Source: The Communication Initiative Network Author: International Planned Parenthood Federation (IPPF) This research report from the International Planned Parenthood Federation (IPPF) describes and analyses 12 programmes and interventions from around the world that have sought to alter the sexual attitudes and behaviours of men.
It is intended for use by programme managers, service providers, and researchers who are part of IPPF Member Associations and other organisations seeking to develop more effective ways of engaging men and boys and addressing their health needs.
The 12 case studies explored working with men from a range of backgrounds, took place in a variety of settings, and addressed a range of issues. They focus on:
Sexuality and sexual and reproductive health:
Case study I: Male involvement in sexual and reproductive health, Namibia - Face-to-face sexual and reproductive health training was held for pastors, nurses, defence officers, male police officers, soccer club managers and coaches, and members of the Namibia Defence Force. Other communication channels described in this case study include printed materials, video clips, person-to-person contacts, group meetings, drama performances during national events such as World Population Day and World AIDS Day, and other outreach activities.
Case study II: Engaging transgender men in preventing sexually transmitted infections (STIs), Indonesia - Involved the distribution of safer sex packages (a packet containing one condom with a sachet of water-based lubricant and behaviour change communication material) and various meetings organised around the waria (transvestite) community in Jakarta.
Case study III: Engaging men who have sex with men and male sex workers in preventing STIs and HIV, Indonesia - Field coordinators and workers conducted group discussions with male sex workers and men who have sex with men, and field staff distributed behaviour change communication materials. Meetings with a condom supplier and STI service providers were held, in addition to a number of advocacy and networking meetings.
Case study IV: Engaging men who have sex with men and male sex workers in preventing STIs and HIV, Bangladesh - Outreach workers and peer educators contacted intended groups through one-to one meetings and group discussions at cruising sites and integrated health centres. In addition to providing referrals, outreach workers and peer educators provided strategic behaviour communication materials.
Case study V: Providing sexual and reproductive health services to the armed forces, Benin - Discussion groups and radio programming covered family planning, STIs, HIV prevention, maternal and child health (including benefits of pre- and post-natal care, attending birthing, spacing of children, and breastfeeding).
Violence:
Case study VI: Engaging men in prevention of rape as a weapon of war, Democratic Republic of Congo - "The programme included two additional components to help increase awareness about the themes addressed in the training at the community level: the formation of working groups with male and female citizens, and a public awareness campaign to emphasize the need to support rather than stigmatize women who suffered rape and other forms of violence."
Case study VII: Engaging young men in prevention of violence, Northern Ireland - Consultations took place with 22 groups of young men in different parts of Northern Ireland to identify themes for the programme. Six workshops/performances were then developed based on the themes that emerged through the consultations. "Methods and sessions related directly to the issues that young men raised in the consultations including day-to-day violence, alternatives to violence, and understanding and managing their own anger. Sessions also often involved movement, activity and a bit of fun."
Case study VIII: Engaging men in prevention of gender-based violence, Liberia - The campaign organised actions in each community including street parades, performances, sports programmes, and speeches. Materials were developed that included T-shirts, hats, and posters reflecting themes of positive masculinity and men as partners. The Lonestar cell phone corporation also sent a text message about the campaign to 150,000 Liberian subscribers.
Healthy relationships:
Case study IX: Engaging young men as partners in healthy sexual relationships, Kenya, Zambia, Tanzania, and Uganda - Provision of sexual and reproductive health and rights information and education, for young men in particular, which has involved training, development of youth-driven activities, establishment of clubs to encourage youth access to HIV voluntary counselling and testing (VCT) services, and so on.
Case study X: Engaging boys and girls in developing healthy relationships, Canada - Seven schools with 1,143 7th to 9th graders took part in the programme. The programme consisted of 53 student-oriented activities, handouts, and print/video resource lists.
Case study XI: Promoting more gender-equitable attitudes in men, Brazil - One intervention component was interactive group education sessions for young men led by adult male facilitators. The other was a community-wide "lifestyle" social marketing campaign to promote condom use, using gender-equitable messages that also reinforced those promoted in the group education sessions.
Case study XII: Challenging and changing gender attitudes among young men, India - Nine peer leaders from the communities underwent a 2-week training programme to strengthen their gender- and HIV-related knowledge and facilitation skills and were trained in qualitative methods of data collection. They were then trained to facilitate group education sessions. They recruited 126 young men to participate in four groups of 30–35 each over a 6-month period.
