Are men well served by family planning programs?

Although the range of contraceptives includes methods for men, namely condoms, vasectomy and withdrawal that men use directly, and the Standard Days Method (SDM) that requires their participation, family planning programming has primarily focused on women. What is known about reaching men as contraceptive users? This paper draws from a review of 47 interventions that reached men and proposes 10 key considerations for strengthening programming for men as contraceptive users. A review of programming shows that men and boys are not particularly well served by programs. Most programs operate from the perspective that women are contraceptive users and that men should support their partners, with insufficient attention to reaching men as contraceptive users in their own right. The notion that family planning is women’s business only is outdated. There is sufficient evidence demonstrating men’s desire for information and services, as well as men’s positive response to existing programming to warrant further programming for men as FP users. The key considerations focus on getting information and services where men and boys need it; addressing gender norms that affect men’s attitudes and use while respecting women’s autonomy; reaching adolescent boys; including men as users in policies and guidelines; scaling up successful programming; filling gaps with implementation research and monitoring & evaluation; and creating more contraceptive options for men

Opção pela vasectomia e relações de gênero The option for vasectomy and implications for gender relations

Realizou-se um estudo qualitativo para conhecer o processo de decisão de casais pela vasectomia, as relações de gênero envolvidas e identificar as fontes de informação sobre o método. Foram feitas entrevistas semi-estruturadas com vinte casais que solicitaram a vasectomia no Ambulatório de Reprodução Humana do Centro de Assistência Integral à Saúde da Mulher, Universidade Estadual de Campinas. Para a análise dos dados, utilizou-se a técnica de análise do conteúdo. A maioria dos casais optou pela vasectomia como último recurso anticoncepcional, após ter utilizado outros métodos, nem sempre com sucesso. Os homens se auto-atribuíram a iniciativa de se submeterem à cirurgia dada a impossibilidade de criarem mais filhos. Pessoas significativas para eles foram as principais fontes de informação, suscitando interesse pelo método e afastando os temores. As relações de gênero desveladas oscilaram entre um modelo quase patriarcal, com o predomínio dos homens nas decisões da vida familiar, e um modelo ambíguo nas decisões reprodutivas, em que as mulheres haviam assumido a responsabilidade da anticoncepção até que, diante da inevitabilidade da esterilização, os homens consideraram que deveriam colaborar.<br>A qualitative study was performed to: investigate the process that leads couples to decide for vasectomy; characterize the gender relations involved in this process; and identify sources of information on vasectomy. Semi-structured interviews were conducted with 20 couples who had requested vasectomy at the outpatient clinic of the Center for Integrated Women's Health Care, State University in Campinas, São Paulo, Brazil. A structured form was used to collect social, economic, and demographic data. The content analysis technique was used for data analysis. The majority of couples opted for vasectomy as a last resort after attempting numerous other contraceptive methods, not always successfully. The emerging gender relations showed fluctuation between: (1) a more rigid, quasi-patriarchal model characterized by male predominance in the family's decision-making and (2) a more ambiguous model in relation to reproductive decisions, whereby women assumed responsibility for contraception until the situation became untenable, at which point men faced up to the unavoidable necessity of sterilization. At this point the male partners felt they should collaborate