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Monitoring and Evaluating Male Engagement in Family Planning Programs

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Presented by Bridgit Adamou at the 2016 AEA conference.

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Monitoring and Evaluating Male Engagement in Family Planning Programs

  1. 1. Monitoring and Evaluating Male Engagement in Family Planning Programs Bridgit Adamou, MPH MEASURE Evaluation University of North Carolina at Chapel Hill October 26, 2016 American Evaluation Association Conference
  2. 2. • Background • Objectives • Methodology • Results • Recommendations • Next Steps Outline
  3. 3. Background Gender equity recognized as a prerequisite for better health and integrated into global development goals. Organized FP efforts focus primarily on women, with less attention to men. Efforts to expand the vision for constructive male engagement are evolving. Male Engagement in FP Programs
  4. 4. Background M&E challenges in this area include: • lack of clear behavioral objectives • limited data on men • lack of a common set of male engagement in FP indicators • difficulty in capturing gender’s complexity • complication measuring gender outcomes M&E of Male Engagement in FP
  5. 5. Objectives • Understand current landscape of M&E of male FP use of services and methods • Identify gaps • Make recommendations to address the gaps
  6. 6. Methodology Peer-reviewed articles and grey literature  English  January 1996—April 2016  Not bound by geographical location  Must include FP, male engagement, and not be redundant  Abstracted data entered into Excel spreadsheet Desk Review
  7. 7. Methodology National FP strategies or policies  2006—present  23 national FP/RH policies, strategies, or frameworks  Representative of all regions of the world  75% of USAID’s FP priority countries represented
  8. 8. Methods  List of individuals developed from the desk review, the team’s experience, in-person contacts at the Women Deliver conference, and snowball sampling  20 people were contacted; 9 people interviewed from 8 organizations  Interviews were conducted by phone or Skype Key Informant Interviews
  9. 9. Results Recent publications reveal increased uniformity in definitions with the most commonly mentioned approaches aligning with Margaret Greene et al.’s framework depicting men’s roles through three overlapping areas:  Men as clients  Men as partners  Men as agents of change Defining and Operationalizing Male Engagement in FP
  10. 10. Results Approach Description Programmatic Examples MEN AS CLIENTS Address men’s reproductive and FP needs Increasing knowledge of HTSP and modern contraceptives; promoting male- controlled FP options; ensuring quality in provision of FP services to men MEN AS PARTNERS Engage men as supportive partners Encourage healthy communication making among couples; foster shared responsibility for decisions around FP MEN AS AGENTS OF CHANGE Promote gender equality as a means of improving men’s and women’s health as an end in itself Promote gender equitable fatherhood; advocate against discriminatory laws; encourage reflection of values that drive gender inequality
  11. 11. Results Men as clients: 37% Men as partners: 25% Men as agents of change: 4% Two or more categories: 25% All three categories: 7% 37% 21% 25% 6% 4% 7% Approaches for Engaging Men in FP Programming Men as clients Men as clients & Men as partners Men as partners Men as partners & Men as agents of change Men as agents of change Men as clients, Men as partners, & Men as agents of change
  12. 12. Results • Significant variation in the degree to which male engagement in FP is mentioned and included as a strategic approach in national FP/RH policies • Some documents, such as Rwanda’s National Family Planning Policy (2012), list promoting greater male participation in FP programs as one of its goals with no further reference to men nor strategy for how that will be achieved • No trend in which countries include male engagement in FP as a goal and/or programmatic approach
  13. 13. Results • Few programs report findings disaggregated by sex and by contraceptive method, making it difficult to determine the effect of programming on male use of methods • Among country strategies and policies, few include indicators for measuring male engagement in FP • KIIs revealed the need to rely on program-specific M&E or through DHS • There are few commonly used indicators specifically capturing male engagement in FP Measuring Male Engagement in FP
  14. 14. Recommendations Many programs may focus on one or two of the three approaches to male engagement in FP, however understanding and addressing the full spectrum of male engagement can provide longer-term, more sustainable impact. USE A SHARED DEFINITION
  15. 15. Recommendations IDENTIFY AND ADOPT KEY INDICATORS MEN AS CLIENTS MEN AS PARTNERS MEN AS AGENTS OF CHANGE INDIVIDUAL  Percent of men who report currently using FP  Percent of men who have ever used an FP method  Number of vasectomies performed  Number of condoms distributed  Couple-years of protection (CYP)  Percent of men who support the use of modern contraception for themselves or their partners  Number of men/women who report joint decision making for FP  Extent of change in attitudes towards gender norms (GEM Scale)  Belief if women use FP, they’re unfaithful/ promiscuous COMMUNITY / FACILITY  Number of vasectomy referrals  Number of operational facilities that offer vasectomy services  Number of FP providers trained on male- specific FP  Percent of primary healthcare facilities providing male-friendly FP services  Number of men reached with FP information/ services by community- based worker  Attitudes regarding male participation in family health care (qual)  Perceived family/social network approval for FP  Number of providers trained on gender equity and sensitivity STRUCTURAL  Vasectomy included in FP guidelines/strategies, regulations, or policies  Evidence of engagement of men in FP incorporated into national health standards or policies  Number of gender equitable laws  Number of national level programs/ policies/advocacy campaigns that address gender equity
  16. 16. Recommendations EMPLOY EXISTING DATA COLLECTION APPROACHES AND METHODS • DHS • Routine Health Information Systems (RHIS) • Facility records • Data collection forms specific to a particular program or intervention for quantitative indicators not covered in RHIS • Structured in-depth interviews • Document reviews of existing laws, strategies, etc.
  17. 17. Next Steps Develop a guide to M&E of male engagement in FP, including key indicators and indicator reference sheets.
  18. 18. This presentation was produced with the support of the United States Agency for International Development (USAID) under the terms of MEASURE Evaluation cooperative agreement AID-OAA-L-14-00004. MEASURE Evaluation is implemented by the Carolina Population Center, University of North Carolina at Chapel Hill in partnership with ICF International; John Snow, Inc.; Management Sciences for Health; Palladium; and Tulane University. Views expressed are not necessarily those of USAID or the United States government. www.measureevaluation.org

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