Inter Press Service - September 1, 2004
Jacklynne Hobbs

LONDON, Sep 1 (IPS) - The same cannot be said of the extent to which men feature in sexual and reproductive health programmes, however.

'Countdown 2015', currently underway in London, aims to assess progress made in implementing the goals of the International Conference on Population and Development held in Cairo in 1994. ('Countdown 2015' ends Thursday, Sep. 2.)

A plan of action produced in the Egyptian capital stated: "Changes in both men's and women's knowledge, attitudes and behaviour are necessary conditions for achieving the harmonious partnership of men and women."

"Special efforts should be made to emphasise men's shared responsibility and promote their active involvement in responsible parenthood, sexual and reproductive behaviour," it added.

Ten years later, these goals remain largely elusive.

"More has been done in the last decade than in the previous 40 years to engage men in discussion, in issues and even in behaviour change with respect to sexuality," Steven Sinding, Director-General of the International Planned Parenthood Federation, told IPS.

"But, I think we're still at a very early stage of discovering how to do that - and what works. Cairo gave substance to the term 'male participation' or 'male responsibility', (however) many governments have had difficulty translating the Cairo language into concrete programmes."

It's not difficult to understand why women remain the primary focus of sexual and reproductive health policy. Family planning initiatives have traditionally been included in programmes that deal with the health of mothers and children.

In an environment where the funding for such initiatives is often scarce, there are fears that introducing additional programmes for men would place an unbearable strain on resources.

Certain research has indicated that men are more open to discussions about family planning than popular beliefs would suggest. But, says Sinding, there's no denying that efforts to extend sexual health programmes to men must also do battle with deeply-rooted beliefs about male sexuality that link it to conquest, dominance and multiple partnerships.

"You know, it's not long ago that the sons of aristocrats throughout Europe were introduced to sex through either the maids, or their fathers taking them to commercial sex workers," he notes.

And, "anti-macho role models" are still fairly thin on the ground, adds Sinding: "The idea of the responsible, caring, nurturing man û the monogamous man, the man who cares about the family and also about the health of women - has not been idealised."

All of these factors conspire to keep much that is related to gender firmly in the female camp.

"We need the men to come on board in a much more serious way," says Gita Sen, a conference delegate and professor at the Bangalore-based Indian Institute of Management. "The tendency is for them to say, 'Oh, gender û that's for the girls and the women'."

However, the AIDS pandemic has given this debate a new urgency. In the context of HIV, promiscuity can carry with it a death sentence û not only for men who have sex with several people, but also their wives and partners.

In fact, a variety of biological factors make women more vulnerable to infection by the AIDS virus than men û something that has seen the ratio of HIV-positive women to men increase in Africa, the continent most affected by the pandemic.

According to the Joint United Nations Programme on HIV/AIDS, women now account for almost 60 percent of persons aged 15 to 49 who are living with HIV (this age group comprises the most economically-active people in a society). In the 15 to 24 age bracket, women account for 75 percent of HIV-positive persons.

Confronted with such statistics, delegates to the London meeting say that programmes on sexual and reproductive health should focus on the youth as far as possible.

"I believe that, in the case of men past the age of youth, education and gender equality is difficult - and I think we need innovation there, to bring them along," Sen told IPS.

"But with young people you can do it much more, because they're not totally set in their ways. I believe that you need to start much earlier than adolescence; you need to start around the ages of seven to 10, 11, 12 û that's where I think the critical moments have to be, in terms of educating boys," she adds.

Fred Sai, an advisor on population, reproductive health and HIV/AIDS to Ghana's president, agrees - saying the Planned Parenthood Association of Ghana has already taken the first steps in this regard.

"Its major programme is called 'Young and Wise', and it is this question of gender equality and equity which is being tackled at that level," he told IPS. Sai also chaired the main committee of the Cairo conference, which negotiated the plan of action that emerged from the meeting.

The question that begs asking, of course, is how effective such programmes can be if the behaviour of parents and other family members undermines the progressive viewpoints being conveyed in classrooms and youth groups.

There is a great deal of research, says Sinding, which shows that values communicated in the home are often the most powerful in forming attitudes on a variety of issues. But, the power which schools and youth programmes have to change values is not to be underestimated.

"I know in my own country that a very important stimulus to the reduction in smoking was children coming back from school and saying to their parents, 'Smoking is bad for you and it's bad for us'," he notes.

As for the older die-hards, experience can be the best teacher.

"What is convincing is when a couple moves from the countryside to the city, and discovers that the only way they can improve their well-being is for the woman to work," says Sinding.

"Families realise, men realise, that the only way they can survive and prosper is by having few children - because children become very expensive in the city. And, the women can go to work if they're not constantly bearing or caring for children.

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