Not everyone agrees, however, that encouraging men's participation in reproductive health activities is a good way to improve women's reproductive health (43, 109, 110, 262). Some argue that men are already too involved—that is, men hold too much power over decisions that affect women's fertility and health. They point out that more attention to men, if not well planned and wisely developed, could reinforce this imbalance rather than correct it.

Some also fear that more attention to men could jeopardize reproductive health services for women (12, 19, 179, 199, 235, 262). They worry that new programs for men will mean more competition for limited, and sometimes shrinking, reproductive health funds.

These concerns are legitimate. Men's policies and programs should be planned using the same criteria as other public health programs—considering the seriousness and prevalence of health problems, the effectiveness of the intervention, program costs, cultural appropriateness, and resource limitations (162). For each country or program, the approach to men depends largely on the available resources and on health priorities (260). It also depends on what mix of programs and services will best serve clients' health needs (12, 59, 100).

Engaging men's participation and providing reproductive health care to men can be scaled to suit resources and priorities. At the least, some programs can designate several clinic hours each week for male clients or encourage female clients to bring their male partners to the clinic. At the other end of the spectrum are special clinics for extensive men's services, expanded contraceptive social marketing programs, and national communication campaigns directed to men. In some places programs can start at once to promote men's participation in reproductive health. In other places, there may be more immediate health priorities, and promoting men's participation may start small or come later.