A recent family planning and reproductive health symposium in Beijing focused on what many participants viewed as the necessity for men to become more involved in taking responsibility with women in contraceptive issues and in the fight against sexually transmitted diseases.
Men?s role in family planning and reproduction health has become a global-concern thanks to the spread of AIDS, and their participation goes far beyond their taking on responsibilities in relation to ordinary contraception and birth control. But in China, policy makers have always targeted women as the mainstay of family planning policy, ignoring men. This has weakened men?s awareness of their responsibilities.
Experts at the symposium emphasized the importance of setting up a new reproductive health culture that includes more involvement from men as well as including different perspectives from sociology, ethics, medicine, physiology and psychology. Family experts are convinced that reproductive health is a matter for both men and women: For both bio-medical and social reasons, men play a key role in reproductive activities, and their increased awareness should help improve the gender equality, promote health, ease women?s burdens, and maintain the stability of the family.
The concept of "men?s involvement in reproductive health" was first put forward at the United Nations International Conference on Population and Development held in Cairo in 1994 and in following years became a global focus. The Final Program of Action adopted at the 1994 meeting presented the following statement on "male responsibilities and participation:"
"Special efforts should be made to emphasize men's shared responsibility and promote their active involvement in responsible parenthood, sexual and reproductive behavior, including family planning; prenatal, maternal and child health; prevention of sexually transmitted diseases, including HIV; prevention of unwanted and high-risk pregnancies; shared control and contribution to family income, children's education, health and nutrition; and recognition and promotion of the equal value of children of both sexes. Male responsibilities in family life must be included in the education of children from the earliest ages. Special emphasis should be placed on the prevention of violence against women and children."
This statement of action was reinforced at the Fourth World Conference on Women held in Beijing in 1995: "The sharing of responsibilities related to reproductive and sexual behaviors by both men and women is essential to improve women?s health."
Hu Hongdao, director of the International Cooperation Department of State Family Planning Commission of China said that men?s participation not only involved methods of contraception but also many other social dimensions. It contains three aspects: family planning, reproductive health and family development.
Contraception and birth control are the main content of the family planning program, and for many complicated reasons, the responsibility for contraception and birth control for years mainly has been undertaken by women.
In 2000, a survey by the State Family Planning Commission showed that over 85 percent of men and women prefer female contraceptive and birth control means. In fact, 87 percent comprehensive of birth control measures are undertaken by women while 13 percent are undertaken by men through condoms or other means.
Liu Xiaozhang, a professor in the Sichuan Institute of Reproductive Health, said that Chinese experts and researchers have made great progress in male birth control measures and that China has been a leader in this field. Male birth control has these advantages: It is simple, safe, cheap and with fewer potential harmful side-effects.
However, Professor Liu said, male measures have not been publicized widely. As a nation, only 6.5 percent of Chinese people on average use male contraception means for birth control. The percentage is higher in Sichuan Province and lowest -- at 0.01 percent -- in Jilin Province.
"If male contraceptive measures are better, then it is unfair to let women bear the burden of birth control," Professor Liu said. "We should make every effort to create an acceptable environment for man?s involvement among society, communities, families and individuals."
The ruthless spread of AIDS and other sexually transmitted diseases has left some 40 millions of population infected by HIV in the world. Some 600,000 people are infected in China.
According to figures provided by the United Nations Fund for Population Activities, about 175 million women get pregnant every year. And 75 million of those pregnancies are unwanted. These women usually choose induced abortion, leading to reproductive health damage.
It is universally acknowledged that men?s sexual behavior has great influences on women?s reproductive health. The problem now is that men lack awareness and responsibility. Men play a key role in behavioral role based on their biological make-up. Research indicates that changing unhealthy male sexual behavior may help stop the spread of AIDS and sexually transmitted diseases. The social roles played by men can decide their lead function in contraception and birth control. So, men should take more responsibilities on reproductive health care.
Participants in the family planning and reproductive health symposium in Beijing also emphasized the involvement of adolescents. Sexually transmitted diseases are mainly concentrated in people between the ages of 15 and 24. If anyone infected with a sexually transmitted disease goes without medical treatment, he will be ten times more likely to contact HIV. Half of the 5.9 million newly HIF-infected people are under 24 years old. According to a figure released by Family Planning Commission of Nanjing [the capital of Jiangsu Province], half of the women there who had abortions were unmarried. So it is also urgent to help adolescents to become aware of reproductive health.
Professor Liu urged improvement of male reproductive health services, including the establishment male outpatient and hot-line services. Preventative measures should also be implemented with regular checkups for diagnosis of infections caused by sexually-transmitted diseases.
In addition, a national campaign to advocate condom is expected. Ru Xiaomie, of the International Cooperation Department of the State Family Planning Commission, said the double functions of condom-contraception and prevention measures related to sexual disease is more and more stressed in China. About 160 million condoms are distributed free of charge by the state. More measures have been taken to improve the quality, marketing and application of condoms. She also said that the popularizing condoms is imperative with an increase of extramarital sexual activity and a rampant expansion of sexually transmitted diseases.
According to World Health Organization, each year about 545,000 women die from problems related to pregnancy, childbearing and unsafe abortions. WHO believes most of these deaths could be avoid. In addition, sexual violence has increased widely in the world. According to a survey of 35 countries by the World Bank, 25-50 percent of women had suffered from violence related to sex.
It is universally accepted that men?s decision and actions can make a great difference between illness and health, life and death. Men should be encouraged to care and understand women, stop domestic violence and cultivate their families together with women.
Zhao Baige, director of the International Cooperation Department of State Family Planning Commission, said:
?The only way to call upon the awareness of men is let them know their important role in a family and society -- as husband, lover, father and friend. Men?s ideas, knowledge, attitudes and actions affect the quality of the family.?
Zhao Baige also said the State Family Planning Commission is carrying on some domestic and international activities to publicize men?s awareness including a campaign to educate the public on new concepts of marriage and family planning.
Supported by the Ford Foundation, Turner Fund and PATH [Program for Appropriate Technology in Health], the State Family Planning Commission located sample targets for research and analysis in Jilin, Shandong and Jiangsu provinces where programs were carried out with training, lectures, publicity and technical services -- playing a vanguard role and proving that men?s involvement is realistic. Figures from the three targeted areas showed that condoms are better accepted and used when condom information is available. Incidents of induced abortion were greatly reduced. People learned more about sexual transmitted diseases and their prevention.
Director Zhao also said that a national family planning and reproductive health service network has been set up over the past 30 years, which will provide a solid foundation for advocating men?s involvement, disseminating information and offering services for men. The State Family Planning Commission is trying to promote domestic programs and international cooperation based on existing resources.
"A single spark can start a prairie fire," Zhao said. According to her, in addition to the aforementioned national campaign, many international cooperation projects are under way, including a reproductive health project sponsored by the UN Population Fund in 32 counties, a high-quality service project that will cover 821 counties, an adolescent reproductive health project that has just been launched and will target a population of 80 million, and an AIDS project that targets 6 million people. She believes all these efforts surely will promote men?s involvement in reproductive health throughout the country.
(by Hui Ting, china.org.cn staff reporter, translated by Li Liangdu, March 28, 2002)
