The impact of “male clinics” on health-seeking behaviors of adult men in rural Kenya

Abstract

BackgroundIn most parts of the world, men access health services less frequently than women, and this trend is unrelated to differences in need for services. While male involvement in healthcare as partners or fathers has been extensively studied, less is known about the health-seeking behavior of men as clients themselves. This interventional research study aimed to determine how the introduction of male-friendly clinics impacted male care-seeking behavior and to describe the reasons for accessing services among men in rural Kenya.Methods and findingsWe questioned men to assess utilization and perceptions of existing health clinics, then designed and evaluated a “male clinics” intervention where dedicated male health workers were hired for one year to offer routine, free services exclusively to men within existing healthcare facilities. Results were compared between data from Male Clinics in specific health facilities, the same facilities concurrently, nearby control facilities concurrently, and intervention facilities historically.Costs of services, distance to facilities, and quality of care were the main barriers to healthcare access reported. The number of total visits was significantly higher than control groups (p<0·0001). In the intervention group, 18·6% of visits were for a checkup compared to almost none in control groups. The most common diagnoses overall were upper respiratory tract infections, malaria and injury. A major limitation of this study is the non-comparability in information captured using the Male Clinic registers compared to control registers.ConclusionsCosts and quality of services deter men from seeking healthcare. The introduction of male-friendly health services could encourage men to seek preventive care and increase service uptake.

Perceptions of “Male Sensitive” Health Services Among Men in Trinidad and Tobago

“…While the provision of private spaces for the delivery of services may be a practical consideration, it may be impossible to achieve since such levels of privacy may not be available in public health settings. The findings from Dowden et al (2019) demonstrate that the provision of privacy with an emphasis on health rather than a disease focus may be more attractive to men in increasing access to “male sensitive” services. Furthermore, men want to access health services in health settings but place a high value on maintaining anonymity although his very presence in the facility may be an indication that he was in need of help.…”

“…Since being a man and how men performed masculinity is based on social contexts, it provides even greater challenges in attempting to define “male sensitive” health services (Bardehle et al, 2016). Dowden et al (2019) intervention which provided male health care workers in separate clinical spaces proved an effective strategy in increasing uptake of health services since it reduced stigma and reduced waiting times for men. While researchers agree that men are not a homogenous group it may not be possible to develop a health service that can be construed as meeting the needs of all men.…”

“…One of the challenges related to the paucity of literature on “male sensitive” health services has been identified as the difficulty in adequately defining men as a group and what is meant by “male health” (Banks, 2004; MacDonald, 2006; Men’s Health Forum, 2004). Some policy approaches to “male sensitive” health services interventions have been implemented in England and Wales (Men’s Health Forum, 2004), Australia (MacDonald, 2006), and Kenya (Dowden et al, 2019). Underwood et al (2009) noted that African American men bear greater burdens of disease as opposed to their Caucasian counterparts, hence, the need for giving “voice” to their “thoughts, concerns and opinions” (p. 53).…”

“…Services targeting men have been limited in scope (Pan American Health Organization, 2019) but should be offered in a timely manner with short waiting periods, confidential, allow anonymity, comprehensive rather that focus on a specific health problem (Banks, 2004; Dowden et al, 2019; Men’s Health Forum, 2004); in socially acceptable spaces where they meet normally (Men’s Health Forum, 2004; Underwood et al, 2009), beyond the traditional hours (Men’s Health Forum, 2004) and with greater involvement of male professionals (Himmelstein & Sanchez, 2016b). Men also require services that include health information that moves beyond common health problems like prostate cancer, but information that will support the promotion of their health (Dowden et al, 2019; Underwood et al, 2009). Doyal (2001, p. 1062) also noted the importance of crafting messages that are “male sensitive” since one of the factors that allow men to hold on to the view that health was female oriented was “that health promotion messages are not addressed to them.” It is against this background that this research project assumes increased significance.…”

The role of self-care interventions on men’s health-seeking behaviours to advance their sexual and reproductive health and rights

“…The combination of social, behavioural and physical factors, and health systems challenges provides a better understanding of barriers men face in accessing health services for their sexual and reproductive health needs [ 18 , 26 , 27 ]. However, when there are services dedicated to men, studies have shown that there is an increase in health seeking behaviours [ 28 ], that underscores the great potential of self-care strategies in increasing safe and private sexual and reproductive health and rights options for men.…”