For each of the 12 programmes, effectiveness was rated by assessing evaluation design and level of impact. Combining these 2 criteria, programmes were rated as effective, promising, or unclear. In addition, the case studies are identified as one of the following: gender-neutral (distinguishing little between the needs of men and women, neither reinforcing nor questioning gender roles); gender-sensitive (recognising the specific needs and realities of men and women based on the social construction of gender roles); or gender-transformative (seeking to transform gender roles and promote more gender-equitable relationships between men and women). The case studies are based on the following format: background, key beneficiaries, objectives, methods, results, good practice and lessons learned, recommendations for the future, analysis of gender perspective, and assessment of programme effectiveness.
An excerpt from the report follows:
"The main findings were:
In all areas - sexuality and sexual and reproductive health, violence and healthy relationships - the interventions led to behaviour change. This further strengthens the existing evidence base showing that interventions with men and boys actually work.
The majority of programmes were found to be either effective (42 per cent) or promising (50 per cent) in reaching men and boys, addressing their needs and changing their attitudes and behaviours...
Seven of the programmes were gender-transformative, four were gender-sensitive and one was gender-neutral.
Gender-transformative programmes were found to have a higher rate of effectiveness.
Although the gender-transformative programmes were found to have a higher rate of effectiveness, programmes that adopted a gender-sensitive approach were also effective.
Those interventions that combined good practice from a range of health issues (for example sexual and reproductive health and violence) were more effective.
...[T]he data does show some recurrent themes that warrant being reflected in future practice. These include:
using a mix of methods such as training peer leaders, educational workshops, service provision and awareness campaigns
undertaking extensive baseline work to establish the current situation, priorities for target groups, and to inform the materials and format of the programme
ensuring that programmes create a context in which men can discuss what it means to be a man without fear of ridicule and where reflection and the exploration of alternatives was actively encouraged
Few of the programmes had been scaled up from a pilot stage. This highlights the importance of a greater focus on ensuring interventions with men and boys are integrated into existing organizational and government strategies and workplans...
These findings clearly suggest a strong link between programme effectiveness and the utilization of a gender transformation approach. Interventions seeking to engage men and boys should therefore seek to adopt this approach, and move beyond only gender-neutral or gender-sensitive programming.
Good practice and lessons learned:
...Target women as well as men and boys when working with men. This is because gender norms and the associated inequities are not maintained and produced by men alone but through relations between the genders.
Some men, but not all, are resistant to change. Equally, some women, but not all, are supporters of change. Programmes should reflect these nuances in their implementation.
Plan for sustainability of programmes from the outset.
Programmes benefit if they include both mixed and single sex group work.
Provide programme staff with training that aims to equip them with skills and confidence in working with men.
Interventions with men should combine both challenging and supporting them.
It is important for interventions with men to have goals and outcomes that are concrete, meaningful and useful to men.
Equip men with skills that allow them to make changes to their behaviour as well as to address knowledge and attitudes.
It is beneficial to base work on men's and women's needs and to involve them in consultation from the beginning of programme development.
Interventions should 'go where men are at'; that is, to take interventions to settings where they are to be found rather than expect them to access interventions in settings with which they may be unfamiliar or in which they may feel uncomfortable.
Consider how programmes can be integrated into existing structures and systems, for example subjects in school curricula, and teaching and professional training.
Ensure that programmes seek to acknowledge and validate men's willingness to change and celebrate these changes when they occur.
Recognize that some men are extremely marginalized - especially men who have sex with men and male sex workers - and that interventions to reach these men need to recognize that their marginalization is in part derived from stigma and homophobia.
Recognize that the public face of masculinity is often completely at odds with the private face of masculinity and that many men need the tools to negotiate the tension between the interface.
It is important to set out with a positive message - aiming to correct the 'faults' in men does not appeal to them.
Recognize that many men are struggling to come to terms with social and cultural change that undermines previously-held certainties about male power, authority and roles, and are actively seeking new identities in relation to other men and women and children.
Accept that men's engagement with programmes may be inconsistent and irregular. This is often because other activities take priority.
Be aware of the importance of transitions in men's lives and the impact that these may have on their willingness and ability to engage with programmes and effect change in their lives..."