Experts want male-friendly services included in healthcare policies

Dar es Salaam. Health stakeholders have recommended that male-friendly services be incorporated into healthcare policies and strategies as a way of reducing new cases of tuberculosis and HIV/Aids.

Some of the male friendly services include meeting men where they are, giving age-appropriate counselling, removing barriers to access and creating men-only clinic spaces.

The services have been tested and proved to be effective.

They have also called for incresed education and uptake of integrated sexual and reproductive health services among men, mostly considered as the main catalyst of change in the society.

The recommendations to mitigate what they see as  limited understanding on issues of family planning (FP), TB, HIV/Aids, which are worsened by presence of destructive cultural gender norms.

They gave the advise during a recent breakfast meeting organised by Policy Forum themed: Revitalizing Tanzanian Men’s Health: Unlocking the Potential of Optimal Healthcare.

“These male-friendly services will increase men’s engagement in sexual and reproductive health services when applied as they will raise their confidence and feeling of involvement,” said Engenderhealth’s Gender, Youth, and Social Inclusion Advisor, Ms Jane Tesha.

USAID Afya Yangu Northern coordinator for Gender, Youth and Social issues, Mr Frederick Maguhwa said incorporation of male-friendly services into healthcare policies, and strategies at all levels will inform best practices.

He said study has shown that men are more likely to contract new infections than females, therefore increasing the possibility of becoming victims of HIV/Aids.

He said it was unfortunate that men were inactive in seeking health services, despite efforts made by the government and civil societies in the intensification of HIV/Aidss.

“Due to men’s reluctance in getting tested against different epidemics, the majority in Sub-Saharan Africa remain ignorant of their HIV status.

“A large number of citizens accessing TB and HIV/Aids health services are women, but since men are the ones holding decision-making powers, the participation of other members of the families including spouses is also affected,” said Dr Maguhwa.

He told The Citizen during a telephone interview that increasing men’s understanding and involvement in HIV testing, treatment and care was crucial for successful control of the epidemic.

“Some men have been prohibiting family members including spouses and children from involvement in healthcare matters, especially HIV/Aids testing and subsequent care,” he said.

He said effective approaches for integrating male-friendly services into existing healthcare services was important to improve services uptake, noting that health outcomes are part of holistic care for men.

“Masculinity, stigma, ignorance, limited understanding as well as economic hardships pose huge challenges in integrated healthcare services for men, especially in rural areas,” he said.

According to him, such issues have been limiting the engagement of male in healthcare services including FP, TB screening and testing against sexually transmitted diseases, provision of care and treatment.

He said studies have revealed that masculinity adversely affects the involvement of men in the access and provision of healthcare services.

“We have a cultural script about masculinity requiring men to be tough, brave, strong and self-dependent, making most of them to have a tendency of bearing everything, therefore abandoning healthcare services when they fall sick,” said the physician.

Dr Maguhwa said the standard of masculinity defines how men are supposed to be, conduct and think on social issues, challenging that these standards contribute to culturally dominant and stereotyped masculinity.

He said the current gender norms include negative views about masculinity, restricting men from seeking professional treatment and care when they experience health concerns.

He said there were common phrases used to amplify masculinity among men including “behave like a man”, noting that they are usually applied from childhood in order ensure the boys to grow with the status and respect as a man.

“It was like a burden to attend clinic sessions when my wife was pregnant. However, I was forced to attend in order to show my wife that I still loved her,” said Mr Salehe Mohamed, a resident of Kiluvya.

Mr Mohamed said he wouldn’t have attended the sessions if there was an alternative, noting that he would have left everything in the hands of his wife.

“These are the things we didn’t grow up with. Attending clinics and hospital sessions seems to be a responsibility of women. Men are supposed to focus on complex issues such as income generation for the family. That was the reason most trained nurses were the females,” he said.

Mr Mohamed suggested that increasing public engagement through use of creative media such as billboards, posters, radio and TV plays was important in order to get rid of harmful cultural gender norms existing in the society.

He called on the government to incorporate antenatal and post-natal care training, labour and delivery as well as family planning in the health education curricula at the grassroots level to enable boys to grow knowing that they are all gender responsible.

Dr Maguhwa advised the government to encourage effective use of professional development opportunities to enhance knowledge and skills to health providers in order to adequately address health needs among men

He said the needs include improving communication with male patients and addressing the issue of stigma, noting that masculinity beliefs have triggered men’s fear of HIV stigma, therefore opting to abandon testing.

Other stakeholders including the Usaid, Elizabeth Glaser Pediatric Aids Foundation (EGPAF), Engenderhealth, Amref Health Africa, D-tree International and Matchboxology shared similar views and recommendations to the government.

They underscored the need to integrate male-friendly health services into existing healthcare services.

“We need to improve health status for all Tanzanians include enhanced enabling environment for health service provision, upgrading availability of quality, integrated health services at the family level and increased access to health services at the community level,” said Dr Maguhwa.

Data show there are over 4.9 million people are living with HIV/Aids, but only 80 percent have been enrolled for treatment.

Out of 60 million Tanzanians recorded by the Population and Household Census 2022, 84 percent have taken measures to create awareness of their HIV/AIDS status and that only 82 percent have been enrolled for treatment.

However, the number is far away from 95 percent targets made by the United Nations Programme on HIV/Aids (UNAIDS), indicating that there are critical challenges in the access and/or continuity of treatment that can lead to increased HIV-related morbidity and mortality.

Seven years are left for Tanzania to realise the 95-95-95 target of ending the HIV/AIDS epidemic by 2030.

The first 95 percent stands for diagnosed people with HIV/Aids, 95 percent of those diagnosed that have been enrolled for antiretroviral therapy (ARV) and 95 percent of those on ARV with suppressed viral load.

The World Bank (WB) estimates that with the ongoing trend, the world is likely to fail to achieve the target of ending the HIV/Aids epidemic by 2030.

This is because of the present number of new HIV infections which is not slowing quickly at an encouraging rate.

Improving prevention, treatment and testing have significantly reduced HIV incidents and Aids related deaths over the last two decades, but the progress has since stalled. “With ambitious targets set for 2030, there is increased urgency for action,” he said.