Factors influencing men’s decisions whether or not to utilize sexual and reproductive health services in Low-Middle-Income countries: A narrative review

Abstract

Background Low-Middle-Income countries (LMIC) present with a high aversion to the utilization of Sexual and Reproductive Health (SRH) services by men. Nevertheless, in both Low-Middle-Income and High-Income countries, low SRH utilization is mainly related to men's poor Health Seeking Behaviour (HSB). Identifying SRH inhibitors and facilitators remains an essential approach to improve SRH utilization and avert higher mortality and earlier morbidity associated with poor HSB among men. This literature review identifies factors contributing to men's decisions not to utilize SRH services, particularly to inform a conceptual model illustrating men's SRH utilization in LMIC. Methods In this narrative review, we searched articles published between 2004 and 2021 from international databases, including Google Scholar, Science Direct, EBSCOhost, Scopus, PubMed, Medline, and reference lists of retrieved published articles. Results A total of 2219 articles were retrieved, from which 51 articles met the inclusion criteria. We reveal lack of access and availability of SRH services, poor health-seeking behavior among men and, SRH facilities often not being seen as "male-friendly” spaces and not providing men's services under one roof as the underlying factors contributing to the poor uptake of SRH services by men. Further influences to decline in SRH utilization by men included lack of focus on adult men's sexual and reproductive health; the lack of inclusion of men in a meaningful way; and the insufficient evidence about large-scale and implementable approaches to address men’s SRH needs. Our reviews reveal that dealing with negative or inhibiting factors to manage low utilization of SRH services had improved men's SRH utilization where this was carried out. We conclude by proposing a framework to illustrate men's engagement with SRH services.

Down But Not Out: Vasectomy Is Faring Poorly Almost Everywhere—We Can Do Better To Make It A True Method Option

“…Consequently, FP service provision has long been oriented to reproductive-age women, and women are the main users of contraception, including PMs. Health care programs generally focus to a lesser extent on men’s health care needs, 31 and services for men in FP settings are typically limited. That there are only 2 contraceptive methods for men, both with method-related challenges—the condom, which is nonclinical and has a failure rate in typical use of 5%–13%, 2 and vasectomy, which must be surgically delivered, is suitable only for limiting fertility, and requires a skilled provider and supportive clinical infrastructure—is also likely a relevant factor in these dynamics.…”