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Male Reproductive Health Matters in Pakistan: A Sociocultural Perspective

Submitted by on April 6, 2016 – 9:20 PM

male-repro-healthCulture is said to be the backdrop to an individual’s development; and cultural beliefs and values are reflected in an individual’s behaviour. Unfortunately the pernicious nature of societal influence means that taboos and stereotypes are harder to challenge. One such important issue that remains unaddressed in Pakistani society is that of male reproductive health: the pubertal changes in a man’s life, sexual health, reproductive pathologies and consequent social challenges.

 

Some of the issues concerned with male reproductive health include infertility, nocturnal emission, unmet sexual needs, masturbation and safe sex education. Many socio-cultural factors weigh in on the stigma surrounding these topics. According to Castro, et al (2014) the men of society are recognized and respected for their role in reproduction, and any shortcoming there is thought to detract from their masculinity.

 

Reproductively fragile men are less accepted by society and are considered as ‘barren’ and ‘weak’. This also affects the self image of the reproductively challenged and becomes a matter of pride. According to Castro, et al (2014) men are more bothered about their self-perception in society than their inability to reproduce. This accounts for the general unwillingness to admit to a problem and to seek a healthcare provider.

 

Another most important cause is gender inequality – according to Castro, et al (2014) as proposed by universal human rights, men and women should be treated in an equalitarian manner and both sexes should have equal access to health care services. Our society is more open about female than male sexual and reproductive health education. The difference is seen especially in terms of public awareness; as community schools prepare girls for menstruation but boys are not taught about nocturnal emission, which is also a natural process.

 

In addition, parents often fail to educate their adolescent sons as well as daughters about healthy sexual behavior as this discussion is deemed inappropriate in many households. According to Ali, et al (2004), parent teen communication is very poor because of which 76% teenage boys acquired information about sexual health only through peers and media. Inadequate awareness also contributes to risk of STDs.

 

Another factor that creates neglect of male reproductive health is the lack of preparation of health care provider in providing care, which may make the patient uncomfortable and hesitant in sharing their problems. According to Marcell, et al (2011) quality of care is improved when health care providers themselves are comfortable and confident in obtaining proper history of male reproductive health patient, and can develop trust and assure them of their confidentiality.

 

Another major barrier in our society is the cultural stigmatization of male reproductive diseases. As shown by Khan, et al (2006) in Bangladeshi culture, semen loss during nocturnal emission and ejaculation is thought to be a sign of weakness, and a consequence of sexual disease. Semen loss is seen as something shameful, moreover many traditional ‘healers’ claim that nocturnal emission reduces potency of semen.

 

Besides this many males believe that their masculinity is defined by their thickness of semen, and any deviation would affect their fertility. Furthermore the idea exists that poor men will have poor quality of semen and would produce physically and mentally challenged offspring. Such prevalent misconceptions discourage men from actively seeking medical care regarding reproductive and sexual matters.

 

In conclusion, the reproductive health of men is largely neglected in our society and must be brought out into the open. According to social cognitive theory, we need to work on the three modifiable factors that can help to reconstruct behavior of people. Firstly on a cognitive level we need to correct their attitude and enhance their knowledge of accessing reproductive health treatment. This can be done by gathering the women and educating them about the importance of talking to their spouses about their mutual reproductive health and to motivate them to access treatment for related problems.

 

Additionally we need to facilitate parent-teen communication. Secondly we can give guidance about access to different treatments. Thirdly on a behavioral level, we may promote awareness among health care providers about effective skills of therapeutic communication, how to show good bedside manner that gains the trust and confidentiality of the patient. Finally on the community level, sessions regarding male reproductive health can be arranged in schools to impart knowledge to adolescents regarding unhealthy sexual behaviours and pubertal changes, and to dispel myths and stigma around it.

References:
Ali, M., Bhatti, A.M., & Ushijima, H. (2004). Reproductive health needs of adolescent males in
Rural Pakistan: an exploratory study. Tohoko ,J. Exp.Med, 204, 17-25
Castro, W.R., Carvalho, M.C.M.P,, Mohamed. R.P., S, Moura, M.A.V., & Queiroz, A.B.A.
(2014).The health of men who experience infertility: a social representations study.  Esc
Anna Nery; 18(4):669-675
Marcell, A.V., Wibbelsman,C.,& Seigel, W.M. (2011). Male adolescent sexual and reproductive
health care. The American Academy of Pediatrics.128(6). 1658-1676. DOI:
10.1542/peds.2011-2384
Khan1,S.A., Rodd,N.H., Saggers,S., Bhuiyan1,M.I.,Bhuiya.I.,Karim3,S.I.,& Rauyajin,O.
(2006). Semen contains vitality and heredity, not germs: seminal discourse in the AIDS
Era. J Health Popul Nutr .24(4):426-437

 

 

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