Male Involvement in Bangladesh's Reproductive Health Programme: A Status Report

Introduction

The issue of men's involvement in reproductive health services emanates from the underlying inequalities and inequities in the established gender-specific roles and responsibilities of men and women. Gendering of the roles and responsibilities tends to disengage men from core areas at the family and societal level (e.g., general health and nutrition, reproductive health, child care). Disengagement excludes men from participating and sharing responsibility in core areas of their life. Such exclusion is thought to be a major source of many gender-specific inequalities and inequities.

Since its inception in the 1960s, the family planning programme (FPP) has primarily ignored men (Drennan, M., 1998). Since women bear the risk of pregnancy and child birth, FPP have assumed women have the greatest stake in protecting themselves against unwanted pregnancy. In the 1980s FPP started giving limited attention to men through workplace programmes and condom social marketing (Drennan, M., 1998). Focus of male involvement was then limited to promotion of male contraceptives. Population planners promoted men's participation as family planning method acceptors in order to ensure sustained use of contraceptive methods. On the other hand, feminists promoted men's inclusion in the FPP with the hope that such inclusion would lead to a situation where men would shoulder the responsibility of contraception. In the 1990s, the concept of male involvement was intensified in the wake of the HIV/AIDS pandemic. It was understood that the dominance of men in every sphere of life demanded the inclusion of men in sexual and reproductive health programmes (RHPs). Efforts to include men in RHPs were intensified during the 1990s. Intensified efforts to include men in RHP were taken in the wake of rising apprehension about HIV/AIDS and other STIs; increasing reports and information on ill effects on women and children resulting from some men's risky sexual behaviour; growing recognition that in many societies men make critical decisions that affect the reproductive health of women; and an increasing awareness that gendered roles affect sexual behaviour, reproductive decision making, and reproductive health in many ways (Drennan, M., 1998).

In 1994, the International Conference on Population and Development (ICPD) gave momentum to the concept of male involvement in RHP. After ICPD, male involvement in RHP gained popularity in many countries. The concept of "male involvement" that resulted from ICPD was wide-ranging, with the intention of addressing gender inequality and inequity in all aspects of reproductive health. The Platform of Action of the Fourth World Conference on Women, in 1995, followed the same tone with regard to the role of men in promoting reproductive health. Initiatives taken by many countries to incorporate and promote male involvement in reproductive health, however, failed to grasp the profundity and spirit of the concept of involving men in many ways. Only recently has the issue of male involvement received due attention in RHP and policies in Bangladesh. However, this prioritization of male involvement has been conceived from a very narrow perspective. Such a narrow conceptualization is likely to have serious implications for the health of both men and women.

In this report, male involvement initiatives in Bangladesh, both past and present, are critically examined, and the prospect of fully involving men in RHP in Bangladesh is explored. The report is based on review and analysis of the male involvement approach and associated initiatives by the RHP of the government of Bangladesh.

Male Involvement Initiatives in the RHP of Bangladesh

The RHP of Bangladesh has its legacy in the family planning programme of the 70s and 80s. The family planning programme (FPP) had remarkable success with respect to bringing down fertility level from 6.3 births per woman in 1975 to 3 births per woman in 2004 (NIPORT, 2004). Over the last three decades, use of any method of contraceptive by married women has increased from 8 to 58 percent and use of modern methods of contraceptives by married women has increased almost tenfold, from 5 to 47 percent (NIPORT, 2004). One of the major reasons for the success of the FPP in reducing fertility was its women-centered-door-to...