washington DC, USA 5-7 September 2001.
5. A study of involvement of men in reproductive health in Jammu & Kashmir-India. Paper submitted for presenta - tion in the 2010 Annual Meeting of the Population Asso - ciation of America Dallas-Texas (USA) 15-17 April, 2010.
6. Saha KB, Singh N, Jain DC, Saha UC, Roy J. Men’s in - volvement in reproductive health among scheduled tribe: experience from Khairwars, Central India. Rural and Re - mote Health 2007;7:605.