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Reviews on engaging men in relation to WHO sexual and reproductive health and rights outcomes and the proportion of which is gender-transformative. Of the reviews, only 39 8. Only 14 of the 39 reviews The agreed ratings for each item of AMSTAR2, as well as the overall rating of included reviews can be found in online supplementary appendix 6. As the checklist was designed to assess the methodological quality of systematic reviews, it was not applicable for assessing four papers identified as reviews of reviews.
Although a number of reviews addressed outcomes spanning multiple domains, reviews were categorised into each WHO domain based on their primary outcome. In contrast to the EGM, where promoting sexual health and well-being, was most frequently reported, a much smaller number of reviews of gender-transformative interventions reported on this outcome Few reviews specifically disaggregated for outcomes related to male adolescent SRH.
Within helping people realise their desired family size, only two reviews included interventions focusing on contraception, 46 47 and no reviews of gender-transformative interventions were identified relating to in fertility.
Evidence of effectiveness is largely inconclusive yet promising. However, a third of reviews reported positive or promising outcomes, and only one review reported no effect. This was especially true where health professionals and fathers were more educated than mothers underlying the imperative to examine for unintended effects on generating gender equalities.
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Overall, however, the quality of evidence on effectiveness is limited for several reasons, including lack of critical mass of high-quality experimental gender-transformative intervention studies and limited studies including behavioural eg, VAWG rates or biological eg, HIV status outcomes. More of the included studies relied on outcomes based on self-reported attitudinal and norm changes and were measured over a limited time period ie, under 1-year duration , which do not necessarily correlate or translate into behaviour change outcomes.
The EGM highlights that while the majority of review evidence on male engagement lies in areas of sexual health, family planning and adolescent SRHR outcomes, there is very limited review evidence on topics related to maternal and child health, VAWG, unsafe abortion and SRH in disease outbreaks. The findings with most significant concerns for policy, research and programming relate to the limited number of reviews that include intervention studies that are gender-transformative ie, that address harmful masculinities, male privilege over women or unequal power relations between women and men.
Moreover, almost 25 years after the ICPD call for male engagement as an approach to promoting gender equality, the findings of this review highlight that the evidence remains sparse in terms of rigour and quality and in demonstrating conclusively the effectiveness on a range of SRHR outcomes. However, findings should be interpreted with caution in light of low-quality review evidence.
This highlights that with more rigorous study designs and outcome measures used, as well as attention to programme and evaluation quality and reporting, progress is likely. Analysis of the review evidence provides direction for a strengthened research agenda. First, there is a need to strengthen programme reporting standards when it comes to reviews and studies—as it is obvious from table 2 that many of the parameters were not reported or unclear while extracting data.
Second is the need for future studies to go beyond self-reported attitudinal outcomes by men and include more biobehavioural outcomes. Third is the need for evaluations to have a longer period of time for programme effects to show results downstream. Fourth is the need for programme implementers and researchers to be explicit about the pathways by which change is likely to occur. Finally, the limited number of higher quality intervention studies ie, quasi-experimental or RCT design , particularly those gender-transformative in nature, highlights the need for investment in more rigorous approaches.
A number of limitations of this review warrant acknowledgement. A general limitation of a review of reviews is there is a risk of missing newer evidence from interventions that have not yet been included in systematic reviews. The focus on effectiveness limited our selection to experimental and quasi-experimental studies, omitting cross-sectional and solely qualitative studies. The next generation of investments in research and programming on male engagement needs to consolidate this emerging evidence and assess SRHR outcomes that are less well covered such as maternal and new-born health, family planning, safe abortion, infertility and SRH in disease outbreaks.
Research and programming needs to be intentional in promoting gender equality and monitoring any adverse or unexpected outcomes that may result from interventions.
Gender-transformative programming requires a balance between appealing to men in order to effectively engage with them and challenging men to contest gender inequalities. Contributors All authors designed the protocol and review procedures. ER-M conducted database search and removed obviously irrelevant records under the guidance of JH. KCvW and FL conducted data extraction for quality appraisal.
ER-M and ML conducted initial analysis of the findings.
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Interventions addressing men, masculinities and gender equality in sexual and reproductive health and rights: an evidence and gap map and systematic review of reviews. Statistics from Altmetric. Public Health Systematic review Key questions What is already known? What are the new findings? What do the new findings imply? Introduction The case for addressing gender equality as part of a human rights-based approach to improving health, including sexual and reproductive health SRH , has been a long-standing guiding principle in the feminist literature on gender and development and significantly foregrounded in global public health since before the International Conference on Population and Development ICPD in Cairo.
Methods The decision to conduct a review of reviews rather than of primary intervention studies was guided by the necessity of including the broad scope of all seven WHO defined SRHR outcomes listed below. We operationalised the WHO 15 definition of gender-transformative programming: Considers gender norms, roles and relations for women and men and that these affect access to and control over resources.
Addresses the causes of gender-based health inequities. Includes ways to transform harmful gender norms, roles and relations. The objective is often to promote gender equality. Supplementary data [bmjghsupp RCTs, randomised controlled trials. View this table: View inline View popup. Table 1 Reviews on engaging men in relation to WHO sexual and reproductive health and rights outcomes and the proportion of which is gender-transformative.
Men's Sexual Health - Brigham and Women's Faulkner Hospital
Table 2 Characteristics of included reviews. Conclusion Analysis of the review evidence provides direction for a strengthened research agenda. References 1. Global prescriptions: gendering health and human rights. Addressing gender dynamics and engaging men in HIV programs: lessons learned from horizons research. Public Health Rep ; : — OpenUrl CrossRef.
Gender CR. Health and theory: Conceptualizing the issue, in local and world perspective. Soc Sci Med ; 74 : — Tallis V. Power To: Local Action. London : Palgrave Macmillan UK , : — Agarwal B. The power of numbers in gender dynamics: illustrations from community forestry groups. J Peasant Stud ; 42 : 1 — From work with men and boys to changes of social norms and reduction of inequities in gender relations: a conceptual shift in prevention of violence against women and girls.
Aim To review the current literature examining diet and dietary patterns and male sexual health. Methods A thorough literature search of peer-reviewed publications on the association between diet and dietary patterns and male sexual health erectile dysfunction, hypogonadism, and infertility was carried using the online PubMed database from through with the keywords diet, dietary patterns, erectile dysfunction, male hypogonadism, low testosterone, and male infertility. Main Outcome Measures Summary of significant findings on erectile function, androgen levels, and semen analysis parameters in relation to diets or dietary patterns.
Results Thirteen studies on diet and erectile dysfunction and 15 studies on diet and testosterone levels were reviewed, including observational studies and randomized controlled trials. Many factors can contribute to male infertility, including low sperm production, anatomical abnormalities, testicular trauma and genetic or immunological diseases, among many others. Determining the exact cause of infertility involves a thorough physical evaluation, lab tests, imagery and semen analysis.