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At Large

Involving men in family planning

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“Male Involvement” has long been a buzz-word (or “buzz-term”) in family planning circles. Often it is paired with the word “increasing,” that is, assuming that male involvement in family planning – either by encouraging their wives or partners to use contraception, paying for the methods, or even assuming responsibility themselves – is deficient if not non-existent.

The question is why so many men refuse or are unable to get involved in family planning, either in decision-making or enabling their partners to use contraception. As for using condoms or undergoing a vasectomy, or cooperating with their partners on natural family planning – well, let’s just say hope springs eternal.

Some answers, though, were forthcoming during the Second International Conference on Family Planning, held late last month in Dakar, Senegal. At a workshop on “Men Behind Family Planning,” a speaker from Nigeria explained that while men have “high awareness” of the need for and importance of family planning, they have “poor knowledge” of the various modern methods of family planning and how these work. The speaker, who assisted in a project on working with men in Nigerian villages, also found the men “unwilling to use family planning” mainly because they were apprehensive and insecure, and didn’t know how exactly they fit in the scenario.

The project intervention among village families included training in spousal communications, encouraging spouses to discuss health issues and engage in “joint decision-making” in choosing the method that best worked for them.

One male workshop participant then stood up and said one part of the problem is that “there are not enough options for men.” “We can only choose between using condoms or having a vasectomy, and I tell you, both options are not attractive to me,” he said. “But if only they would come up with a pill for men, I would take it at once.”

* * *

Another presentor on “Gender Norms and Family Planning in Tanzania,” presented the findings of the “Champion Project,” a detailed survey on men’s attitudes toward gender equity and planning their families.

The researchers found that 72 percent of those surveyed would be “very comfortable” with being counseled on family planning with their partners; while 75 percent stated that it was “very important” for men to be part of family planning. “The more a man believed in gender equality, the more likely it was for him to believe in taking part in family planning,” the researcher said. But two out of every five respondents said they “believed that health facilities do not welcome men,” with some reporting that health workers were unaccommodating, if not hostile, to the men among their women and children clients.

This is unfortunate, given the generally positive results seen when men are actually encouraged to take active part in promoting the health of family members.

Mahboob E-Alam, of Engenderhealth, Bangladesh, spoke on a project to increase the use of vasectomy in their country. While Bangladesh has a pretty high contraceptive prevalence rate of 56 percent, only 5 percent of method users are men. This was unfortunate, E-Alam said, since studies have shown that “husbands play an important role in family planning decisions,” since a disapproving or indifferent husband can actually discourage a woman from using a family planning method.

* * *

E-alam engaged men who had gone through a vasectomy to act as “champions” of the method among other men, saying that men often felt “scared and isolated” after undergoing the procedure. What he and his team did was to gather “satisfied clients” and glean insights into what made them satisfied. Some important factors: a skilled surgeon, prompt and effective management of side effects, and effective client follow-up.

The “champions” turned out to be excellent promoters of vasectomy, using themselves as examples, and engaging men in the neighborhood or in community centers in discussions about their family planning needs and health concerns. The group later found that the “champions” were able to refer an average of two or three clients a month to undergo a vasectomy. The program is now being applied in 16 districts of rural Bangladesh.

* * *

The value of engaging men not just in family planning but even in female genital cutting was brought home during a visit to the village of Keur Simbara in Senegal. Asked what men thought of the movement to bring an end to FGC, a man in a bright yellow tunic stood up and introduced himself as Menadou Konate, 54, a radio announcer.

Previously, he said, he didn’t believe there was any harm done by cutting. “People said that women who have been cut could not have many children, but my two wives have been cut, and they have given me many children. They also said that women who have been cut do not enjoy any sexual pleasure. But they tell me that if I don’t visit them for two days, they will cry.”

But after undergoing training in human rights, including women’s rights, Menadou began to change his mind. He also accompanied one wife to the health center and there the midwife explained the injury done by cutting and the health risks a scarred or wounded cervix posed to a woman during delivery.

“After being educated on the right to health of women, and of the dangers posed by cutting, I could no longer support the practice,” Menadou said. He then began talking to his men friends and went around talking to various groups about the risks of cutting. “When I began, talking about cutting was taboo, people would get upset and ask me to stop. But the more we talked, the more we lifted the veil that concealed the practice of cutting, and now we are able to discuss it openly.”


