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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
  1. Eimear Ruane-McAteer1,2,
  2. Avni Amin3,
  3. Jennifer Hanratty2,
  4. Fiona Lynn1,2,
  5. Kyrsten Corbijn van Willenswaard1,2,
  6. Esther Reid1,
  7. Rajat Khosla3,
  8. Maria Lohan1,2
  1. 1School of Nursing and Midwifery, Queen's University Belfast, Belfast, United Kingdom
  2. 2Centre for Evidence and Social Innovation (CESI), Queen's University Belfast, Belfast, United Kingdom
  3. 3Department of Reproductive Health and Research (RHR), World Health Organization, Geneve, Switzerland
  1. Correspondence to Professor Maria Lohan; m.lohan{at}qub.ac.uk

Abstract

Objectives Working with men/boys, in addition to women/girls, through gender-transformative programming that challenges gender inequalities is recognised as important for improving sexual and reproductive health and rights (SRHR) for all. The aim of this paper was to generate an interactive evidence and gap map (EGM) of the total review evidence on interventions engaging men/boys across the full range of WHO SRHR outcomes and report a systematic review of the quantity, quality and effect of gender-transformative interventions with men/boys to improve SRHR for all.

Methods For this EGM and systematic review, academic and non-academic databases (CINAHL, Medline, PsycINFO, Social Science Citation Index-expanded, Cochrane Library, Campbell Collaboration, Embase, Global Health Library and Scopus) were searched using terms related to SRHR, males/masculinities, systematic reviews and trials (January 2007–July 2018) with no language restrictions for review articles of SRHR interventions engaging men/boys. Data were extracted from included reviews, and AMSTAR2 was used to assess quality. Outcomes were based on WHO reproductive health strategy.

Results From the 3658 non-duplicate records screened, the total systematic reviews of interventions engaging men/boys in SRHR was mapped through an EGM (n=462 reviews) showing that such interventions were relatively evenly spread across low-income (24.5%), middle-income (37.8%) and high-income countries (37.8%). The proportion of reviews that included gender-transformative interventions engaging men/boys was low (8.4%, 39/462), the majority was in relation to violence against women/girls (n=18/39, 46.2%) and conducted in lower and middle-income countries (n=25/39, 64%). Reviews of gender-transformative interventions were generally low/critically low quality (n=34/39, 97.1%), and findings inconclusive (n=23/39, 59%), but 38.5% (n=15/39) found positive results.

Conclusion Research and programming must be strengthened in engagement of men/boys; it should be intentional in promoting a gender-transformative approach, explicit in the intervention logic models, with more robust experimental designs and measures, and supported with qualitative evaluations.

  • Public Health
  • Systematic review

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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Footnotes

  • Handling editor Sanne Peters

  • Contributors All authors designed the protocol and review procedures. ER-M conducted database search and removed obviously irrelevant records under the guidance of JH. ER-M, KCvW, ER and ML and trained data screeners (Dr Conall O'Rourke, Matthew Johnston, Reem Saeed Alghamdi, see Acknowledgements) screened records for inclusion. ER-M and KCvW conducted review of review data extraction. KCvW and FL conducted data extraction for quality appraisal. ER-M and ML conducted initial analysis of the findings. ER-M and ML drafted the manuscript. AA, JH, FL, KCvW, ER and RK provided critical revisions to the manuscript. All authors read and approved the final manuscript.

  • Funding This review is funded by the Human Reproduction Programme (United Nations Development Plan, UNDP/United Nations Population Fund, UNFPA/UNICEF/WHO/World Bank Special programme of research, development and research training in human reproduction – HRP) at the WHO).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.