How To Reach Men in Gender Perspective of SouthEast Asia, PAKISTAN

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How To Reach Men in Gender Perspective of
South-East Asia, PAKISTAN Presented By DR.
YASMEEN SABEEH QAZI PAKISTAN AT Conference
on Reaching Men to Improve Reproductive and
Sexual Health for All September 15 -18,
2003 Washington DC-USA Organized by Interagency
Gender Working Group of USAID
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Gender Facts in South East Asia

• South Asia has one of the most distorted sex
  ratio in the world there are only 940 females
  for every 1000 males
• Womens political representation is very poor in
  South Asia, only 7 of South Asian
  parliamentarians are women
• South Asian womens real GDP per capita at US
  874 is lower then any other region in the world,
  including sub Saharan Africa

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Facts About Women Status

• Pakistan is known for some of the most several
  forms of patriarchy in the world
• Average number of female to every 100 males is
  93.7
• Survival itself is highly gendered in these
  societies
• There are significant sex wise difference in rate
  of mortality, morbidity, malnutrition and in
  access to health care

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Facts About Women Status

• Like wise, there are strong sex wise differences
  in literacy rates, school enrolment ratio and
  other indicators of education
• About 50 mothers die each, from pregnancy related
  causes childbirth, MMR is 340 per 100,000 live
  births
• 15 of maternal deaths are due to violence in
  pregnancy
• One quarter of the population does not have
  access to health facilities
• Incidence of maternal deaths in adolescents is
  2-5 times greater than for women over 18

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PAVHNA PROJECTS

• PAVHNA initiated Community Based programs in 1991
  through CBD model (door to door approach)
• Approach was initially women to women through CBD
  workers in pilot phase (3 yrs program)
• Approach evolved to involve men in greater
  proportion in second phase of program (5 yrs
  program)
• Organization adopted gender based policy to focus
  on men as well in all RH programs
• Programs for young boys were initiated with the
  launch of PAVHNA adolescent reproductive health
  projects

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Strategies adopted by PAVHNA programs to focus on
men

• Involving men in project activities through
  formation of advisory groups or committees
• Awareness raising workshops for important
  influential groups like religious political
  leaders in communities
• IEC materials at cafes, barbers, factories
  other workplaces
• Orientation meetings with local elected district
  persons
• Strong advocacy program through street theatres,
  group meetings, public messages mass media

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• Introducing School based sexual health talks in
  selected project areas
• Training of teachers to communicate with young
  boys about RH, especially HIV/AID/STDs
• Organizing media meetings to highlight adolescent
  issues for public and policy attention
• Peer educators trained to communicate within
  communities, nearly 400 peer educators have been
  trained so far
• Training of trainers for other NGOs Social
  welfare officials through a culturally adopted
  Better life skills curriculum
• Providing clinical services for young boys men
  including counseling on sexual health matters

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Indicators used to measure expected outcomes and
project activities

• Services statistics through quarterly report
• Output to Purpose Review
• Mid term Review
• Baseline Survey
• Monitoring evaluation by PAVHNA quality
  management team
• Focus Group discussions with different groups
  like peer educators, service providers, managers,
  teachers community members

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Results

• Projects, have been rated successful by external
  evaluators during reviews
• Success of the projects were attributed to
  following factors
• Extensive community involvement
• Sensitive planning
• Strong management
• Donors support
• Efficient team work
• Strong leadership
• Networking with other groups
• Facilitative supervision and monitoring

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Challenges Faced

• Strong patriarchal culture in Pakistans
  communities
• Gender inequity
• High rate of illiteracy
• Poverty
• Religious political opposition
• Weak civil society impression
• Inconsistent political support
• Absence of ARH programs and policies at national
  level

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Some contributing factors to the success of the
projects

• Initial community sensitization through CBD
  program to initiate ARH project
• Government policies which support RH programs,
  HIV/AIDs/STDs projects
• Increased awareness on HIV / AIDs through an
  effective mass media campaign by Ministry of
  Health
• Effective Social Marketing programs which has
  largely contributed to increased awareness
• Realization by parents other stake holders
  about educating youths in SRH issues

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Lesson Learned

• Project design needs to include gender sensitive
  strategies to ensure program focus on men
• Strong advocacy to make men realize about their
  strategic role in RH programs
• Encouraging men to attend clinics with their
  wives by making clinic men friendly
• Peers are the best medium for sensitizing youth
  by a strongly managed program

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• Programs needs to have holistic approach to
  move away from the rhetoric trend of targeting
  women only
• If programs need to see any sustained changes in
  womens health status, the men needs to be
  involved in RH programs, at all levels
• Strategic approach to reach the young couple, is
  a crucial determinant in measuring the success of
  any program
• Programs which do not focus or pay attention to
  the access quality issues, usually falls short
  of expected outcomes