If the gender ratio of the 3,800 attendants of the fifth International Conference on Family Planning (ICFP), the world’s largest gathering on sexual and reproductive health and rights held in Kigali, Rwanda this year, is any indicator, deciding whether and when to have children is a woman’s job. In the halls of the city’s congress center, women vastly outnumber men.
Considering 100% of the population who gets pregnant and delivers babies is female (at least biologically), it’s pretty clear why the global efforts towards family planning—that is, giving the opportunity to decide when to have children, and how many—have typically focused on women first (although, of course, it is predominantly men who make the rules when it comes to access to reproductive health).
“We establish our goals in terms of women and girls as a matter of empowerment and equity,” Beth Schlachter, the executive director of FP2020, an global initiative established in 2012 with the goal of giving access to family planning to an additional 120 million women and girls in 69 poor countries by 2020, told Quartz. “We want women in developing countries to have the same access to bodily autonomy, to reproductive healthcare and to controlling their fertility as [women in wealthy countries] assume they have.” Though the latest progress report released by FP2020 in Kigali shows that the goal will likely be missed, so far 317 million women are using modern contraceptive in the 69 selected countries, and globally nearly 60% women who are in a relationship use contraception.
Yet, as women gain more agency an important development is emerging in the global health community: Getting men on board, too.
For long, particularly in developing countries, this has meant getting men to allow their wives, sisters, or daughters to use contraception, or lobbying to governments to implement policies that protect women’s rights.
Yet family planning isn’t just a woman’s business. On the contrary, particularly in countries that are dealing with excessive population growth, it is a fundamental element to development and prosperity for all, and not just women. So, increasingly, the conversation is turning to men.
“It is difficult to get men not to be just spectators of family planning, or supporters,” Juan Carlos Negrette, Director of Global Health at the University of Utah, told Quartz “but [become] an enabler and participant.”
But several countries are beginning to have pilot projects where men are more directly involved in contraception and planning, and don’t think of it just as a woman’s job, or worse, as something they ought to oppose as a part of their male role in society. In Mali, Togo, and Benin—all countries included in the group of nine Francophone West African countries that, in 2011, committed to promoting family planning through the Ouagadougou Partnership—projects have been made that revolve around groups of men and boys, the so-called écoles des maris (schools for husbands) and clubs des garçons (boys clubs).
These groups—which often get the key support of local traditional leaders—are created with the scope of including husbands in the planning of family contraception, and educating them in reproductive care and women’s rights, and to help boys develop respectful intersexual dynamics and healthy relationships with girls and women.
While it’s common to see similar circles for women, they are rather rare when it comes to men. In the groups, said in a presentation Tchagbele Djeri Bouraima, a project coordinator from Togo, men are educated on family planning and reproductive health, as well as positive masculinity and rejection of gender-based violence. It’s health workers such as Bouraima, who coordinates 10 husband schools and 10 boys club, together with community and religious leaders that deliver the education, as well as members of the groups themselves, who educate other men either directly, or through broader channel, such as participating in the creation of sexual health and positive masculinity messages to be incorporated in popular radio shows.
“This is a model for a constructive way to be a man,” says Negrette, “a positive [way of] living to look at as a reference.” He believes that this kind of initiatives will soon generated tangible progress, and that “these guys are at the cusp of a societal transformation.”
But though less coordinated, initiatives educating men in reproductive health are happening outside the Ouagadougou Partnership, too. In Rwanda, too, where more than half the population (52%) is female, counseling for reproductive health is nevertheless done on men and women—most frequently as couples, but as individuals, too—Rukundo Athanase, a doctor and director of Rwanda’s NGO Health Development Initiative (HDI), told Quartz.
And, far away in Pakistan, young activist Sarmad Soomar, who teaches reproductive and sexual health all over his native country as a way to dispel stigma and sexism, told Quartz he also coordinates a group of 40 young men (16 to 24) who meet to discuss pressing sexual issues (he says the most common is “is masturbation a sin?”), contraception, and respectful behavior with women, then share their lessons with their peers in their respective communities.
Reproductive health education for men means “bringing a man to understand that the welfare of his own life is linked to family planning,” says Gisele Dunia, a doctor and author of a research study on male engagement in family planning in Benin. A man who is aware of his role in family planning, and the role of family planning in the economy, will be more likely to understand the importance of contraception, and respect a woman’s body.
Further, many of these clubs encourage men to take action: By getting vasectomies, a procedure that would completely end the risk of further pregnancies, relief the woman from the burden of hormonal contraceptive, or the couple from having to use condoms.
In countries such as Canada or the US, vasectomies are a common occurrence: in the US, up to 350,000 men a year get one, and in certain parts of Canada, such as Quebec, nearly a third of men have vasectomies, Michel Labrecque, a specialist in vasectomies, told Quartz. But in developing countries, they are far surpassed by tube ligations—a practice far more invasive: Only 0.7% of men have vasectomies in the countries reached by FP2020, and in Africa they are all but absent.
Or rather, were: One of the goals of the schools of men is to explain the procedure, and dispel myths and stigma, including that the procedure would be invasive and painful, that a man wouldn’t be able to ejaculate, or that he would lose his manhood.
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