Mbizvo M T, Bassett M T
Department of Obstetrics & Gynaecology, University of Zimbabwe Medical School.
Health Policy Plan. 1996 Mar;11(1):84-92. doi: 10.1093/heapol/11.1.84.
Reproduction is a dual commitment, but so often in much of the world, it is seen as wholly the woman's responsibility. She bears the burden not only of pregnancy and childbirth but also the threats from excessive child bearing, some responsibility for contraception, infertility investigation and often undiagnosed sexually transmitted diseases (STDs) including AIDS. Failure to target men in reproductive health interventions has weakened the impact of reproductive health care programmes. The paper proposes that sophisticated and dynamic strategies in Africa and elsewhere which target women's reproductive health and research (such as control of STDs including AIDS, family planning, infertility investigation) require complementary linkage to the study and education of men. Men's perceptions, as well as determinants of sexual behavioural change and the socioeconomic context in which STDs, including AIDS, become rife, should be reviewed. There is a need to study and foster change to reduce or prevent poor reproductive health outcomes; to identify behaviours which could be adversely affecting women's reproductive health. Issues of gender, identity and tolerance as expressed through sexuality and procreation need to be amplified in the context of present risks in reproductive health. Researchers and providers often ignore the social significance of men. This paper reviews the impact of male dominance, as manifested through reproductive health and sexual decisions, against the background of present reproductive health problems. A research agenda should define factors at both macro and micro levels that interact to adversely impinge on reproductive health outcomes. This should be followed up by well-developed causal models of the determinants of positive reproductive health-promoting behaviours. Behaviour specific influences in sexual partnership include the degree of interpersonal support towards prevention, for example, of STDs, unwanted pregnancy or maternal deaths. Perceived efficacy and situational variables influencing male compliance in, say, condom use, form part of the wider study that addresses men. Thus preventive reproductive health initiatives and information should move from the female alone to both sexes. Women need men as partners in reproductive health who understand the risks they might be exposed to and strategies for their prevention.
生殖是一项双重责任，但在世界上许多地方，它常常被视为完全是女性的责任。她不仅要承担怀孕和分娩的负担，还要承受过度生育带来的威胁，承担一些避孕、不孕症检查以及通常未被诊断出的性传播疾病（包括艾滋病）的责任。在生殖健康干预措施中未能将男性作为目标群体，削弱了生殖健康保健项目的影响。本文提出，在非洲和其他地区，针对女性生殖健康和研究的复杂而动态的策略（如控制包括艾滋病在内的性传播疾病、计划生育、不孕症检查）需要与男性的研究和教育建立互补联系。应该审视男性的观念，以及性行为改变的决定因素和包括艾滋病在内的性传播疾病盛行的社会经济背景。有必要研究并促进变革，以减少或预防不良的生殖健康结果；识别可能对女性生殖健康产生不利影响的行为。在当前生殖健康风险的背景下，需要强化通过性和生育表现出来的性别、身份认同和包容问题。研究人员和提供者常常忽视男性的社会意义。本文在当前生殖健康问题的背景下，审视了通过生殖健康和性决策表现出来的男性主导的影响。一项研究议程应确定在宏观和微观层面相互作用、对生殖健康结果产生不利影响的因素。接下来应该建立完善的促进积极生殖健康行为决定因素的因果模型。性伴侣关系中特定行为的影响包括人际间对预防（例如预防性传播疾病、意外怀孕或孕产妇死亡）的支持程度。影响男性使用避孕套等行为依从性的感知效能和情境变量，是涉及男性的更广泛研究的一部分。因此，预防性生殖健康倡议和信息应从只针对女性转向针对两性。在生殖健康方面，女性需要男性作为伴侣，他们要了解自己可能面临的风险以及预防策略。
