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OJHAS Vol. 11, Issue 1:
(Jan-Mar 2012) |
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| A Qualitative Study on Men’s
Involvement in Reproductive Health of Women among Auto-rickshaw Drivers
in Bangalore Rural |
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Vaishali S. Gaikwad, Associate
Professor,
TS Mahadeva Murthy, Associate Professor,
Sudeepa D, Assistant Professor,
Department of Community Medicine, MVJ Medical college & RH, Dandupalya,
Kolathur Post, Hosakote, Bangalore Rural - 562114, India. |
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Address for Correspondence |
Associate
Professor,
Department of Community Medicine,
MVJ Medical college &
RH
Dandupalya, Kolathur Post,
Hosakote, Bangalore Rural - 562114, India.
E-mail:
drvbg@yahoo.com |
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Gaikwad VS, Murthy TSM, Sudeepa D. A Qualitative Study on Men’s
Involvement in Reproductive Health of Women among Auto-rickshaw Drivers
in Bangalore Rural. Online J Health Allied Scs.
2012;11(1):3 |
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Submitted: Feb 19,
2012;
Accepted: Mar 24, 2012; Published: Apr 15, 2012 |
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| Abstract: |
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Background: Men’s reproductive health directly affects the
partner’s reproductive health. Men also may serve as gatekeepers to
women’s access to reproductive health services. “Male involvement” in reproductive health and
family planning programmes is not just promoting the use of male methods
of contraception, but men’s supportive roles in their families. Objectives: 1. To know the attitudes of men regarding the family
planning and women’s health. 2. To know the involvement and participation
of men in maternity, delivery, post-natal care and family planning.
3. To study the treatment seeking behaviour of men for the reproductive
health. problems. Methods: The study was conducted on the auto-rickshaw drivers
in the Hoskote town. Total 96 married men were interviewed using a well-designed
and pretested questionnaire. The aspects covered are awareness and practices
related to RTIs/STIs/HIV/AIDS, family planning, antenatal care and treatment
seeking behaviour for the reproductive health problems. Results: Majority (62.50%) of the men did not help their
wives seek antenatal care. Only few 7(7.29%) were aware of parameters
of antenatal care. There were 44 (45.83%) men who reported the symptoms
of reproductive tract infections (RTIs). Among the men suffering
from RTIs, only 32(72.73%) took treatment. Only 6(6.25%) people were
aware of the all family planning methods. There were 39 (40.63%) participants
having extramarital sexual relations with prostitutes or other females,
of which 25(64.10%) people do not use condoms while engaging in the
high risk sexual encounters. There were 34 (35.42%) men not aware of
HIV/AIDS. Conclusion: Antenatal care and family planning are considered
the primary responsibility of the women. Also majority of the men in
the study group have high risk sexual behaviour. The awareness regarding
HIV/AIDS is low.
Key Words:
Men’s involvement; Reproductive health; Contraception;
Antenatal care.
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In recent years, many family planning and other reproductive
health programs have become interested in the topic of men and reproductive
health. These programs recognize that men’s reproductive health directly affects
that of their partner’s health. Men play key roles in supporting women’s and children’s
health, preventing unwanted pregnancies, slowing the transmission of sexually transmitted
infections, making pregnancy and delivery safer, reducing gender-based violence and also have
distinctive reproductive health needs of their own.(1)
It is shown in some studies that men also may serve as gatekeepers to women’s access to reproductive health
services.(2) However, reproductive health programs have traditionally
focused on women. The exclusion of men from such programs considerably undermine
it’s own effectiveness.As men are dominant decision maker in the society,
they exert a strong influence over their partners, determining the timing and conditions
of sexual relations, family’s social well-being and access to health care. Their
distance from reproductive health programs debarred female from their sexual rights
coupled with lesser utilization of reproductive health services. As a matter of fact,
not only male, but also a large proportion of ill health suffered by females. Such
gender inequalities in access to health care create a wide gap between facilities available
and its utilization and pose a challenge to reproductive health services to overcome the deficiency.(3) Traditionally, health care providers and researchers
in the field of reproductive health have focused almost exclusively on women when planning
programmes and services, especially with regard to family planning, prevention of unwanted
pregnancy and of unsafe abortion, and promotion of safe motherhood. In recent
years, efforts have been made in many countries to broaden men’s responsibility
for their own reproductive health as well as that of their partners.
