It Works:
Why Engage
Men and
Boys?
2000 Rick Maiman/David and Lucile Packard
Foundation, Courtesy of Photoshare
We Have a Global Mandate to Engage Men: Cairo 1994
“Special efforts should be made to emphasize men’s shared
responsibility and promote their active involvement in
responsible parenthood, sexual and reproductive behaviour,
including family planning; maternal and child health; prevention
of STIs, including HIV; .... shared control and contribution to
family income, children's education, health and nutrition; and
recognition .... of the equal value of children of both sexes. Male
responsibilities in family life must be included in the education of
children from the earliest ages. Special emphasis should be
placed on the prevention of violence against women and
children.”
ICPD Programme of Action, 1994, Paragraph 4.27
Growing International Consensus for Engaging Men
and Boys in Sexual and Reproductive Health
•
•
•
•
•
•
•
•
ICPD, Cairo, 1994
Beijing Conference on Women, 1995
World AIDS Campaign on Men and AIDS, 2000-2001
USAID Conference on Men and Sexual and
Reproductive Health, 2003
Expert Meeting on Involving Men and Boys in
Achieving Gender Equality, United Nations
Commission on the Status of Women, 2004
Global Symposium on Engaging Men and Boys in
Gender Equality, 2009
PEPFAR (emphasis on addressing male norms and
behaviors)
Global Health Initiative
In Spite of the Global Mandate,
We Have a Long Way to Go

Female-controlled methods account for 74% of
contraception use worldwide.


Male methods—condoms and vasectomy—account for
only a small percentage (26%) of global contraceptive
use except in industrialized countries.
Globally, there are 600,000 maternal deaths/year.

Yet, many men lack information or access to maternal
health services that include them.
In Spite of the Global Mandate,
We Have a Long Way to Go (continued)

Boys and men are often socialized to use violence to
display their manhood, using it against women and
men.

Men are more likely to experience violence at the
hands of a stranger, while women are more likely to
experience violence by a male partner.

30–50% of women worldwide have experienced
some form of gender-based violence.

10–20% of women worldwide say their first sexual
experience was coerced.
In Spite of the Global Mandate,
We Have a Long Way to Go (continued)

Men are often pressured to prove their manhood
through sexual aggression and risk taking.

Globally, men have higher reported rates of partner
change than women.

340 million new cases of sexually transmitted
infections (STIs) per year (excluding HIV; ages 15–
49)

In some developing countries, at least 3 in 10 men ages 15–
24 with STIs did not tell their partner.
In Spite of the Global Mandate,
We Have a Long Way to Go (continued)

In many cultures, men are socialized to be selfreliant and not to seek help, including health
information and care, in times of need.

Young men are likely to know more about
women’s bodies than about their own.

