"Men have to be responsible about family planning and [pregnancy]...
They also have to think about [childrearing] because the tendency
is to leave the woman to take care of everything."
Men in Colombia are communicating more
openly with their partners, their families, and each other.
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According to a study conducted last fall in Colombia's five largest
cities, attitudes such as this--voiced by a young, male focus group
participant in Medellín--are becoming more common. Rather
than being seen as acting macho and behaving irresponsibly, men
are now expected to communicate more openly with their families
and take more responsibility for their own and their partners' sexual
and reproductive health.
Extensive Research Effort
The aim of the study, which was conducted in Baranquilla, Bogotá,
Bucaramanga, Cali, and Medellín, was to find out men's, women's,
and health care providers' knowledge, attitudes, and needs regarding
sexual and reproductive health services for men. Data were collected
through 60 focus groups, 720 surveys of service users and nonusers,
45 interviews with health care staff, and five couples' life histories.
AVSC supported the study, which was conducted by the Center for
Multidisciplinary Research for Development, a research organization
affiliated with the University of Valle in Cali.
Few Services Offered
The study found that while men, women, and providers want men
to assume greater responsibility for their and their partners' reproductive
health, providers are ill-equipped to help them achieve this. Only
nine of the 14 health care facilities surveyed offered any services
for men, such as general health care or vasectomy (four sites),
health care promotion or prevention (two sites), and educational
programs aimed at men (two sites).
According to providers, one reason for the lack of services is that
even when they are available, few men know about and use them. Thus,
the need for services is perceived as being low, and they are not
offered. In addition, existing services focus on disease management,
so there are no programs, policies, or protocols to guide them in
developing preventive services.
The low demand for men's services supports another study finding:
70% of the men and 57% of the women surveyed were unaware that men
had any sexual or reproductive health care rights in Colombia. This
is despite passage of a groundbreaking 1993 law guaranteeing health
care services for all, including reimbursement for men's reproductive
health services.
Pilot Services Planned
Given the law mandating universal health care and attitudes about
men's changing role, the time is right for AVSC and our counterparts
to establish men's services in Colombia.
Using the study results, AVSC will work with health care facilities,
the Ministry of Health, and health insurance companies to pilot
sexual and reproductive health services for men in Bogotá,
Cali, and Medellín. The program will also focus on health
care rights, men's roles in the family, and community outreach to
alert men to existing services.
Andrea Eschen is a senior director of AVSC programs in Latin
America. Fabio Castaño manages AVSC programs in Colombia.
