Enlisting men as allies in women’s health.

Program overview

Responding to a clear unmet need for male involvement in family planning/reproductive health, in 2007 Think Responsive designed and implemented the first family planning/reproductive health training program specifically designed for male doctors and nurses in Afghanistan.

Through this program, and in partnership with the local government and NGOs, Think Responsive has provided training to over 200 male doctors and nurses from over ten provinces, including Badakhshan, Bamyan, Daikundi, Faryab, Kabul (Bagrami), Kapisa, Logar, Nangarhar, Jalalabad, Panjshir, and Parwan.

Program goals

To reduce maternal mortality and morbidity, and increase access to family planning services by training male health providers as agents of change.

Curriculum

Leveraging empowerment strategies designed to promote self-reliance and cooperation, the men’s curriculum covered:

  1. Infection-prevention techniques

  2. Family planning counseling for male patients

  3. Family planning/contraceptive methods (including injectables, oral pills, IUDs, tubal ligation, condoms, and vasectomy)

  4. The detection, prevention, and treatment of STIs

  5. Education and methods of prevention for HIV/AIDS

  6. Violence against women and its relationship to health and social progress

To make the program replicable on a local level, Think Responsive created a series of educational materials—including manuals, handouts, and posters—in the local language, Dari. Each trainee received a set of educational materials to take back to their clinics and share with the local population.

Evaluation and Results

We used evidence-based evaluations to track our programs’ effectiveness. Specifically, we tested trainees’ knowledge of the material and attitudes toward family planning, birth spacing, infection prevention, and male involvement.

Specific outcomes are outlined below.

Knowledge increases

We used both qualitative and quantitative methods to assess knowledge increases.

  • Quantitative improvements. The two-fold increase in pre- and post-training exam scores (44% to 87%) on knowledge-based portions of the test indicated that our methods presented the material in an accessible, engaging way that had lasting impact.
  • Qualitative improvements: To assess the program’s qualitative impact, we asked male doctors and nurses to respond to questions regarding family planning and male involvement. Data across three questions indicated a strong desire among male providers to involve men in the family planning process.

Enduring behavioral changes

Because knowledge does not necessarily lead to behavior change, we monitored our male trainees in the field for 60 days. We found that  male health providers applied their new knowledge and skills effectively.

In the two months after completing the training course, male doctors and nurses provided counseling to a more than 15,000 male patients in rural areas in five subcategories:

  • 92% of patients received counseling in birth spacing
  • 83% in male involvement, 85% in HIV/AIDS
  • 75% in condom as prevention
  • 71% in referring wife to family planning clinic

Program expansion

The success of this program prompted policy changes at the Afghan Ministry of Public Health and led to the expansion of male involvement in family-planning programs throughout the country.