• Recalls family planning and other reproductive health messages
• Understands what messages mean
• Can name products, methods, or other practices and/or sources of services/supplies

• Responds favorably to reproductive health messages
• Discusses messages or issues with members of personal networks (family, friends)
• Thinks family, friends, and community approve of practice
• Approves of practice

• Recognizes that specific health practices can meet a personal need
• Intends to consult a provider
• Intends to practice at some time

• Goes to a provider of information/supplies/services
• Chooses a method or practice and begins use
• Continues use

• Experiences and acknowledges benefits of practice
• Advocates the practice to others
• Supports community programs

Many men appear ready to change their reproductive health behavior and willing to participate more in reproductive health activities. In changing their behavior, people generally pass through five steps: knowledge, approval, intention, practice, and advocacy (121, 190) (see model at above).

Surveys and other studies suggest that many men have already gone through the stages of knowledge and approval and are now ready to adopt healthier practices. Hundreds of millions of men and their partners are using family planning. Millions more know and approve of contraception but are not using it (see Avoiding Unintended Pregnancies, Meeting Unmet Need and The Gap Between Approval and Use). Unmet need for family planning is substantial. Even where contraceptive prevalence is low, as in West Africa, many men say that they want to learn about family planning and to improve their own reproductive health and that of their families (10, 12, 60, 207, 276).

More men probably would take better care of their own reproductive health and that of their partners if programs reached out to them with appropriate information. A number of programs are finding ways to do that. Concerned about the spread of HIV/AIDS, the Transport Corporation of India, in collaboration with the AIDS Control and Prevention Project (AIDSCAP), started the Bhoruka AIDS Prevention Project (BAP) in 1995 (7). Thousands of truck drivers spend days waiting to cross the Nepal-India border. Separated from their wives or girlfriends, the men often turn to commercial sex workers. Social workers educate the truck drivers about HIV/AIDS and refer them to the BAP clinic in Raxaul, a checkpost city on the Indian side of the border. Collaboration with outreach workers in Nepal helps to ensure that truck drivers on the Nepali side also are referred to the clinic. At the clinic male and female doctors offer the men medical services, particularly counseling and treatment of STDs.

During the first year of the program, the number of people seeking counseling and testing for HIV increased from 136 to 2,431. Requests for condoms rose from 630 to 26,290. The BAP project adopted a condom logo, which it pretested to ensure its appeal to both Indian and Nepali truck drivers. It uses the logo on posters, leaflets, and counter displays urging the truck drivers to practice safe sex (7).

In Mardan, Pakistan, outreach workers with the Urban Community Development Council, an all-male organization founded 20 years ago, found that there was much higher demand for family planning information and contraception among men than assumed (195). Although most people in Mardan have conservative attitudes, husbands responded positively when male field workers approached them with information about reproductive health services. Demand for contraceptives exceeded expectations. The project now includes five clinics, and over 200 male Community Educators provide family planning information, distribute condoms, resupply oral contraceptives, and refer men to clinics (195).