title: Male involvement in sexual and reproductive health in the Mendi district, Southern Highlands province of Papua New Guinea: a descriptive study.
abstract: BACKGROUND
  Lack of male involvement and support for sexual and reproductive health services is seen by many Papua New Guinean women as a barrier to accessing services. Poor utilization of services by both men and women is reflected in high maternal mortality and high rates of HIV/AIDS and sexually transmitted infections in the Southern Highlands Province. It is therefore important to understand the type of services provided, men's perceptions of these services and the Health Sector's capacity to involve men in its programs.
  
  
  METHODS
  Information from interviews of married men, officers in charge of health facilities, and information from a focus group discussion with village leaders was collected to assess possible constraints to reproductive and sexual health care delivery.
  
  
  RESULTS
  Although many men had heard about antenatal care, supervised births, family planning and sexually transmitted infections including, HIV/AIDS, many were unaware of their importance and of the types of services provided to address these issues. There was a very strong association between men's literacy and their knowledge of Sexual and Reproductive Health (SRH) issues, their discussion of these issues with their wives and their wives' utilisation of sexual and reproductive health services. Some men considered SRH services to be important but gave priority to social obligations. Although men made most decisions for sexual and reproductive issues, pregnancy, child birth and rearing of children were regarded as women's responsibilities. Knowledge of HIV/AIDS appeared to have changed sexual behaviour in some men. Services for men in this rural setting were inadequate and service providers lacked the capacity to involve men in reproductive health issues.
  
  
  CONCLUSIONS
  Poor knowledge, socio-cultural factors and inadequate and inappropriate services for men hampered utilization of services and impaired support for their wives' service utilization. Programmatic and policy initiatives should focus on improving service delivery to accommodate men in sexual and reproductive health.
authors.affiliation: School of Medicine and Health Sciences, University of Papua New Guinea, PO Box 5255, Boroko, Port Moresby, Papua New Guinea. johndvince@gmail.com.
authors.forename: Sally
authors.initials: S
authors.lastname: Kura
authors.forename: John
authors.initials: J
authors.lastname: Vince
authors.forename: Paul
authors.initials: P
authors.lastname: Crouch-Chivers
mesh_terms: D000328:Adult; D005193:Family Planning Services; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D057220:Health Literacy; D006801:Humans; D008297:Male; D010219:Papua New Guinea; D011247:Pregnancy; D011446:Prospective Studies; D060728:Reproductive Health; D034121:Reproductive Health Services / Q000706:statistics & numerical data*; D012424:Rural Population; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000208:ethnology / Q000517:prevention & control*
references.citation: Reprod Health. 2012 Nov 21;9:32
references.pmid: 23171709
references.citation: Rural Remote Health. 2007 Apr-Jun;7(2):605
references.pmid: 17511523
references.citation: AIDS. 1994 Jan;8(1):93-9
references.pmid: 8011242
references.citation: Health Educ Res. 2007 Apr;22(2):166-76
references.pmid: 16855015
references.citation: J Indian Med Assoc. 2001 Mar;99(3):138-41
references.pmid: 11478756
references.citation: Am J Epidemiol. 1997 Aug 15;146(4):350-7
references.pmid: 9270414
references.citation: Genitourin Med. 1994 Jun;70(3):155-61
references.pmid: 8039777
references.citation: Stud Fam Plann. 1993 May-Jun;24(3):163-74
references.pmid: 8351697
references.citation: Health Policy Plan. 1996 Mar;11(1):84-92
references.pmid: 10155880
references.citation: Int Perspect Sex Reprod Health. 2010 Mar;36(1):36-43
references.pmid: 20403804
references.citation: Stud Fam Plann. 1988 May-Jun;19(3):162-8
references.pmid: 3406964
references.citation: J Int AIDS Soc. 2011 Sep 13;14:43
references.pmid: 21914207
references.citation: BMJ. 1992 Mar 28;304(6830):809-13
references.pmid: 1392708
references.citation: Cult Health Sex. 2000 Apr-Jun;2(2):135-50
references.pmid: 12295879