SRHとはsexual and reproductive healthのこと。日本では「男女のリプロダクティヴ･ライツ」といった具合に並列的に扱うことで、女性のSRHの保障と、そのための男性の関与という本来の意味が薄れています。以下は、Pan American Health OrganizationのもうひとつのFact Sheet（INVOLVING MEN IN SEXUAL AND REPRODUCTIVE HEALTH）より
Why Involve Men?
Women have been both the principal targets and
beneficiaries of international and national family
planning and reproductive health programs. Policy
makers, health planners and service providers have
overlooked and even ignored the influential role that
men play in the sexual and reproductive health (SRH) of
their families, and especially their sexual partners. The
failure to incorporate men in SRH promotion,
prevention, and care programs has had a serious
impact on their health, the health of women, and the
success of the programs themselves.While many advocate for involving men in sexual and
reproductive health to improve women’s health, various
researchers and advocates have also affi rmed that
engaging men in these issues is also necessary for their
own sexual and reproductive health and wellbeing.
The main reasons for this growing interest are:§ Recognition of men’s influential role in the sexuality
and reproduction of couples;§ Recognition that men have their own distinct SRH
needs and demands;§ Awareness that inequitable gender relations affect
the SRH of both sexes;§ Increasing evidence of the negative effects of men’s
risk behavioural patterns on women and children;§ Concern over increasing rates of STIs and HIV/AIDS;
§ Desire to prevent unwanted or unplanned
pregnancies through the increased or more
effective use of family planning methods;§ Requests from women to incorporate their partners
into SRH promotion, education, and service
delivery, particularly pregnancy and delivery.Why aren’t more Men Involved?
A number of factors combine to limit men’s involvement
in their and their partners’ SRH:§ Gender roles – masculinity and femininity - are internalized early in life, when boys and girls learn that society has different expectations for each of them. Masculinity includes a strict set of norms that influence men’s sexual and reproductive health behaviour and attitudes;
§ A man’s virility is measured by his sexual conquests and number of children, and by the behaviour of the females in his familial/social circle (wife, girlfriends, daughters, mother etc.);
§ In Latin America and the Caribbean, sexual initiation generally begins earlier for males than for females, and adolescent males are required to constantly prove their manhood through sexual activity. Young and adult men often view sexual initiation and intercourse as a way to prove they are “real men” and to gain status in their peer group, rather than as an opportunity for intimacy;
§ It is expected that men will be sexually knowledgeable. In reality, both boys and men are frequently either uninformed or misinformed, but do not seek information for fear of appearing inexperienced;
§ Most men know about contraceptive methods, though this knowledge does not always translate into practical or consistent use of contraceptives;
Though men have traditionally held more social,
economic, and political power than women, they
nevertheless seek ways to increase or affirm it, such
as rape and domestic violence, sexual harassment,
withholding of financial and other economic
resources, and exercising control over women’s
behaviour, including their fertility. Research has
found that only a few men are successful at
repudiating the hegemonic model of masculinity, so
great is the pressure from both male peers and the
media to conform to it.Involving more Men: Recommendations
Rather than viewing men from the perspective of a deficit or a challenge, policy makers as well as project planners should consider how men are already involved as sexual partners, husbands, and fathers, and use those roles to try to involve men in sexual and reproductive health programs and services from a gender equality and partnership perspective. Partnership signifies men and women making decisions and choices together, from equal positions of power, to achieve common sexual and reproductive health goals. In particular, couple communication and negotiation is generally a positive factor and should be promoted in order to reach agreement on SRH goals, such as family planning and HIV/STI prevention and increase gender equality among couples.
Some innovations that have been successful in involving men in SRH are:
§ Incorporating the gender and life cycle perspectives into SRH programs;
§ Creating opportunities for discussion about masculinities and gender equality among both men and women;
§ Providing comprehensive SRH services for men that go beyond contraception, and that include the provision of counseling to men on family planning, contraception, STI transmission and couple communication;
§ Reaching men in the workplace or where they socialize, instead of relying on a
traditional clinical setting;§ Using social marketing campaigns to promote male involvement in SRH;
§ Involving local opinion leaders in marketing campaigns and service design and delivery;
§ Reaching out to adolescents and young men through creative marketing and public communication;
Notes
1. Morris, L. Determining Male Fertility through Surveys: Young Adult Reproductive Health Surveys in Latin America. Paper presented at a meeting of the IUSSP
Committee on Demography and Anthropology at the IUSSP Conference in Montréal, 1993.
2. UNAIDS. Men and AIDS: A Gendered Approach. Geneva: Joint United Nations Programme on HIV/AIDS (UNAIDS), 2000.
http://www.unaids.org/wac/2001/Files/WACmenE.pdf
3. Morris, 1993.
4. Necchi, S. and M. Schuffer. Adolescente varón: Iniciación sexual y conducta reproductiva. Buenos Aires: University of Buenos Aires, World Health Organization,
CONICET, 1998.
5. Zambrana, E., C. Reynaldo, D. McCarraher, and P. Bailey. The Impact of Knowledge, Attitudes and Practices of Men Regarding the Regulation of Fertility on the
Lives of the Women of Cochabamba. North Carolina: Family Health International, 1998. http://www.fhi.org/en/RH/Pubs/Briefs/bolivia/bolab26.htm
6. Pantelides, E. Male Involvement in Prevention of Pregnancy and HIV: results from Research in Tour Latin American Cities. Paper presented at the WHO Meeting
of Regional Reproductive Health Advisors. Washington DC, 2001.
http://www.who.int/reproductive-health/publications/rhr02_3_male_involvement_in_rh/contents.en.html
7. UNAIDS. AIDS Epidemic Update. Joint United Nations Programme on HIV/AIDS (UNAIDS), 2001.
http://www.unaids.org/worldaidsday/2002/press/Epiupdate.html
8. Ministry of Health. Encuesta Nacional de Salud Masculina. Honduras: Ministry of Health, 1998.