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Tags: At Large , family planning , opinion , Rina Jimenez-David

  • http://www.facebook.com/people/Franzeline-Perdubal/100002708434971 Franzeline Perdubal

    To the Author Rina David, are you also aware of the “lobby” money for media practitioners like  you? We noticed that 50% of your columns are all related to the same topic. Hope you are soaring above all this hoopla.

    • Rocky6076

      Good that you notice it,I too have a reservation with this columnist,Not worthy of a spot in this newspaper,she will do better in tabloid showbiz columns.

    • Islaslolo

      If you are referring to the RH bill or family planning as the same topic, then I believe that we should have more  discussion about it. It is such an important topic for the equality of women and their health, the responsibility of both partners in planning their family, the future of our country that is burdened by chronic poverty, lack of educational opportunities, overpopulation, not to mention graft and corruption …

      The biggest lobbyist I can see in the whole debate about this topic is the Catholic Church that keeps on imposing its dogmas through fear and guilt. Sometimes, I wander if we are truly a domocratic country or a theocracy?

  • quirinomayer

    So many stories about the extremes Filipino men would go when turned down by their wives. There was this squatter area razed to the ground some years ago because a man went home at night and wanted sex but the wife was not in the mood. He doused their house with gasoline and set it on fire. There is this spurned man who was asked by his wife to split wood the following day and he said “use yours to split wood.” And there’s this husband who left their house in a huff and went down to the yard and shout “tightfisted” in the vernacular in the middle of the night. Ashamed that the neighbors easily understood what was happening, the wife went down to the yard and mollified her enraged husband by promising to give what she  what he was asking for earlier.

    It is the prodigious libido of Filipino men who can’t take no for an answer which family planning workers say make most Filipino women opt for modern family planning methods to the natural family planning method. With modern family planning methods wives cannot ward off their husbands  so  how much more if they ask  their husbands to exercise self-control for so many nights  not to include the days? So if we the government adheres to the natural family planning only line of the CBCP, I am sure there will be more neighborhoods going up in smoke and more female organs splitting wood in this country.

    PASS THE RH BILL NOW BECAUSE A SPURNED FILIPINO HUSBAND IS DANGEROUS. OR LET’S JUNK THE RH BILL ON CONDITION THAT THE CBCP WILL SEND  ITS FAMILY PLANNING ARMIES TO EVERY HOME TO FORCE CATHOLIC HUSBANDS TO EXERCISE ABSTINENCE  WHEN THE WIFE IS FERTILE. I BELIEVE THAT THE CBCP WILL NOT DARE BITE MORE THAN IT COULD CHEW SO LET’S PASS THE RH BILL NOW AND MAKE A REALISTIC ATTEMPT TO SLOW DOWN THE BIRTH RATE TO MANAGEABLE LEVELS. 

    • IanAlera

      Replying to quirinomayer and other pro rh:

      Quirino, It is just common sense that contraceptives have nothing to do with women being in the mood. For example, may contraceptives nga yung tao, pero amoy grasa naman yung partner, ma-t-turn on ba yung asawa? For you to connect how husbands react to unresponsive partners, to the rh bill is nothing but nonsensical propaganda..
      ——————-

      If only all pro rh people will have themselves ligated or have vasectomy, we won’t need to worry about over-population or whatever it is that men will do when spurned by wives.

      Don’t be hypocrites.  Gusto ninyo ng rh bill. Why don’t you show the people what should be done.. Set an example. Propaganda kayo ng propaganda, but you won’t commit yourselves.

  • bgc4vrbtravels

    Involving the men to understand family planning is a good idea, drowned away by the noise of adopting contraceptive methods, devices, procedures and services.  The married man and woman have to understand why they are doing or about to adopt one or other modern Natural Family Planning Methods which can be adapted to their life situation.  Talk about the Creighton Model Fertility Care System, the Billings Ovulation Method, various combinations of cervical mucus, saliva, urine, basal body temperature synchronized with the fertile and infertile period of a woman’s reproductive cycle, that the men should understand also, and properly communicated and effectively understood (with follow up instructions) to the couple, you’ll have a better success rate.  This is something that government workers could very well do, as reproduction and conception require the participation of the male partner.  If the cooperation and understanding of the male partner is unconditionally given, the success of modern Natural Family Planning Methods, their adoption and continued success may be insured.

