In the shell of an unfinished health center and under clear skies in Rupandehi, we met with nine young men (18 – 21 years old) for a focus group. We had recruited the men to help us test qualitative questions for an upcoming evaluation. They were dressed in button-down shirts and slacks, and each was adorned with gelled bangs flipped over and toward the sky.
As with other focus groups of men we have been part of, their comments confirmed how the same male-centric attitudes and behaviors that negatively impact women’s lives also harm men.
Our qualitative evaluation focuses on two activities that are part of the FACT Project in Nepal. The first is a series of games called Pragati that address fertility awareness, social norms, and increasing family planning knowledge, among other topics. The second is a cohort of roving (mobile) auxiliary nurse midwives (RANMs) working in nine communities near Nepal’s border with India. Although the RANMs’ main audience is adolescent women in hard to reach communities, they make efforts to reach men; and the RANMs are trained to integrate men into pre- and post-natal counseling activities. In the overall evaluation of these activities, we want to understand whether the games reached younger men and how the men interacted with the RANMs.
The men in our group were from the same community, and it was clear that a certain comfortable rapport existed among them. Rajesh, the moderator, got the conversation going with general questions about life in their community. He then began to ask about the men’s sources of sexual and reproductive health information. Frequently, responses were couched in semi-embarrassed smiles and scans of their peers. Rajesh managed their open responses well, especially given that a big foreigner was standing in the back of the room taking notes.
The men stated that they:
- would never have a conversation about sex with their parents,
- would not go to the health center to learn about reproductive health, and
- would only talk to close friends about sex or family planning
It was clear that open communication about sex and reproductive health was taboo.
Rajesh continued to inquire about how these men interact with the health system. Although the men knew about the games being played in the community, they assumed the games were only for the women. Services from the mobile nurse were also assumed to be solely designed to address women’s needs.
One man said, “When the nurse came to the door, all of the men and boys in the house ran out.” His comment was met with laughs and head-nods from the group. Someone commented that men were as much foreigners to these services as I was in the back of the room. On a global level, there is nothing unique about the comments coming from this one group of Rupandehi men. The comments are also not unique to low-resource settings or ethnic groups.
At one point, my co-investigator, Sharada, interrupted the conversation and asked, “If you won’t go to your parents or the health center and you run away when the nurse comes to the door, where do you get your information about sex?”
After a brief moment, one of the young men said, “We learned about sex from Google.”
Seeking information about sex on the internet is not unique to Nepal. Google and other search engines have placed a world of health information at our fingertips. Unfortunately, that information is not necessarily accurate, and it certainly isn’t tailored to these young men’s needs. It isn’t even likely to be presented in either Nepali or their local language of Awadi. Furthermore, receiving sexual and reproductive health information in isolation and – without messages and activities that combat negative social and gender norms – further reinforces the stigma felt by each of these men.
Tested and refined programs that target the reproductive health needs of men do exist and can be integrated into other activities targeting women. Building upon more than a decade of male mentoring programs facilitated by IRH and other organizations, the Pragati intervention trained a small number of influential men in the rural villages to play the games. By raising issues such as couple communication, son preference, and knowledge of the menstrual cycle and fertility, Pragati directly addresses men’s needs for information. Pragati games and reflective discussion provide a balance between empowering young men with information and equipping them with the ability to use that information equitably.
Young men will continue to get information about sex from Google. Our hope is that they will feel capable discussing and utilizing that information in ways that are in the best interest of both themselves and their partners.