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Population Reports is published by the Population Information Program, Center for Communication Programs, The Johns Hopkins School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland 21202-4012, USA

New information, new understanding, and new approaches promise to help men become full partners in better reproductive health. Men, as well as women, play key roles in reproductive health, including family planning, but increasing men's participation has been difficult. Adopting new perspectives can help.

Today's new perspectives recognize that:

• Men play important, often dominant roles in decisions crucial to women's reproductive health;
• Men are more interested in family planning than often assumed but need communication and services directed specifically to them;
• Understanding—and influencing—the balance of power between men and women can help improve reproductive health behavior;
• Couples who talk to each other about family planning and reproductive health can reach better, healthier decisions.

Men's participation is a promising strategy for addressing some of the world's most pressing reproductive health problems. With HIV now spreading faster among women than among men in some regions, the AIDS epidemic has focused attention on the health consequences of men's sexual behavior. Also, millions of pregnancies are unintended, and each year many thousands of women die as a result of these pregnancies.

At the same time, surveys, mostly in Africa, find that many men favor family planning and are concerned about reproductive health. For example, in 8 of 12 countries with surveys of men, at least 70% of men approve of family planning. Increasingly, men make reproductive decisions together with their wives. Such findings suggest that men's reproductive health behavior is ready to change.

If men are ready, why have some programs to involve them fallen short? Some efforts may have been too weak and too brief or based on incomplete understanding of men's motivations, couples' interactions, and what engages men.

Gender—the different roles that men and women play in a society and the rights and responsibilities associated with those roles—is a powerful force. In many countries gender roles make it difficult for men and women even to discuss family planning. Men often dominate decision-making and so can seriously harm or help women's reproductive health.

Communication plays a key role in new approaches to men. Communication can help promote equity between partners. Encouraging couples to discuss contraceptive use and other reproductive decisions can lead to healthier practices. Messages in the mass media can address men's specific concerns and give men positive models to follow. At the same time, service delivery now recognizes men's distinct reproductive health needs.

Nine major lessons learned from research and program experience can help to increase men's participation:

• Reach Male Audiences with Appropriate Messages
  Lesson 1. Build on men's approval of family planning.
  Lesson 2. Use the mass media to communicate with men.
  Lesson 3. Reach out to young and unmarried men.
• Use Communication to Promote Behavior Change
  Lesson 4. Understand the influence of gender.
  Lesson 5. Encourage couple communication.
  Lesson 6. Bring information to where men gather.
• Offer Information and Services That Men Want
  Lesson 7. Inform men about condoms and vasectomy.
  Lesson 8. Counsel men with respect and sensitivity.
  Lesson 9. Offer men a range of health services.