    It is unfortunate that many responsible parenthood counsellors lack the patience in dealing with the initial resistance of couples, especially of the male partners, who need understanding and correct information.  They find it easy to just go right ahead into the discussion of the desirability and effectiveness of artificial contraceptive methods which are always provided and do not spend patient time to discuss thoroughly the responsibility of the male partner to make the program work.  But, in fact, doing so, makes the concern of government easier to “inform about choices” on family planning.  Modern Natural Family Planning Methods make the couples aware of their responsibilities, to have mutual respect for each other, and to understand the physiological and biological order and good natural design in sex, its correct use, and the practice of virtue, avoiding excesses and deficiencies in its practice.  Proper instructions would inform the woman about the significance of the natural symptoms related to her reproductive cycle and even remind the couple about the rights of the woman that should be respected by men under certain circumstances, protected by law.

    MODERN NATURAL FAMILY PLANNING METHODS are cost efficient, more reliable and safer than condoms and artificial contraceptive methods (mechanical, surgico-medical, chemical, including injectables and the “after morning pill”).  Women need to have control over their bodies and getting the cooperation of the husband from the start avoids much negativism and disinformation about Natural Family Planning Methods that could save hundreds of billions of taxpayers’ money for the purchase of so called “essential medicines” that should be instead spent for genuine human development, to uplift the lives of people, especially those in abject poverty, in the slums, in the underdeveloped in the countryside, provide more education opportunities, jobs, livelihood and needed skills training, direction to productivity, among others.  It is very logical that if those who regard their future as endless despair and hopelessness see a reason to hope and if social justice is given sway to restore the social order in Jesus Christ, society would be better oriented and population growth, which is more complex than proponents of the rh bill have ever conceived, could be reduced to the ideal population growth rate, allowing for a sound replacement rate.  The secular order cannot be dissociated from the moral order. Legislated artificial contraceptive birth control measures can be an irreversible trend which, covering generations to achieve zero or negative growth rates, could instead lead the country in the opposite extreme.  Unfortunately, not in the lifetime of the most avid among rh proponents and advocates!  No to the rh bill!

    • quirinomayer

      Just like most anti-RH bigots, you talk about ideal population growth rate but what is in the back of your mind is really for Filipinos to keep multiplying like rabbits. I will prove that:

      First, you know deep in your heart that at least under the watch of President Aquino, your ideal world where the government will give up contraceptives in favor of NFP will never happen meaning in the remainder of his term, NFP will never get off the ground and the confused Catholics  who believe usage of contraceptives will bar them from heaven  will continue  considering malnourished and grimy children they cannot clothe properly as assets and produce one each year. 

      Second, you want NFP to become the one and only family planning method but want the RH Bill to be junked.  You think the teaching of family planning especially NFP comes for  free? And do you realize that compared with modern family methods, you need both husband and wife when you teach NFP meaning during the duration of the seminar, they will have to forgo their earnings. Do you realize that we need the RH Bill to be approved for a more aggressive teaching of the NFP? Or are you fantasizing that you dictate on the government the family planning method and then force it to
      fund and implement the program?  You realize how much money is needed to
      make people accept the NFP seeing that only five percent of family planning
      acceptors opt for the method at this point in time? I guess you and your fellow
      anti-RH  bigots want your cake and eat it, too.

      Third, like I have been asking you for ages now, why does not the Catholic church put its money where it’s mouth is if it really believes in the efficacy of the NFP as an answer to the un-ideal population growth rate we have now? This means that your church is not really serious in arriving at the ideal population growth rate.  Try to
      prove me wrong by telling us about  the Philippine Catholic Church program to convert this country into the only pure NFP nation in the world if there is any. Tell us of success stories, if any.

  • IanAlera

    Rina Jimenez-David,

    Puro ka propaganda for the rh bill but won’t fully commit yourself to your cause.

    Why don’t you show the people what should be done? It is just reasonable to expect that people who encourage other people to commit themselves to ligation and vasectomy should themselves set an example. Set an example — Get yourself ligated.

    Actually, if only all pro rh people will have themselves ligated or have themselves undergo vasectomy, we won’t need to worry about over-population.

    • http://pulse.yahoo.com/_EXFI4EUGM23PQ4FMQKLVH36OXI Jose

      I’ve got to say, your complete lack of understanding about the RH bill is absolutely hilarious.

