IV. Advocacy and IEC strategies
Advocacy will be necessary to reach policy and decision-makers, as well as programme managers, in order to convince them that programmes, activities and resources need to be focused on promoting and facilitating male involvement in reproductive health. Information, education and communication (IEC) efforts will focus on promoting active involvement of the men themselves in reproductive health issues throughout their life cycles. These strategies will need to be tailored to the socio-cultural aspects of each target audience.
1. Collect and assess baseline information
It is important to begin any advocacy and information, education and communication (IEC) initiative with a participatory approach to collecting and assessing baseline information about the current situation (socio-cultural, political and health) related to gender roles and responsibilities, as well as their impact on the reproductive health situation of both men and women in the population. Also, it will be important to identify the means through which information and ideas are transmitted to the population, to see who are the true community leaders and power brokers that affect public opinion. In the area of interpersonal communications, information could be collected to respond to issues such as whether separate discussion groups should be conducted for men and women, what topics can be discussed in mixed groups and when to target couples rather than men and women as individuals. Focus group discussions with men can be very helpful in collecting this type of information.
2. Integrate into existing programmes, activities and strategies
It is possible to integrate skills and approaches into activities and services of different agencies that can complement or support one another. For example, counselling is important for helping men and women to better understand how strengthening male involvement in reproductive health can be of benefit to both them and their families. Counselling is particularly important for young people, for it is an effective means of personalizing information and responding to concerns and fears and correcting misconceptions, and it can be incorporated into school activities, youth centre activities, as well as in places where young men tend to gather in the community. Interactive and participatory educational approaches can be incorporated into already planned activities, including small group presentations, role plays and simulation games. Staff outreach, hotlines (where there is access to effective telephone service) and resource centres targeted specifically for boys and men can help them gain access to relevant reproductive health information and evaluate how it relates to themselves personally, as well as provide an opportunity to have a confidential dialogue over sensitive issues with a trained counsellor.
3. Identify and promote convincing arguments
Both individuals and groups of people with common interests will be more inclined to try out behaviours that are not the ones traditionally linked with their gender if they are convinced that such behaviour will be of benefit to them and their families socially, economically, and educationally. It is important that the goal of education and communication activities is seen as stimulating reflection and discussion rather than persuading and convincing people to adopt ready-made solutions. Change can only come from within the group and it usually knows best what is feasible and likely to work. Thus, a key goal is to help the group come up with its own ideas for solutions. Barriers to establishing equitable gender relationships should be identified along with possible ways to overcome them.
Since people see the world in different ways, depending upon their perspectives, it is helpful to segment the population so that messages can be appropriately developed and shaped. Accordingly, within the general population, it helps to decide if the arguments are being developed for men or women, people that are single or have children, people that are young, middle aged or older, as well as looking at differences based upon income and educational levels and social status. Young people are particularly known for having special words and a language of their own.
For policy makers some convincing arguments might come from citing the relationship between internationally recognized human rights instruments and promoting gender equity, strengthening and supporting the male role, and promoting reproductive health. Also, decision makers will be attracted to the cost-benefit arguments of supporting responsible male involvement in reproductive health and how effective it is to focus on prevention through early intervention, particularly with young people. Establishing a national policy can help to institutionalize the political commitment and vision of the government for more equitable roles and responsibilities. It can also help to promote a consensus among leaders and organizations in a position to promote reproductive health, provide a consistently applicable framework for identifying and responding to needs, recognizing that men have special needs distinct from women but equally important, and establishing a wider perspective that includes more than the health sector, such as employment, education, family life and the media.
In developing appropriate messages, it is important to focus on the positive aspects of what can be achieved by strengthening the role of men in reproductive health. It can be helpful to package and disseminate research findings that highlight the importance of male reproductive health needs and the importance that their participation in reproductive decisions has for women's health as well. Men can be very sensitive to anything perceived as an attack on them and good humour is an essential ingredient in information, education and communication (IEC) efforts. Entertaining stories which can be presented in many ways are a good avenue for broaching sensitive topics and stimulating discussion in groups. At the same time, it is important to combat some of the negative myths related to how people perceive men's attitudes and behaviours.
4. Sensitize media specialists and orchestrate mass media collaboration
Media professionals are looking for information and stories that will be exciting, news worthy and that will capture the attention and interest of the population. They need to be sensitized to the importance that male involvement has for both men's and women's reproductive health and they need to be continually provided with new information that is expressed in a catchy way so that they themselves will be motivated to promote the topic. Since the mass media is an ongoing means of sending messages and influencing public opinion, time and effort invested in cultivating the collaboration of media specialists can have a big pay off.
5. Mobilize other means of communication
Traditional means of communication, such as drama, folklore, songs, dances, utilizing local markets, fairs and festivals, as well as mass communication such as television, radio, newspapers and magazines are all very effective in disseminating information and promoting new ways of looking at gender roles and responsibilities. They can be an entertaining way of using drama, dialogue and debate to highlight the most pertinent issues and provide various perspectives on how they might be addressed. Printed materials, such as fotonovelas and comic magazines are popular with young people and adults with a minimal literacy level. While being entertaining, they can be an effective forum for reproductive health information dissemination, providing real life examples of issues such as sexuality that people might otherwise feel uncomfortable discussing.
Other helpful approaches include: using personal stories to illustrate why the issue of gender is important and how others have developed more equitable and healthy relationships; ensuring that where appropriate there are facts to substantiate the messages; and utilizing quotes and statements from people that are well known and respected.
6. Start where there is the best chance of success
Changing behaviours related to gender roles and responsibilities may be a lengthy process. Resistance to change is firmly entrenched and a single exposure to an idea is not sufficient to result in such change. Accordingly, when promoting gender role behaviour change, it will be important to seek out those individuals who might be more receptive to change or to trying something new, for these are the ones who will be most likely to take the risk of going against the tide of what the others do. Also, it is important to enlist support from those that are known and admired by the target audience.
Sharing the work in Burkina Faso
The sexual division of work and responsibilities in most societies imposes on women a multitude of "feminine" tasks which tend to be more numerous than men's. Thus time budget studies inevitably find that women have a longer working day than men do. Many West African women, for example, put in a 12-hour day. Concerned by the health consequences of this workload, the Regional Antenna of Women and Health (with financial support form the Canadian International Development Agency) undertook a pilot project in selected villages in Burkina Faso to encourage men to help with domestic tasks. The results seem to indicate that the sexual division of labour is more flexible than pessimists might have thought.
One of the men involved in the project tells of the difficulties faced by the men who decided to help their wives as a result of the training and discussion groups held by the project. "When we started carrying the water and fetching the wood, even the little children made fun of us because this had never been seen". Nevertheless, the elders recognized that there was no taboo against men doing domestic tasks. After the initial difficulties' helping the women has become a habit and the men are reaping the benefits: "Our wives are cleaner, smarter, they have some time to look after themselves and us, they are more relaxed" Both wives and husbands claim they discuss problems more often. It is interesting that the men would now like to acquire bicycles or wheelbarrows so that carrying wood and fetching water can become less tinny.
Extracted from "Femmes et Santé", No.5, November 1993