Presented by Bridgit Adamou at the 2016 AEA conference.

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. • Background
• Objectives
• Methodology
• Results
• Recommendations
• Next Steps
Outline

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. 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. Objectives
• Understand current landscape of M&E of male FP use of
services and methods
• Identify gaps
• Make recommendations to address the gaps

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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Next Steps
Develop a
guide to M&E
of male
engagement
in FP,
including key
indicators and
indicator
reference
sheets.

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