Engaging and serving men in the Indonesian Reproductive Health Program: issues and obstacles

Abstract

The Indonesian government has discussed the need to involve men in the promotion of contraceptive use since the late 1960s, but there has seldom been consensus on what men should do in the family planning program. The government has never given innovative consideration of the clinical and psychological needs of men in the context of fertility control. Instead the actions of the program have reinforced patriarchal gender relations, and presumed that men would not want to take a direct role in contraception adoption. As Greene and Biddlecom have argued, the Cairo Conference, with its emphasis on the broader issues of reproductive health, has expanded the issue of male roles in family planning to incorporate a wide range of issues related to sexuality, sexually transmitted diseases, couple interactions, and family dynamics. This paper examines the ways in which the Indonesian government and NGOs could address these issues. Particular attention is paid to the obstacles to more effective engagement of men in reproductive health initiatives, and the likelihood of more successful activities being developed under more democratic governments. Among the intractable problems for service providers are the uncertain safety of male circumcision, testing and treatment in STD programs including partner notification, and the bias against vasectomy and condom promotion in the management of the government family planning program. Other reproductive health issues of potential interest to men, such as infertility and cancer are unlikely to be feasibly treated through the public health system, but they do offer important venues for education and counseling that would support gender equity. One of the challenges for the program is to present services and information in ways that engage the attention and commitment of men, while reinforcing the effort to protect and promote the reproductive health interests of women.