In some countries, men access antiretroviral
therapy (ART) for HIV later in the disease’s
progression than women, with more
compromised immune systems and at greater
public health costs.
Start by Accepting the Complexity of Gender Relations
2009 Anil Gulati, Courtesy of Photoshare
• Power and vulnerability
exist on multiple levels
• Power and vulnerability
are not mutually exclusive
• Gender intersects with
other systems of power
(e.g., age, race, class,
sexuality)
• Masculinities: gender
norms vary based on
contextual factors and
individual experiences
The Driving Questions
• Can men and boys—and masculinities—change?
• Can they change quickly enough to matter for this
generation of girls and women? Of boys and men?
• How can we promote change with men and boys?
What works? Can we take it to scale?
• What are the implications for programs in the areas
of RH, HIV/AIDS, maternal and child health (MCH),
and gender-based violence?
Age hierarchies
Urban-rural
hierarchies
Social exclusion,
poverty,
demographic
pressures
Gender norms socially constructed
roles and status of
women and girls,
men and boys
Masculinities
Ethnicity/
ethnic tensions
Weakness/strength of the State and
civil society organizations
Can men and boys—and masculinities—change?
Can they change quickly enough to matter for this generation for girls and women,
boys and men?
Changes in How we View Men
• From obstacles to partners
• From means to an end to
subjects of their own needs
• From insensitive to potential for
caring
• From individualists to complex
subjects
How can we promote change with men and boys?
2001 Edward Reilly/Lutheran World Relief,
Courtesy of Photoshare
Recognition of Men’s Multiple Needs
•
•
•
Men and employment
Men, boys, and
education
Other health issues:
accidents, violence,
prostate cancer,
infertility, mental health
2009 Anil Gulati, Courtesy of Photoshare
How can we promote change with men and boys? What works?
Increasing Focus on the
Socialization of Boys and Men
•
More research on how boys
and girls are socialized into a
gender-segregated and
unequal world
•
Increasing awareness that
gender role socialization puts
men and their partners at risk
•
Understanding that it is
possible to question this
socialization
2004 Bangladesh Center for Communication
Programs, Courtesy of Photoshare
How can we promote change with men and boys?
What works?
What to Do? Find the Entry Points
• Even in settings where gender norms are rigid, there are
men who question them.
• Even men who generally have rigid attitudes may have
some domain in which they are more gender-equitable.
• Reach out to the silent majority of men and boys who do
not believe in using violence and do not believe that men
are inherently superior to women.
• Work with women to support more gender-equitable
behaviors and norms of masculinity.
Finding Resistance to Prevailing
Social Constructions of Manhood
Identify:
• Young men who
empathize with the
challenges girls/women
face
• Role models who question
prevailing discourses
Engage them through:
• Reflection on personal
and family experiences
1998 William Finger/FHI, Courtesy of Photoshare
We Must Start Early and
Keep Working.... a Lifecycle Approach
• Young Boys/Pre-School: Engaging men as caregivers in the
childcare setting and as educators
• School Age: 6–12: Training of teachers, after-school programs,
educational activities
• Adolescence: Promoting critical thinking about gender roles,
information, campaigns, group educational activities, hands-on
experience in caring for children
• Late Adolescence/Young Adulthood: Fatherhood, relationship
courses, HIV prevention
• Mid-Adulthood: RH, engaging men in maternal and child health
• Late Adulthood: Men as grandfathers, preparation of next generation
Common Elements of Promising Approaches
• Explicit inclusion of discussions of
manhood/masculinities in
educational activities
• Creation of an enabling
environment (peers, social groups
that support change)
• Alliance building (using an
ecological perspective to reinforce
messages)
• Critical reflection about violence,
manhood
• Vocational/direct benefit of some
kind—something that directly
benefits boys and men
1997 CCP, Courtesy of Photoshare
WHO-Instituto Promundo Review: Evaluation
Data From 57 Programs Engaging Men and Boys
Type of Intervention
n
Effective
Promising
Unclear
Group Education
20
-
11
9
Services-Based
8
2
4
2
Community
Outreach/Mobilization
8
6
2
-
Integrated (includes more than 1
of the above)
21
6
5
10
TOTAL
57
14 (24.5%)
22 (38.5%)
21 (36.8%)
Gender Transformative Programs Were
Even More Effective in Achieving Change
(n=27 programs)
30%
44%
26%
Effective
Promising
Unclear
Take It to the Policy Level
• Engaging male policymakers in
open, public discussions about
harmful aspects of traditional
manhood
• Making clear the “costs” of traditional
views of manhood in campaigns,
policy briefings
• Engaging men and boys via the
public sector: military, police, public
education, health sector, national
youth corps, the Scouts, technical
schools
• Applying a perspective of
“masculinities” in national AIDS
programs and public health
programs
2004 Bangladesh Center for Communication
Programs, Courtesy of Photoshare
Thank You!
References
Barker G., C. Ricardo, and M. Nascimento. 2007. Engaging Men and Boys in
Changing Gender-Based Inequity in Health: Evidence from Programme
Interventions. Geneva: World Health Organization.
Cohen, Sylvie, Michelle Burger, Akinyele Dairo, and Wariara Mbugua. 2000. It
Takes 2: Partnering with Men in Reproductive and Sexual Health. New York:
UNFPA.
Doggett, Elizabeth and Britt Herstad. 2008. Men Matter: Scaling Up Approaches to
Promote Constructive Men’s Engagement in Reproductive Health and Gender
Equity. Washington: USAID|Health Policy Initiative. Available at:
http://www.healthpolicyinitiative.com/Publications/Documents/722_1_Men_Matte
r_IA8_FINAL.pdf.
Greene, Margaret, Naomi Walston, Anne Jorgensen, Mean Reatanak Sambath, and
Karen Hardee. 2006. From Adding to the Burden to Sharing the Load:
Guidelines for Male Involvement in Reproductive Health in Cambodia.
Washington: POLICY II Project. Available at:
http://www.policyproject.com/countries.cfm?country=Cambodia.
References, continued
Population Reference Bureau. 2004. SysteMALEtizing Resources for Engaging Men
in Sexual and Reproductive Health. Washington: PRB for the IGWG. Available
at: http://www.igwg.org/Publications/Systemaletizing.aspx.
UNAIDS. 2008. 2008 Report on the Global AIDS Epidemic. Geneva: UNAIDS.
UNFPA. 2005. State of the World Population 2005. Partnering with Men and Boys.
New York: UNFPA. Accessed at:
www.unfpa.org/swp/2005/english/ch6/chap_page1.htm.
UNFPA. 2008. State of the World Population 2008. New York: UNFPA. Accessed at:
http://www.unfpa.org/swp/2008/en/04_reproductive_health.html#3.