Healthy Images of Manhood: A “Male Engagement” Approach for Workplace Health Pauline Muhuhu...
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Transcript of Healthy Images of Manhood: A “Male Engagement” Approach for Workplace Health Pauline Muhuhu...
Healthy Images of Manhood: A “Male Engagement” Approach
for Workplace Health
Pauline MuhuhuDavid WoffordExtending Service Delivery ProjectFebruary 11, 2010
What is the Extending Service Delivery Project (ESD)?
Global project in reproductive health and family planning (RH/FP) funded by USAID
Addresses unmet need for RH/FP and increases access to services by the poor and underserved at the community level
Project Organizations: Pathfinder International – Managing partner IntraHealth – gender, religious leaders, BPs Management Sciences for Health – Health
systems Meridian Group International Inc. – CSR
What are ESD’s main technical focuses for reproductive health/family planning?
Best Practices – identifying BPs in and promoting use of BPs
CSR and Corporate Partnerships Family Planning-HIV Integration (of
services) Healthy Timing and Spacing of
Pregnancy Gender – launching HIM approach for
companies and workplaces
What is ESD’s experience in Africa?
Country-level projects: Kenya (North East Province APHIA –HIV/AIDS); Burundi; Guinea; Angola; D.R. Congo; Ethiopia; Sudan
Tanzania Unilever Tea: HIM + service delivery Medical Women Association of Tanzania: healthy
timing and spacing of pregnancy
Kenya Dadaab/Kakuma – religious leaders training; youth
training in gender-based violence prevention
Who are ESD’s Corporate, NGO Partners?
Unilever Tea Tanzania and Kenya Ltd. – workplace peer education project using the Healthy Images of Manhood approach
Business for Social Responsibility – (Health Enables Returns) HERproject technical advisor
Levi Strauss & Co. – Workplace health program in 3 supplier companies in Egypt/2 suppliers in Pakistan
Bayer Schering Pharma – Healthy Timing and Spacing of Pregnancy education materials
The Calvert Group (social investment firm) – the Calvert Women’s Principles/Gender Equity Principles
Global Business Coalition on HIV/AIDS, TB, and Malaria – HIM in Kenya; CSR workshop on health
Where did HIM come from?
HIM takes the best of: Proven “community-based”
gender programs – Project H, Raising Voices, and Men as Partners AND
Integrates ESD’s expertise in reproductive health/family planning and workplace programs
TO address the needs of companies & workplaces.
What is the HIM approach?
HIM is about men’s and women’s empowerment to improve health: Helping men to reflect on negative social
norms that lead to unhealthy behaviors Providing peer educators “gender”
knowledge and skills to influence their peers to adopt healthy behaviors
Linking health education to health services Taking a holistic approach to health –
integrating of HIV, family planning etc.
What is the meaning of Gender?
What is the meaning of Gender?
Sex or Gender:
Breastfeeding? Changing Nappies? Driving a trailer truck? Getting a vasectomy? Giving birth? Going to a bar? Washing clothes?
Definition of Sex and Gender Sex refers to the physiological
characteristics that identify a person as male or female.
Gender refers to the widely shared, expectations and norms about BOTH men and women and their behaviors.
Sex is a fact of biology (genitalia, hormones etc.)Page 24 – HIM Training Manual
Why is male engagement important in general and for companies?
Many good health education programs fail to address the effect of cultural beliefs on men’s behavior
Companies are not getting as much out their investments in worker health
Why is male engagement important in general and for companies?
Men’s unhealthy choices and behaviors harm more men– but also their families and entire communities
Peer health educators need specific knowledge and skills for addressing men’s cultural beliefs
What is unique about HIM as a gender program?
It shares many elements BUT
1. Gender programs are not tailored to the workplace realities
2. They are focused on a narrow, specific area: Gender-Based Violence; HIV/AIDS and care-giving;
3. Family planning & reproductive health are not integral
How is HIM different from most peer education training?
Many elements are the same BUT
1. Gender skills/knowledge are made integral to development of communication skills and health knowledge and outreach
2. Personal behavior change by PHEs themselves is essential
3. HIM takes a “whole person” approach to health
What are the main elements of HIM?
