Council Commentary

Family Planning: Not Just for Women

Family planning programs have traditionally assumed that women are responsible for contraceptive use, so that men's job is to support them or at least get out of the way.

But a new recently published analysis "Are Men Well Served by Family Planning Programs" (Reproductive Health) by the Evidence Project found that adolescent boys and men also have a desire for sexual and reproductive health information and services. When information and services are made available they respond with greater contraceptive use. But they aren't very well served by existing programs.

In this study, we reviewed 47 interventions reaching men in 27 countries on five continents between 2010 and 2015, plus a few earlier ones, and interviewed 36 programing and research representatives.

We found that even two decades after the 1994 International Conference on Population and Development called for involving men as partners in family planning, reproductive health facilities are still largely seen as spaces for women. Men aren’t welcomed. Health workers often share the common view that avoiding pregnancy is a female responsibility, and they either lack the capacity to counsel men or resist talking to them about sex, especially to unmarried boys.

Local norms of masculinity may challenge men who seek information or services and disparage those who talk with their wives about it. Boys often get what little information they have from online and social media, including porn sites, and from male friends who are as uninformed as they are. Men also have few contraceptive options: condoms, vasectomy, and withdrawal about sum it up, although they can also contribute to use of the Standard Days Method, a natural modern contraceptive method that requires their cooperation to use.

As a result of these factors, only about one-quarter of contraception users worldwide are men. But many pilot programs have succeeded in addressing these issues. What's needed now is to scale them up.

Would family planning be seen as controversial if it were viewed as something of equal concern to men and women alike?

The study proposes ten ways to move toward that equality: 

  1. Provide information and services to men and boys where and when they need it;
  2. Address gender norms that affect men’s use of contraceptive methods;
  3. Improve couple and community communication;
  4. Meet men’s needs while respecting women’s autonomy;
  5. Link men’s family planning use with their desire to support their families;
  6. Teach adolescent boys about pregnancy prevention and healthy sexual relationships;
  7. Develop national policies and guidelines that include men as family planning users;
  8. Scale up programs for men;
  9. Fill the gaps through monitoring, evaluation, and implementation science; and
  10. Create more contraceptive options for men.

Men's needs can't be met if they are only viewed as obstacles or accessories to women's health. The more options men have, the more options women will have too.