1. M.E.Khan PhD Population Council, Delhi mekhan@popcpouncil.org
Male Involvement in Family Planning and Reproductive Health: Observations from Three Operations Research Studies
M.E.Khan PhD
Population Council, Delhi

2. Three OR studies Men in maternity care
men as health care taker of partner
Men in promoting post partum contraception
Men in family planning
Provision of RH services from women centric clinic
Men as client , gender equity to services
No need to reemphasize the importance of male involvement in FP and RH , Kampala meeting Has remained a neglected area

3. Broad Questions Addressed
Feasibility Can it be done?
Operational details How to implement?
Sustainability Can it be integrated with exiting health system?
Affordability At what cost?
Creating condition for scaling up

4. Men in Maternity care Project goal:
To develop a cost-effective and sustainable maternity care program which incorporates male partners and aims to improve reproductive health and pregnancy outcomes
Coverage:
Implemented in MCH clinics of Delhi managed by ESIC
Initially in 6 clinics; scaled up in all 35 clinics in Delhi
Study Design:
Quasi experimental- control with pre-post design

5. Men in Maternity care: Interventions
Couple counseling: birth plans, emergency obstetric care, breastfeeding, family planning
Same sex individual or group counseling on
STIs, condom demonstration
Universal on-site syphilis screening
Syndromic management of male urethral discharge, male and female genital ulcers
Promoting utilization post partum services

6. Men in Maternity Care: Results
More men came with their wives (91% Vs 64%), received any counseling (52 %Vs 21%), joint counseling (26% Vs 2 %), more received information on BF, immunization
Increased knowledge of danger sine, pregnancy preparedness, STI, Dual protection of condom, …
Increased H-W communication
Increased use of FP ( 51%V41%) and condom (36V26 %)

7. Promoting Post partum Contraception A BCC Intervention
Project Goal:
To develop a BCC campaign model to to promote PPC among zero and first parity women using
Coverage: 24 villages now scaled up to 48 villages.
Study Design: Quasi- experimental- control, pre-post design
600 pregnant women were registered and followed up till 9 month post partum

8. Promoting Post partum Contraception: Interventions
Educational campaign by Community level workers(CHW) – ASHA, AWW, ANM
Audience specific messages reinforcing their perceived needs for spacing. Husbands were focused target
Alignment and reinforcement of messages through different channels
CTU and reorientation of CHW for strengthening counseling skills and use of counseling aids
Supportive supervision and regular review meetings
Joint effort to implement intervention by two Ministries—optimum use of existing resources

9. Promoting Postpartum Contraception: Results
Significant increase in correct knowledge of all FP methods (LAM 74 Vs 1%) IUD (68 Vs 18)
4-month follow up:22% against non were using LAM
68 % LAM users switched over modern FP methods
H-W communication on FP / STI increase significantly
9-month follow up: 63% against 32% were using any FP method

10. Integration of RH services for men in HFWC, Bangladesh
Project Goal: To test feasibility of integrating men RH services (STI , FP ) in Health and Family Welfare Centers(HFWC) – a women centered clinic . HFWC covers 30,000-50,000 population
Coverage: 12 HFWC – 8 experimental and 4 control . Scaled up in 40 HFWC . Third stage MOH recommended for scaling up in100 HFWC
Study design: Quasi-experimental –control design

11. Integration of RH services for men in HFWC: Intervention
Orientation of the staff in syndromic management of RTI and STI –theoretical as well as practical
Introduction of Systematic screening tool to identify unmet RH needs
Educational campaign using different channels
of communication

12. Integration of RH services for men in HFWC: Results
Significant increase in knowledge of workers in Exp. group about signs and symptom of different STI. No change in Control group
Demonstrated correct knowledge of using flow graph for of the syndromic management of RTI
Large number of men started availing services from of HFWC – mostly for general heath problems
Number of women clients using HFWC also increased significantly
Utilization of HFWC increased by more than 60 percent

13. Conclusions
Younger generation is changing fast and men are willing to be involved in maternity care and supporting PPC
Lack knowledge and generally are neglected by health and FW workers
Men involvement leads to positive RH/FP/ MCH results
Men and women could be served from same clinic
With minor modification in existing health system, men involvement could be achieved
Most required changes are financially sustainable
Long term TA for HS capacity building is critical
In resource constrained country, partnering with other donors could make significant difference