Barriers to the participation of men in reproductive health care: a systematic review and meta-synthesis

Roudsari, Robab Latifnejad; Sharifi, Farid; Goudarzi, Fatemeh

doi:10.1186/s12889-023-15692-x

Cited by 23 publications

(10 citation statements)

References 90 publications

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“…The authors emphasize the need for culturally sensitive approaches that recognize and address power dynamics, social norms, and gender inequalities (Greene et al, 2006). However, there are some barriers to men's participation in reproductive health care, such as social norms, dominant culture, social stigma, lack of services in low-income countries, and financial restrictions, among others (Roudsari et al, 2023).…”

Section: Figurementioning

confidence: 99%

Male Involvement in Sexual and Reproductive Health and Rights

Lamsal,

Aryal,

Adhikari

et al. 2024

INT. J. Multi. Res.

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Sexual and reproductive health and rights focus on advocating, supporting, and participating in various aspects of male involvement in sexual and reproductive health and rights. Family planning, safe abortion, HIV and RTIS/STI prevention and treatment, and maternal health care pursue male involvement. The article employs a review of relevant contemporary literature from various resources. Men have three specific sexual roles as clients, supportive partners, and agents of change to their spouses as well as societies. More specifically, men's involvement accelerates the effectiveness of family planning programmes, promotes mitigating gender-based violence, promotes women empowerment, enhances adolescent reproductive health, maternity care, and knowledge and behavior change on HIV/AIDS, STIs, and RTIs. However, there are more significant challenges to male involvement in sexual and reproductive health and rights. Despite the need for men’s involvement in SRHR, there are barriers in various forms, such as social stigma, cultural determinants, and financial restrictions. Government policies can address the barriers to providing equitable services to needy people.

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Section: Figurementioning

confidence: 99%

Male Involvement in Sexual and Reproductive Health and Rights

Lamsal,

Aryal,

Adhikari

et al. 2024

INT. J. Multi. Res.

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Section: Introductionmentioning

confidence: 99%

“…The few studies in African countries focusing on men’s healthcare needs have revealed significant barriers and challenges hindering their access and utilization of healthcare services [ 6 , 22 ]. Financial constraints emerge as a significant hurdle, deterring some men from seeking healthcare when needed [ 6 , 22 , 24 ]. Furthermore, negative perceptions and attitudes towards healthcare services, often fuelled by fears of stigmatization and mistreatment, act as barriers to engagement [ 22 , 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

“For a man to go to hospital, then that would be his last option”: A qualitative study exploring men’s experiences, perceptions and healthcare needs in the implementation of Universal Health Coverage in Kenya

Mokua,

Ombogo,

Mathu

et al. 2024

PLOS Glob Public Health

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The achievement of Universal Health Coverage (UHC) requires equitable access and utilization of healthcare services across all population groups, including men. However, men often face unique barriers that impede their engagement with health systems which are influenced by a myriad of socio-cultural, economic, and systemic factors. Therefore, understanding men’s perspectives and experiences is crucial to identifying barriers and facilitators to their healthcare-seeking behaviour under UHC initiatives. This qualitative study sought to explore men’s perceptions, experiences, healthcare needs and potential strategies to inform an impartial implementation of Universal Health Coverage (UHC) in Kenya. The study employed a qualitative research design to investigate men’s healthcare experiences in 12 counties across Kenya. Thirty focus group discussions involving 296 male participants were conducted. Men were purposively selected and mobilized through the support of health facility-in-charges, public health officers, and community health extension workers. Data was coded according to emergent views and further categorized thematically into three main domains (1) Perspectives and experiences of healthcare access (2) Socio-cultural beliefs and societal expectations (3) Desires and expectations of health systems. Findings revealed complex sociocultural, economic, and health system factors that influenced men’s healthcare experiences and needs which included: masculinity norms and gender roles, financial constraints and perceived unaffordability of services, lack of male-friendly and gender-responsive healthcare services, confidentiality concerns, and limited health literacy and awareness about available UHC services. Our study has revealed a disconnect between men’s needs and the current healthcare system. The expectations concerning masculinity further exacerbate the problem and exclude men further hindering men’s ability to receive appropriate care. This data provides important considerations for the development of comprehensive and gender-transformative approaches challenging harmful masculine norms, pushing for financial risk protection mechanisms and gender-responsive healthcare delivery attuned to the unique needs and preferences of men.

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“…Although it has been suggested that the supply is not the issue ( Shelton & Jacobstein, 2016 ), concerns have been raised about biases and knowledge among non-vasectomy providers. A recent systematic review of barriers to male participation in general reproductive health care highlighted that barriers to inclusive and integrated quality reproductive health services are the primary limitation to male engagement in reproductive health, and pointed to health care workers as a major contributor to the lack of access to reproductive health services ( Roudsari et al , 2023 ). Another recent study similarly highlighted that many health professionals involved in contraception have unsatisfactory knowledge of male contraceptive methods and are not reliably offering male options during couple contraceptive counseling sessions ( Tcherdukian et al , 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Vasectomy provider decision-making balancing autonomy and non-maleficence: qualitative interviews with providers

Hoover,

Shattuck,

Andes

2023

Gates Open Res

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Background Male sterilization, or vasectomy, is 99.9% effective at preventing pregnancy with less than a 2% risk of complications. Despite the high efficacy, low risk, low cost, and gender equity benefits of vasectomy, just 2% of women reported that they and their partners relied on vasectomy as their contraceptive method globally in 2019. Health care providers can be both a facilitator and a barrier in men’s health generally, and may be in vasectomy provision as well. This study sought to describe the decision-making rationales of experienced vasectomy providers when evaluating patient candidacy in complex cases. Methods Fifteen vasectomy providers belonging to the global Vasectomy Network google group from seven countries participated in online interviews using a semi-structured in-depth interview guide. Providers were asked about their vasectomy training, their reasons for vasectomy provision, challenging cases they have faced, and approaches used to manage challenging cases. Vignettes were used to further elicit decision-making rationale. Thematic analysis was conducted using MAXQDA20. Results Provider decision-making was predicated on ensuring patients were well-informed, able to consent, and certain about their choice to have a vasectomy. Once those foundational conditions were met, providers filtered patient characteristics through their training, laws and policies, sociocultural norms, experience, and peer influence to produce a cost-benefit breakdown. Based on the cost-benefit analysis, providers determined whether to weigh autonomy or non-maleficence more heavily when determining vasectomy patient candidacy. Conclusions Despite clinical best practices that promote prioritizing patient autonomy over non-maleficence, some providers continued to weigh non-maleficence over autonomy in vasectomy patient candidacy evaluations. Non-maleficence was particularly prioritized in cases providers deemed to be at higher risk of regret. The findings of this study suggest vasectomy provider training should emphasize evidence-based best practices in shared decision-making and patient-centered care to facilitate vasectomy provision that honors patient autonomy and rights.

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Barriers to the participation of men in reproductive health care: a systematic review and meta-synthesis

Cited by 23 publications

References 90 publications

Male Involvement in Sexual and Reproductive Health and Rights

Male Involvement in Sexual and Reproductive Health and Rights

“For a man to go to hospital, then that would be his last option”: A qualitative study exploring men’s experiences, perceptions and healthcare needs in the implementation of Universal Health Coverage in Kenya

Vasectomy provider decision-making balancing autonomy and non-maleficence: qualitative interviews with providers

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