      After posting in pretty much every article about the RH bill, you’d think you’d realize that it has absolutely nothing to do with ligation, but you keep on trumpeting your ignorance.

      I really wish the Inquirer had better forums, so you could be the board-wide laughing stock you deserve to be.

      • IanAlera

        Replying to Jose,

        Jose, do you not even read the comments as well as the article before you make your replies? 

        The only hilarious thing here is that your unthinking ‘spaced-out propagandist’ attitude is not doing any thing good for your cause. Just want to let you know.
        —————-

        You said — “…the RH bill, you’d think you’d realize that it has absolutely nothing to do with ligation…”

        I say —  Tell that to the author, of the article above who has spent a great deal of her efforts in promoting population control/ rh bill. Ask her why she had to include the portion about vasectomy in her article. Why discriminate?  If she advocates vasectomy, why not ligation? Why not do it for herself as an example?

        By the way Jose, — You know you lied. Promoting ligation and vasectomy is as part of the rh bill as promotion of other contraception methods.

        And since you are so hung-up on population control, why not have yourself ligated too?

      • http://pulse.yahoo.com/_EXFI4EUGM23PQ4FMQKLVH36OXI Jose

        Fact: Only an idiot would equate supporting population control with getting a vasectomy or ligation.

        If you can get anyone, even your ridiculous acolytes, to back you up on this I’ll take it back.

      • IanAlera

        Replying to Jose,

        You said — “… Only an idiot would equate supporting population control with getting a vasectomy or ligation.”

        I say — Did you not read the article above? It says “The “champions” turned out to be excellent promoters of vasectomy, using themselves as examples…”

        Now if your statement is true, then It just follows that you are admitting that you, as well as the entire pro rh lobby are idiots.

        The Pro-rh are the ones supporting the rh bill, which in fact encourages people to get ligation and vasectomy in support of population control.

      • http://pulse.yahoo.com/_EXFI4EUGM23PQ4FMQKLVH36OXI Jose

        Still waiting for anyone to backup your ridiculous position.

      • IanAlera

        Replying to Jose,

        Tell that to the author of the article above…

        It is your position that those who equate getting ligation or vasectomy in support of population control are idiots…

        The pro rh are the ones encouraging ligation and vasectomy in support of population control…

        Jose, in effect you are admitting that you and the other pro rh people are idiots. IDIOT.

      • http://pulse.yahoo.com/_EXFI4EUGM23PQ4FMQKLVH36OXI Jose

        Still no backup.  Tsk tsk tsk

      • IanAlera

        Replying to Jose,

        You still have no brain? IDIOT.

    • Jomex

      Ian, this is the most moronic comment here or anywhere.

      • IanAlera

        Replying to Jomex,

        Coming from you and other rabid pro-rh, it is a compliment. Haven’t you heard of sarcasm? Now you know how moronic the position of the pro rh is.

  • http://pulse.yahoo.com/_OHOD5EA75DBBUH53UKLRXRK764 Mang Teban

    Ms. Rina David:
    Do we have female genital mutilation now in the Philippines? If there is none, what’s your point about writing about it? What does that got to do with Filipinos and the RH bill?

    Did you really think that Filipino males will buy that sick humor you wrote about women who had theirs cut and supposedly lose their libido for sex would still expect their husbands to have sex with them? That is simply gross.

    Check with Muslim countries like Malaysia and Indonesia where their governments and their people condemn such practice done on teenage girls by misled parents who think that genital mutilation will prevent them from being promiscuous and get into premarital sex before they are paired for marriage with predetermined husbands.

    I really wish that you can write on truthful matters and not some strange social behavior endemic probably in some African countries and has nothing to do with Filipino culture. I think that pro-RH bill people like you are running out of imagination and gimmicks to promote an unnatural, unhealthy, life-threatening, and sick contraceptive methods to avoid pregnancy. Do not take Filipinos as ignorant as those you have been citing as experiences in other countries. In fact, that is exactly what you guys, contraception-minded individuals do.

    In preparation for the Christmas season, please be reminded that we are commemorating the Author of Life, Jesus Christ, who shall be displeased with people like you who miscalculates God’s empowering love for mankind and would like to take over His work of deciding who shall be born and whose life will be taken away any moment now. I only know one entity who likes to destroy the work of God and that is Satan who is the Author of Death, contraception, abortion, breakup of families. Now, those who do not believe this truth  – you know whose side you are on, don’t you?



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