Gottert Ann, Pulerwitz Julie, Weiner Renay, Okondo Chantalle, Werner Jesse, Magni Sarah, Mathur Sanyukta
Population Council, Washington, District of Columbia, USA
Population Council, Washington, District of Columbia, USA.
BMJ Open. 2025 Jan 20;15(1):e083950. doi: 10.1136/bmjopen-2024-083950.
Evidence regarding interventions to engage men and boys to improve sexual and reproductive health and rights (SRHR) has grown rapidly across subtopics such as HIV, family planning and gender-based violence (GBV). We conducted a review of the effectiveness of interventions to engage men and boys across SRHR domains, lessons learnt about successful programming, and about harms/unintended consequences, in low- and middle-income countries (LMIC).
Systematic review of reviews following Cochrane guidelines.
PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science and Cochrane were searched (18 October-9 November 2022; 9 September 2024).
Eligible reviews were published since 2015, covered WHO-defined SRHR domain(s) and focused mostly on LMIC.
Data extraction by multiple reviewers focused on intervention effectiveness, implementation best practices, unintended consequences, and quality/risk of bias.
Thirty-five systematic reviews were included, comprising ~960 primary studies. Reviews focused on HIV prevention/care, reproductive health, maternal and newborn health, and GBV. Reviews consistently concluded that men were successfully engaged, yielding benefits to both women and men's SRHR outcomes; no adverse intervention impacts on prevalence of SRHR outcomes were reported. We summarised the interventions most consistently found to be effective across reviews, in a programmer-friendly visual mapped onto a framework of men as clients, partners and agents of change. Person-centred, gender-transformative, multilevel approaches were most effective. Remaining evidence gaps include engaging men as contraceptive , sexually transmitted infections other than HIV, preventing unsafe abortion and SGBV as experienced by men and boys.
There is substantial evidence supporting a range of successful interventions to engage men and boys to improve SRHR, with markedly similar principles and approaches emerging across SRHR domains. It is time to scale up and integrate these strategies, monitoring for any potential harms and tailoring as needed to socio-cultural contexts and for specific vulnerable subpopulations.
关于促使男性参与以改善性与生殖健康及权利（SRHR）的干预措施的证据，在诸如艾滋病毒、计划生育和基于性别的暴力（GBV）等子主题中迅速增加。我们对中低收入国家（LMIC）中促使男性参与SRHR各领域的干预措施的有效性、成功项目的经验教训以及危害/意外后果进行了综述。
遵循Cochrane指南对综述进行系统评价。
检索了PubMed、护理及相关健康文献累积索引、科学网和Cochrane（2022年10月18日至11月9日；2024年9月9日）。
自2015年以来发表的符合条件的综述，涵盖世界卫生组织界定的SRHR领域，且主要关注中低收入国家。
多名评审员进行数据提取，重点关注干预措施的有效性、实施最佳实践、意外后果以及质量/偏倚风险。
纳入了35项系统评价，包含约960项原始研究。综述聚焦于艾滋病毒预防/护理、生殖健康、孕产妇和新生儿健康以及基于性别的暴力。综述一致得出结论，男性成功参与其中，对女性和男性的SRHR结果均产生了益处；未报告干预措施对SRHR结果患病率有不良影响。我们总结了在各项综述中最常被发现有效的干预措施，以一种对项目人员友好的可视化方式呈现，并映射到男性作为服务对象、伙伴和变革推动者的框架上。以人为主、具有性别变革性的多层次方法最为有效。其余证据空白包括促使男性作为避孕者参与、除艾滋病毒外的性传播感染、预防不安全堕胎以及男性和男孩所经历的性暴力和性别暴力。
有大量证据支持一系列促使男性参与以改善SRHR的成功干预措施，在SRHR各领域出现了明显相似的原则和方法。现在是扩大并整合这些策略的时候了，要监测任何潜在危害，并根据社会文化背景和特定弱势群体的需求进行调整。
