Understanding men's responsibilities in addressing gender inequality.

Are we on the right road now in relation to understanding men's responsibility in sexual and reproductive health? It is, after all, the tenth year of ICPD implementation and next year, the ten year review of the Beijing Platform for Action.

The Cairo and Beijing agreements are based on the belief that more women and men can and need to be truly partners who value, respect and love one another as equal human beings. Respectful, safe and mutually enjoyable sexual relations is a foundation to such an equal partnership.

Yet there is still confusion and uncertainty about the frameworks related to men at both conceptual and operational levels. Is this the intention of the ICPD Programme of Action (POA)? ARROW reviewed the POA and compared the agreements to what is happening in the field. What we found is that the ICPD concept of men's responsibility and participation has either been confined to only a part of the concept focusing on men's need for reproductive health services or the limited approach of 'men's involvement', primarily in the area of contraception.

It is apparent that the main initiative now is to focus on setting up reproductive health services for men, both within the Family Planning Associations and government. In Malaysia for example, the Health Ministry is in the process of setting up services to address men's health. Furthermore, there is also growing interest among private health professionals in men's health services.

In itself, the provision of these services is positive. However, if this development is based on the rationale that 'men have been neglected' or 'women have had their chance, now it is men's turn', with no reference to the gender equality objectives of ICPD and Beijing, then this focus on men's individual needs is on the wrong track.

It would appear that the spirit, language and framework of ICPD on men and gender equality has been forgotten. There are several reasons behind this disheartening lack of progress. First, men's responsibility is a complex concept. Then, there has been little attempt on the part of relevant UN agencies, (particularly UNFPA) and women's health groups to explain the conceptual differences pre and post ICPD. 'Men's involvement' remains the most widely used term, even though the POA calls it 'men's responsibility'. Similarly, the concept of gender equality is not clear and is commonly referred to as 'gender' or gender issues, which leaves out the goal of equality.

In revisiting the POA, there are a few critical differences that practitioners, policymakers and women's health groups need to be clear about.

* Men's responsibility and partnership is a section in the fourth ICPD chapter on Gender, Equality and Empowerment of Women. This shows clearly that men's responsibility is agreed to as a key strategy to achieving equal power relations between men and women and also for the empowerment of women. There is no concern expressed in this chapter on men's physical health but on their behaviour and social (i.e. gender) roles. The old term 'involvement' is not used.

"To promote gender equality in all spheres of life, including family and community life, and to encourage and enable men to take responsibility for their sexual and reproductive behaviour and their social and family roles" (ICPD POA 4.25).

* The POA clearly states why an equal relationship between men and women is essential in women's productive (paid work) and reproductive life.

i) Women's empowerment and autonomy is very important in itself. Globally, women lack power and are over-burdened by work due to unequal power relations with men.

ii) For real sustainable development to be achieved globally, women's empowerment is essential.

iii) Improving women's decision-making power at all levels will especially improve sexual and reproductive health decisions and lead to more successful population programmes.

This concern is derived from principle four of the ICPD which states that "the human right of women and the girl child are an inalienable, integral and indivisible part of universal human rights" (ICPD POA 4.1). The reference to the responsibility of men (and women) is also mentioned in Chapter VII in the POA on Reproductive Rights and Reproductive Health, in the section on human sexuality and gender relations.

"Equal relationships between men and women in matters of sexual relations and reproduction, including full respect for the physical integrity of the human body, require mutual respect and willingness to accept responsibility for the consequences of sexual behaviour" (ICPD POA 7.34).

The objective stated is to develop responsible sexuality and equitable gender relations (POA 7.36). In this section, responsibility is understood again as accepting the consequences of the effect of one's behaviour on another person's life. What is confusing is the fact that the ICPD POA in the same chapter makes several references to men and also advocates for comprehensive reproductive health services to be accessible to all people who need them, including men, by the year 2015 (POA 7.5 and 7.6). The complication is that this recommendation is however not mentioned in the chapter on gender equality. To provide better conceptual clarity, we need to explain the two ICPD concepts on men more clearly.

* Men have the responsibility for promoting gender-equality, becoming equal partners with women in childbearing and housework and taking greater responsibility for the consequences on women of men's sexual and reproductive health behaviour.

* Men have the need to comprehensive, accessible, affordable reproductive health services.

The two are separate concepts with different objectives. They do have linkages, however. While the POA agrees that "innovative programmes must be developed to make information, counselling, and services for reproductive health accessible to adolescents and adult men", the reproductive health needs of women, young people and the poor are emphasised more than men, in Chapter VII on Reproductive Rights and Reproductive Health. As women are the reproducers and make up 70 per cent of the poor, this emphasis makes sense. The POA does not state that men have been especially neglected in the provision of services but acknowledges that individuals of all ages, including men, have the need (and implicit right) to access the comprehensive services. This implicit right however is often the main focus of the men's responsibility concept, due probably to insufficient familiarity with the POA and its complexity.

Addressing The Issue of Clarity

Given this complexity and lack of clarity, how should policy and service implementers address men's responsibility? We need sexual and reproductive health services in which both women and men actively participate as partners first and then also as individuals. We need services which:

* Are committed to gender-equality with the aim to have gender-sensitive health services in operation.

* Acknowledge that women's reproductive health is still poor and that men have an important role to play in changing their behaviour in order to protect women's health.

* Work to eliminate violence against women through screening, and advocating that the issue is seen as a critical public health problem as well as a key gender-inequality issue.

* See both men and women as positive contributors to the sexual and reproductive health in our societies.

* By Rashidah Abdullah, Executive Director, Asian-Pacific Resource and Research Centre for Women.

* Endnotes

Abdullah Rashidah. Sept 2003. Gender-Equality and Men's Responsibilities and Participation - Clarifying Concepts in the ICPD Programme of Action. Paper presented at the National Seminar on Men as Partners in Sexual and Reproductive Health: The Malaysian NGO Coordinating Committee for Reproductive Health