More Than Supportive

Redefining Male Responsibility in Reproductive Health

AI generated image in the style of Eyvind Earle.

Men are increasingly voicing interest in reproductive health and family planning, yet their involvement remains limited. Around the world, studies show that men express strong interest in participating in sexual and reproductive health (SRH) decisions—yet programs and policies often fail to meet them halfway. Most SRH initiatives still position men as passive supporters rather than as active, relational partners in decision-making (Hardee et al., 2017). This dynamic not only reinforces harmful gender norms, but it also leaves crucial opportunities for shared responsibility and improved outcomes on the table.

If we want to build more equitable and effective family planning systems, we must actively center male engagement as an essential step toward shared responsibility and better health outcomes. That means designing programs and health policies that anticipate, encourage, and recognize men as active, relational partners in reproductive health, with a vested interest in their partners' pregnancy outcomes and the wellbeing of their children.

AI generated image in the style of Eyvind Earle.

Outdated Models, Missed Opportunities

Historically, family planning programs were designed around women as clients and decision-makers with the goal of empowering women to make informed decisions about their bodies. Although this goal is both valid and essential to correcting decades of bad reproductive health care and power inequities, its implementation led to models that sideline or ignore men altogether. As Hardee and colleagues noted, most services remain "feminized", from clinic environments to provider expectations, leaving men unsure of their place and often unwelcome when they do show up.

This exclusion reinforces the belief that contraception is a woman’s burden. In turn, it discourages men from seeing themselves as stakeholders or stewards of shared fertility goals. The result? Lopsided communication, decision-making imbalance, and increased pressure on women to navigate SRH issues alone.

AI generated image in the style of Eyvind Earle.

What Brings Men In, and What Keeps Men Out

Contrary to stereotypes, men across settings report their interest in being a positive and active participant in reproductive decisions. In the Philippines, Lantiere et al. documented that many men want to be involved but often feel excluded by both their partners and providers. In Rwanda, Corey et al. found that men were eager to use services when they felt welcomed and informed. And in El Salvador, Lundgren and colleagues showed how integrating SRH into male-dominated community development activities opened new doors for engagement.

So why doesn’t this interest translate into action? The barriers are structural and normative: men are rarely approached by providers, materials rarely speak to them, and social expectations (of many men and women) often brand SRH as "women’s business." Many men also fear being seen as controlling or intrusive if they initiate conversations about contraception. This last concern is not a good excuse to step back, but given the other factors, the feelings are real. These dynamics can leave men uncertain about how to engage, leading both men and women to default to narrow definitions of men’s roles in reproduction, often describing their primary value as financial providers, as highlighted in recent data (Gupta et al., 2025).

AI generated image in the style of Eyvind Earle.

Redefining "provider" before we redefine masculinity

One approach to redefining male roles in reproductive decision-making is to promote men's participation as relational rather than transactional. This means asking men to "provide" in pro-social ways that enable them to be present and active participants throughout their sexual and reproductive health experience. Programmatic efforts that enhance men's skills around open and intimate communication can help ensure that reproductive choices don’t happen in isolation, but rather unfold in the context of relationships, trust, and shared values.

Programs that facilitate equitable couple communication consistently show higher rates of contraceptive uptake and better partner satisfaction. When men are engaged as partners and not gatekeepers, the dynamics shift: women feel supported and gain more agency, not less (High Impact Practices in Family Planning (HIP), 2022). 

Conversations about reproductive health can't be limited to their partners. Recently, in Zambia, through World Vasectomy Day and Marie Stopes International, vasectomy provision is complemented by the development of "Responsible Men's Clubs". The clubs, initially populated by recent vasectomy clients, act as a resource for their community on the topic of reproductive health. Men enjoy their structured time, the training, and their role mentoring younger men in the community that they are beginning to expand their skills to address other topics related to men's health and wellbeing.

AI generated image in the style of Eyvind Earle.

Strategies That Work

We already know what works. Gender-synchronized approaches—those that engage both men and women in dialogue and reflection—have proven effective across settings (Sianis et al., 2024). Couple-based counseling, peer educator models, and integrating SRH discussions into existing male spaces (like workplaces or water committees) have all helped normalize male involvement (Gottert et al., 2025).

The key is not just adding men to the conversation, but designing programs with them in mind from the start. That includes using language that speaks to their values, training providers to communicate effectively with male clients, and ensuring that men’s participation enhances, not overrides, women’s autonomy.

AI generated image in the style of Eyvind Earle.

The Policy Gap: Systems Must Catch Up

Programmatic innovation alone is not enough. As the Global Action for Men’s Health (GAMH) policy report makes clear, men’s SRH is often invisible in national strategies, underfunded, and unmeasured. Few countries have comprehensive policies addressing men’s sexual health needs, and many fail to include indicators on male engagement or couple decision-making.

To shift this landscape, we need policy frameworks that explicitly support men as SRH clients in their own right. That means:

• Training providers to work with men and couples

• Funding male-specific outreach and education campaigns

• Measuring shared decision-making in FP indicators

• Normalizing public conversations about men’s fertility, contraception, and relational health

Until men’s SRH is treated as a policy priority, programs will continue to struggle against systemic resistance.

Conclusion: Shared Responsibility, Better Outcomes

It’s time to move beyond the narrow idea that men are simply "supportive" in reproductive health. True engagement means recognizing men as relational beings whose participation can foster equity, trust, and shared wellbeing.

To get there, we must design programs that reflect men’s realities, train providers who welcome them, and write policies that include them. But how do we enact this shift at scale? What will it take to reimagine systems and norms so that shared responsibility is not the exception but the standard? Only then can we build a family planning ecosystem where responsibility is shared, and outcomes improve for everyone.

AI generated image in the style of Eyvind Earle.

References

• Corey, J., et al. (2022). Family planning demand generation in Rwanda: the role of interpersonal communication and gender norms. Breakthrough ACTION.

• Gottert, A., et al. (2025). Engaging Men and Boys in Sexual and Reproductive Health and Rights: A Review of the Evidence and Recommendations for Policy and Practice.

• Gupta, T., Barker, G., & Lewis, C. (2025). State of American Men 2025. Equimundo: Center for Masculinities and Social Justice.

• Hardee, K., Croce-Galis, M., & Gay, J. (2017). Are men well served by family planning programs? Reproductive Health, 14(1), 14.

• High Impact Practices in Family Planning (HIP). (2022). Promoting healthy couples’ communication to improve reproductive health outcomes. Washington, DC: USAID. Available from: https://www.fphighimpactpractices.org/briefs/couple-communication/

• Lantiere, A., et al. (2022). Men’s sexual and reproductive health care decision-making in the Philippines: a systematic review. BMC Public Health, 22(1), 1294.

• Lundgren, R., et al. (2005). Cultivating men’s interest in family planning in rural El Salvador. Studies in Family Planning, 36(3), 189–202.

• Sianis, V., et al. (2024). Strategies for Gender-Transformative Health Programming: Evidence from Sub-Saharan Africa.

* * I used AI to generate images based on the content of the blog. I recently saw landscapes painted by Eyvind Earle and wanted to see what AI would create. Here are a couple of sites to learn more about this artist (site 1; site 2).