Measures are also being taken to improve gender relations by promoting
men’s understanding of their familial and social roles in family planning
and sexual and reproductive health issues. The Cairo International Conference
on Population and Development (ICPD) Programme of Action (1994), urged
that: "… 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; prenatal, maternal child health; prevention of sexually
transmitted diseases, including HIV; prevention of unwanted and high-risk
pregnancies; shared control and contribution to family income, children's
education, health and nutrition; recognition and promotion 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".
The above challenge calls for more intense efforts
to foster partnerships between men and women which help men identify
with the magnitude and range of reproductive illnesses which affect
women .(4) “Male involvement” in reproductive health and family
planning programmes is not just promoting the use of male methods of
contraception, but men’s supportive roles in their families, communities
and workplaces to promote gender equity, girls’ education, women’s
empowerment and sharing of child rearing and caring.(5)
Objectives of this study:
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To know the attitudes of men regarding the family
size preferences, family planning and women’s health.
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To know the involvement and participation of men
in maternity, delivery, post-natal care and family planning.
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To study the treatment seeking behaviour of men
for the reproductive health problems.
The study was conducted on the auto-rickshaw drivers
in the Hoskote town. Only married men having children were interviewed
using a well-designed and pretested questionnaire. Total 96 men participated
in the study. The men’s involvement in reproductive health has been
studied by examining their supportive role to wives and concern for
their own health problems. The aspects covered are awareness and practices
related to RTIs/STIs/HIV/AIDS, family planning, antenatal care and treatment
seeking behaviour for the reproductive health problems.
Total of 96 auto-rickshaw drivers participated in
the study. Most of them were educated up to secondary school and belonging
to the class III and IV of the Modified B. G. Prasad’s classification
of socioeconomic status.
There were 8(8.33%) respondents who reported that
their wives deliveries were home deliveries. The distribution of respondents
according to the parameters of men’s involvement in reproductive health
is shown in Table 1.
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Table 1: Distribution of respondents according to
the parameters of men’s involvement in
reproductive health |
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Help wife seek antenatal care |
36(37.50%) |
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Aware of antenatal care |
07(07.29%) |
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Aware of all family planning methods |
06(06.25%) |
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Currently using condoms |
26(27.08%) |
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Aware of HIV/AIDS |
62(64.58%) |
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Reported symptoms of RTIs |
44(45.83%) |
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Wife reported symptoms of RTIs |
45(46.88%) |
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Helped wife seek treatment for RTIs |
28(62.22%) |
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Reported extramarital sexual behaviour
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39(40.63%) |
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Wife undergone abortions due to unwanted pregnancies |
22(22.92%) |
Majority (62.50%) of the men did not help their wives
seek antenatal care. Only few 7(7.29%) were aware of parameters of antenatal
care.
There were 44 (45.83%) men who reported the symptoms
of reproductive tract infections (RTIs). The distribution of respondents
according to symptoms of reproductive tract infections is shown in Table
2.
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Table 2: Distribution of respondents according to
symptoms of reproductive tract infections |
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Urethral discharge |
31(32.29%) |
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Burning micturition |
06(06.25%) |
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Itching of genitals |
07(07.29%) |
Among the men suffering from RTIs, only 32(72.73%)
took treatment. The rest were not bothered about their own health. Among
the men who sought treatment, 14 (43.75%) men took treatment in PHCs,
8 (25%) in private hospitals, and 10 (31.25%) men went to quacks. Even
though most of them preferred government services , they reported
the attitude of govt. doctors was apathetic.
Among the study group 45 (46.88%) men reported that
the wife also suffers from the RTI symptoms but only 28(62.22%) men
actually helped their wife seek treatment.
Only 6(6.25%) people were aware of the all family
planning methods. Not a single man reported of vasectomy done or willingness
to do it. There were 22(22.92%) men who reported that their wife has
undergone previous abortions due to unwanted pregnancies.
In 12 (12.50%) men the wives have undergone tubectomy.
In the remaining group, only 26 (27.08%) men were using condoms occasionally
while having sex with the wife. There were 24 (25%) men having 3 or
more children. This shows the unmet need for contraception.
There were 39 (40.63%) participants having extramarital
sexual relations with prostitutes or other females, of which 25(64.10%)
people do not use condoms while engaging in the high risk sexual encounters.
