Male students take part in the sexual and reproductive health programme at Townside Secondary School, Busembatia. Photo: Noraly Schiet, 2017
In Eastern Uganda, when a teenage girl becomes pregnant, she will stop attending school and instead, begin a life rearing children and looking after the family home and land. Teenage pregnancy remains high in Uganda, where more than one-third of girls give birth before the age of 18. Predictably, this is higher in rural areas. As well as teenage pregnancy, women and girls here face many sexual and reproductive health (SRH) challenges throughout their lives, including sex in exchange for “necessities,” poor menstrual hygiene, and a lack of access to family planning methods. This is why teaching and empowering girls from a young age about sexual and reproductive health and rights is a must. As part of the small grassroots organisation Women in Leadership (WIL) Uganda, based in Busembatia, for the last three months I have been doing just that across a number of schools.
Twelve years ago, I sat in a waiting room in a small clinic on the outskirts of Byumba, Rwanda, and listened as one man after another stood up and asked the nurse at the front of the room what methods of family planning they could use, as men. The nurse had just completed a presentation of different family planning methods, and these men were hungry for an option besides condoms, the only male method available at that facility. It was powerful and moving to witness men who wanted to directly engage in family planning, not just as supportive partners, but as users themselves.
K4Health and FP2020 have been working hard to document and share the stories of individuals working around the world to improve access to family planning via the global Family Planning Voices initiative. Some of the people we’ve sat down with, like Easmon Otupiri, the Principal Investigator for the Performance Monitoring and Accountability 2020 (PMA2020) Project in Ghana, are natural storytellers. Here’s one memory he shared with us when we met him at the 2016 International Conference on Family Planning.
Family jewels, balls, baby-makers, nuts, rocks, beanbags, huevos. In the United States, this is a classic undergraduate Women’s Studies 101 exercise: Brainstorm as many slang words as you can for men’s genitals, do the same for women, and compare. Inevitably far more slang words exist for men’s parts than for women’s, and the words are less insulting, more affectionate, and less violent. Many of these men’s terms are downright complimentary: It is common for a woman to be told that she “has some serious balls” if she accomplishes something impressive, or that a bold decision was “ballsy.”
A couple in Kenya meets with a health worker. Although overall modern contraceptive use is rising markedly, vasectomy remains marginalized and essentially unavailable in most low-income countries. Photo by Trevor Snapp/IntraHealth International
Increasing access to vasectomy isn’t easy or a quick fix in low-income countries, but investing in it is the right thing to do.
Vasectomy is not only a highly effective contraceptive option for men, it also changes the conversation around family planning from a women’s issue to a couples’ issue. And across the world, we see that higher vasectomy rates come hand in hand with greater gender equity and higher socio-economic development.
Animation still from Promundo's When Men Change video.
Unfulfilled sexual and reproductive health needs around the world continue to endanger women’s and men’s health, and they pose major barriers to achieving gender equality. Every day, over one million people contract a sexually transmitted infection (STI). In fact, sexual and reproductive health conditions represent 14% of the global burden of disease—a number that has shifted little over the past two decades.
“To be frank, I was going through a process when my wife was pregnant. A process of finding the true meaning of being a father.”
The old trope of a man nervously pacing the hospital’s waiting area, wringing his hands, while his wife labors in a private back room is reserved for old movies and nostalgia, right? That may not be true, according to State of the World’s Fathers, the world’s first report to provide a global view of the state of men’s contributions to parenting and caregiving.
Even before the delivery room, some men are missing out on the chance to be involved. While more than 80% of fathers in Cambodia, the Maldives and Rwanda were present at a pre-natal check up for their youngest child, less than 20% of fathers in Burundi, Pakistan and Zambia made the trip. Traditional expectations of what it means to be a man – and a woman – alongside sometimes unsupportive, or unprepared health systems and restrictive policies, set up barriers to men’s full participation in maternal, newborn and child health.