Scaling up approaches to promote constructive men's engagement in reproductive health

Mali has a low modern contraceptive prevalence rate (CPR) and there is national concern about high maternal and neonatal mortality rates. Despite men's central role in families' decisionmaking related to health, they often are not included in RH programs. Health programs often prioritize women's RH, despite men's need for information and services related to family planning and their own RH. To address this issue at the policy level, the USAID | Health Policy Initiative worked with the Ministry of Health's RH Division and a multisectoral group to draft a national guide on constructive men's engagement (CME) in RH to support Mali's National RH Strategy. With the approval of the CME guide, Mali's government has made a commitment to improving men's RH for the first time. This commitment includes support for cultural changes specifically related to gender norms that typically discount men's RH needs. To begin making such changes, the project initiated one of the strategies in the guide, partnering with a local organization working with men in RH to design and pilot an innovative module to train community peer educators in counseling couples on joint decisionmaking and communicating more openly on RH matters. The work of the trained educators resulted in increases in men's attention to their wives' RH; in accompanying their wives to health centers for prenatal care visits; and in the demand for contraceptives. The project shows that a national policy commitment to men's CME and local-level support through pilot activities can improve the overall health environment for men and women.