There were 34 (35.42%) men not aware of HIV/AIDS.
Also most of them who are aware of it, have no proper information about
its transmission and prevention.
In the study, the men’s participation in the antenatal
care is less. Only few were aware of parameters of antenatal care. Similarly,
in a study by KB Saha et al, only 12% men helped their wife avail antenatal
care. (6) Men consider pregnancy and its care as a woman’s affair
and she is only the sole responsible for the all consequences. Accompanying
the wife to the hospital for visits is not considered as the husband’s
role. This shows their negligible participation in antenatal care.
There were 45.83% of men who reporting the symptoms
of reproductive tract infections RTIs. Urethral discharge was the commonest
symptom. Around one third of the men did not take any treatment. Among
the study group, 46.88% of the men reported that the wife also suffers
from the RTI symptoms but only few actually helped their wife seek treatment.
Similarly in the study by KB Saha et al, only 12 % of the men got the
wife treated.(6)
The awareness about all the family planning methods
was very low. Most of them knew only condoms and tubectomy as the family
planning measure. Only few men use condoms occasionally. The men’s
involvement in the family planning is very minimal. This may be due
to the lack of knowledge of various family planning measures. Also,
due to the myths pertaining to the male sterilization, ultimately the
responsibility lies on the female partner either to do sterilization
or land up with unwanted pregnancies. Contraception use and effectiveness
depends on the male involvement. Usually in India men are the decision
makers in the family and they may have significant influence over women’s
contraceptive choice and decisions.
Almost half of the participants were having extramarital
sexual relations mostly with the prostitutes and only about one third
of them were using condoms while engaging in sex. This shows that these
men and indirectly the female partners are at risk of sexually transmitted
infections and HIV/AIDS.
RTIs were reported more in the men having extramarital
sexual relations. ( p < 0.001) Similarly in a study by Kate M Dunn et al, men having extramarital sex and men having
sex with prostitutes were more likely to RTIs than men not having
extramarital sex.(7)
Antenatal care and family planning are considered
the primary responsibility of the women. Also majority of the men in
the study group have high risk sexual behaviour. The awareness regarding
HIV/AIDS is low.
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Educate the young men about the sexual responsibilities.
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Involve men in the maternal care.
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Train the medical personnel in counselling the couple
for the reproductive health.
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Design and implement IEC strategy about the reproductive
health issues and their role.
We sincerely acknowledge the management of MVJ Medical
College, Bangalore, for their support for this work. We are grateful to the group who participated
and extended their full cooperation in the study. We would like to thank
our field team and the local health workers who helped in this work.
- PAI (Population Action International). Men:
partners in reproductive health. 2001. Available at:
http://209.68.15.158/Publications/Reports/A_World_of_Difference/Men_Partners_in_Reproductive_Health.shtml. Accessed on Feb 10th 2012.
- Greene ME, Mehta M, Pulerwitz J, Wulf D, Bankole A, Singh S.
Involving Men in Reproductive Health: Contributions to Development, Background paper to the report Public Choices,
Private Decisions: Sexual and Reproductive Health and the Millennium Development Goals. Available at
http://www.unmillenniumproject.org/documents/Greene_et_al-final.pdf. Accessed on Feb 12th 2012.
- Saha KB, Singh
N, Jain
DC, Saha UC. Men’s Involvement in Reproductive Health: A study among the
Khairwar Tribe of Central India. Proceeding of National Symposium on
Tribal Health. pp 265-273.
- Programming for male involvement in reproductive
health. Report of the meeting of WHO Regional Advisers in Reproductive
Health WHO/PAHO, Washington DC, USA 5-7 September 2001.
- A study of involvement of
men in reproductive health in Jammu & Kashmir-India. Paper submitted for
presentation in the 2010 Annual Meeting of the Population Association of
America Dallas-Texas (USA) 15-17 April, 2010.
- Saha KB, Singh N,
Jain DC, Saha UC, Roy
J. Men’s
involvement in reproductive health among scheduled tribe: experience
from Khairwars, Central India. Rural and Remote Health 2007;7:605.
- Dunn KM, Das S, Das
R. Male Reproductive Health: A village based study
of camp attenders in rural India. Reproductive Health 2004;1:7.
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