The Barriers of Men’s Involvement in Sexual and Reproductive Health: A Mixed-Method Study

Introduction Sexual and reproductive health (SRH) is considered as one of the most unfamiliar dimensions of our society despite being one of the main aspects of the healthcare system (1,2). Each year, from among 200 million pregnancies that occur in the world, more than one mother dies per minute due to the complications of pregnancy and childbirth. In general, 585 000 mothers die every year because of this problem (3). SRH is not merely related to women, but one of its critical aspects links with the role of men (4,5). These responsibilities could vary from healthy sexual relationships up to childbearing, proper decision-making and supporting in economic, social and mental health areas, feeding the child to the upbringing of the children, and applying preventive methods for unwanted pregnancy to other duties and supports (6,7). Although men are highly interested in contributing to the SRH of their wives, low-knowledge and inadequate information about women and the constraints of pregnancy prevent men from acting and supporting (8,9). According to a systematic review, educational and informational weaknesses are the main barriers to male participation in SRH (10). High-risk behaviors including drug abuse are one of the reasons for men’s failure to participate in reproductive health programs (8,11). In addition, cultural differences are found to inhibit SRH communication and contribute to reproductive health (12). On the other hand, a previous study indicated that reproductive health services are not user-friendly or of need-based type (13). Overall, the results of previous studies significantly showed that male participation in reproductive health programs encounters a wide range of barriers that need to be addressed to improve male involvement in reproductive and maternal health promotion. Thus, providing better evidence on this issue in developing countries, especially among the Iranian population as a Abstract Objectives: Maintaining and promoting women’s reproductive health is one of the main goals of healthcare system. Meanwhile, men play a substantial role in the success or failure of reproductive health programs though their role is unfortunately unknown in many countries including Iran, thereby facing many problems. The purpose of this study was to investigate the barriers to the role and understanding of men’s involvement in sexual and reproductive health (SRH) of their wives. Materials and Methods: The present study mixed-method study (review and qualitative design) was conducted in 2 steps. First, relevant data were retrieved using several online databases such as Scopus, Medline, Science Direct, Google Scholar, SID, Noormags, and Magiran. Then, additional information and supplementary codes were gathered utilizing an in-depth semi-structured individual interview with 13 married men and 2 focus groups among 14 married women after obtaining the informed consent. Results: The study findings showed that men had a good perception of participating in reproductive health at the levels of family supervision and management, creating a suitable condition for their wives’ pregnancy and overall health, and finally, taking actions regarding medical care and preventions and providing informative and helpful educations for their wives. However, a wide range of economic-occupational, psychological-mental, socio-cultural, educational-informational, and policy barriers to the healthcare system of the community have prevented their participation in SRH care and programs. Conclusions: Overall, policymakers and stakeholders are expected to consider these barriers to men’s involvement in SRH in their policy and management plans, leading to the development of men’s participation in SRH care of their women.