What are the main elements of HIM? Core Curriculum blending:
Gender skills/knowledge Health knowledge (RH/FP/HIV/Child health) Participatory outreach skills
Modular curriculum adaptable to each workplace Other valuable elements
Linkages/improvements to health services Capacity building:
Strong supervision – focused on mentoring, Ongoing skills development for PEs Company management ability to
maintain/expand program on its own
What other elements are in the HIM approach?
Data collection & analysis – by and for PHEs
M&E: “feedback loops” among PEs, Health Providers and the community
0
5
10
15
20
25
30
35
40
45
JAN FEB MAR APR
# of condoms
# of educationalsessions
# of referrals
# of family planningdiscussions
HIM Modules 1 & 2
HIM Modules 3 & 4
HIM Module 5 & 6 (& Appendices)
What materials supplement the HIM approach?
A PE Workbook A HIM Coordinator
Guidebook Pop Council Balanced
Counseling Strategy Video, Brochures, Posters
on Healthy Timing and Spacing of Pregnancy
A Small Taste of HIMExercise 1: Values Clarification
Experiences with HIM
How did we arrive with Unilever at Healthy Images of Manhood
Responding to specific needs of the company High HIV rate; good
health services/ systems
Low use services, particularly by men
Creating a “male engagement” program adapted to a workplace
What were the main goals of HIM at UTTL?
Primary Goal: to increase men’s use of UTTL’s health services (HIV, family planning etc.)
Secondary Goals: Improve the quality of PHEs’ outreach Promote behavior change in PHEs
themselves Create linkages between peer education
activities and service providers
How was the HIM program implemented at UTTL?
HIM Program Start-Up: Training program for 29 male peer health
educators – begun January 2008 (six days) ESD trained an external Tanzanian trainer
in HIM for initial training and capacity building for coordinator
Full-time coordinator assigned: mentoring, support
Monthly follow-up meetings
How was HIM implemented at UTTL?
HIM Development over 18 months: September 2008: 3-day refresher training Full-time coordinator assuming full
management Data collection system improvements
Changes and Scale-Up of program 52 new PHEs trained in HIM in September Half of new HIM PHEs are women HIM elements now in basic PHE training
What has been the impact of HIM to date? Referrals: Increase in male enrollment at CTC In 2009, for first time, men coming STI clinic at same rate as
women (and lower STI rate overall)
Family Planning services: Gradual uptake in FP by HIV clients (not previously offered in
CTC): 17 new FP clients and 70 repeat visits Jan-June 2009
Gradual increase overall of new FP clients: 16/month Jan-June 2009 compared to an average of 11/month for Jan-June 2007
PHE Productivity: 122,492 male and 5,321 female condoms distributed by HIM-
trained PHEs over 17 months
What has been the impact of HIM to date?
Qualitative: HIM-trained peer educators highly positive about
training and personal changes Positive reaction from women: “HIM is our
salvation”- PHEs have been asked to mediate marital
dispute Peer educators are seen as a resource On mobile clinic days (Maternal & Child
Health/FP), PHEs provide health education and assistance
“I always thought I was right. I treated her as a worker rather than a spouse. I have changed my behaviors towards my wife. I have began consulting her in family matters, sharing domestic responsibilities.
“People now come to me for referrals”
“Company leadership has received HIM very well. Unfavorable behaviors of masculinity have gone down at that level.”
Changes in the belief that HIV+ person committed a sin and that condoms are for prostitutes. Less suspicion in the home now when a woman finds a packet of condom in the husbands pockets.
One cited an incident where a woman came to him to thank him for whatever he did to her husband because the beatings have stopped
HIM Exercise 2: Proverbs
Each group will receive a proverb or saying for around Discuss what you think is the meaning of
the proverb Explain what it tells you about what is
that society’s view of men or women
Each group will identify 1-2 similar proverbs/sayings from their communities
The Business Case for HIM
ESD has major focus on Return on Investment analysis: Workplaces in Bangladesh and
Guatemala (studies) Interest in health outcomes and business
outcomes
HIM also is designed with the business case in mind
The Business Case for HIM
Business is investing in health program on HIV/AIDS, TB, Malaria:
HIM is designed to complement these efforts in order to: Get more return from these investments Be easily adapted cost-effectively into
existing PE and health programs Provide easy tools for implementation
Business Case for HIM
Each company has its own business interests:
Fulfillment of CSR commitments and obligations
Legal obligations: eg. The Sexual Offenses Act in Kenya
Better use of resources More impact from existing investments