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Engaging Men as Partners in Family Planning

Addressing Harmful Gender Norms and Increasing Use of Reproductive Health Services

Studies have shown that men are highly influential in couples’ decisions about family planning (FP) and that their engagement in FP and other health services can be beneficial to their partners, their children, and themselves. However, in many countries, deeply embedded ideas about appropriate gender roles, as well as myths and misconceptions about FP, create barriers to men’s support for and participation in FP services.

The Emanzi Program

Like many of his peers in the Rubirzi district of Western Uganda, Noel Julius says he used to neither endorse his wife’s use of family planning nor take an active role in household responsibilities. However, after participating in a male engagement program called Emanzi (which means “role model” in the local language), Julius said that he and the men in his village now support their wives using FP and that they better understand their own responsibilities at home.

Through the USAID-funded Advancing Partners & Communities (APC) project, FHI 360 implemented Emanzi in seven districts of Uganda. The program’s goal was to improve reproductive and sexual health outcomes by promoting men’s constructive engagement in health behaviors. Emanzi aimed to increase communication between men and their partners, improve couples’ relationships, and promote shared decision-making, while preparing Emanzi men to be role models for other men in their communities.

Men participate in the Emanzi program in Uganda. Photo: Christopher Arineitwe, FHI 360.

FHI 360 trained male community health workers (members of village health teams or VHTs) to serve as Emanzi facilitators. VHTs were already experienced in working with community members, knowledgeable about HIV and FP, and had proven to be interested in transforming harmful gender norms (as determined by a pre-training assessment using the Gender-Equitable Men (GEM) scale). The VHTs worked in pairs to facilitate groups of about 15 men ages 18 to 49 years, who had female partners, through nine group sessions. The sessions covered topics such as understanding gender roles and stereotypes, gender-based violence, FP use, and HIV prevention. Emanzi culminated with a community celebration and graduation, which the men attended with their partners, where they received certificates and recognition for completing the program.

Key Results

Between 2014 and 2019, more than 4,000 men graduated from the Emanzi program. In addition, FHI 360 researchers evaluated the program using the GEM scale and followed up with a cohort of 250 men and their wives. The evaluation found that six months after completing the program, the men still believed in and practiced shared responsibility, shared decision-making, and couple communication, among other positive behaviors. Additionally, APC established a system to track the activities of the project’s collaborative partners. They found that Emanzi men were among the top three partners (along with local councils and religious leaders), referring the most clients to FP services.

The majority of the Emanzi groups have continued to meet since the program ended. Many have formed savings groups or started income-generating activities, such as beekeeping and animal rearing, so they can buy household goods and pay school and hospital fees.

Members of the Mugyera Emanzi Gamba Nokora group at their beehive project in Katanda Sub county in Rubirizi District. Photo: Brian Ayebesa for FHI 360.

“In our group,” Julius said, “every member now has a beehive at his home, and the group has pooled money. Each month, we will give about two hundred thousand shillings to a member to start small projects at their homes.”

The formation of savings groups was not part of the original program, but came about organically, because the men wanted to continue to meet and were motivated to improve their household incomes. This activity was influenced by what the participants learned during the session on domestic violence, where they identified poverty as one of the major causes of domestic violence.

Emanzi’s success spurred USAID’s YouthPower Action project to develop the Young Emanzi Toolkit for Mentoring Adolescent Boys and Young Men, in which Emanzi graduates are trained to be mentors and facilitate sessions for adolescent boys and young men (ABYM). This multicomponent mentoring program for ABYM (ages 15–24) covers gender, soft skills, financial literacy, puberty and reproductive health, addiction and alcohol abuse, and violence prevention. Similar to Emanzi, Young Emanzi aims to promote positive gender norms, gender equitable and healthy relationships, and economic productivity while also addressing the reproductive health needs of ABYM.

A Call to Action

Emanzi’s success supports research and other programmatic evidence that male involvement programs can drive increases in the use of reproductive health services. Program managers, decision-makers, implementers, and other key stakeholders can develop similar programs or adapt Emanzi with approaches that fit into their local context. Emanzi also shows how it is possible to make the program sustainable by motivating participants to engage in income-generating activities and by working through available local structures, such as community development committees and VHTs.

Christopher Arineitwe

Christopher Arineitwe, MPH, works in FHI 360’s Research Utilization Department as the Senior Technical Advisor for Family Planning in Uganda. In his role, he is responsible for the technical leadership and oversight of the family planning component and responsible for the implementation of evidence-based, high quality, clinical and multi-sectoral interventions. He recently worked on the USAID Advancing Partners & Communities (APC) Project, where he led the implementation of high-impact practices such as community-based family planning as part of task sharing, the introduction of family planning into the private sector including drug shops, addressing social norms that affect modern contraception uptake, the integration of family planning into HIV care services, and gender-related projects. He led the male engagement program known as Emanzi (role model) aimed at bringing men to utilize sexual reproductive health services and improving their partner relationships. He holds a BSC, Diploma in Clinical Medicine and Community Health and Master of Science in Public Health.

Suzanne Fischer

Suzanne Fischer, MS, joined FHI 360 in 2002 and is now an Associate Director of Knowledge Management in the Research Utilization division, where she supervises a team of writers, editors, and graphic designers. In addition, she conceptualizes, writes, revises, and edits curricula, provider tools, reports, briefs, and social media content. She also trains international researchers on writing scientific journal articles and has co-facilitated writing workshops in eight countries. Her technical areas of interest include youth sexual and reproductive health and HIV programs for key populations. She is the co-author of Positive Connections: Leading Information and Support Groups for Adolescents Living with HIV.