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Men and Reproductive Health Programs: Influencing Gender Norms

Introduction

In September 2003, program implementers, researchers, evaluators, and donors came together in a four-day conference in the Washington, D.C., area to learn about men and reproductive health programs around the world that had challenged gender norms. Participants in the conference were particularly interested in those programs that could show through evaluations that gender-related attitudes and behaviors had changed in a direction likely to reduce health risks, specifically, those associated with violence and unsafe sex. Identifying these programs and the strategies that made them successful has implications for future gender-related reproductive health, HIV/AIDS, and maternal and child health programming because they may serve as models to be adapted, scaled up, or replicated elsewhere. This review aims to highlight these good programmatic models, some of which were presented at the September 2003 conference.

Four general themes emerged in the process of conducting this review. First, initiatives affecting gender norms for the sake of doing so are still relatively nascent. Only in the past ten years have they become a significant subset of the wide range of programs in the global health arena.

Second, substantive evaluations are not common. There simply is not a large enough sample of thorough and systematic data on the efficacy of these programs as a whole. Data are typically gathered and analyzed from the perspectives of participants and facilitators at a level too cursory to allow an in-depth assessment of their outcomes. Often, these evaluations do not include comparable data from a control group; therefore, it is unknown whether or not the results are statistically significant.

Third, evaluations that specifically report the program’s effect on gender norms—and not only on health outcomes—are rare. Programs may influence this type of social norm, either directly or indirectly, but they generally neglect to include their effects on gender norms in an evaluation.

Fourth, health programs affect social norms related to gender roles even if they do not aim to address these norms directly. Despite their inclusion of and near virtual effect on gender roles, few programs actually separate their work of influencing gender norms from their efforts to modify or eliminate the behaviors that arise from these social

constructs. For example, programs designed to curb gender-based violence may include a short module on gender roles and challenging contemporary definitions of masculinities; similarly, life skills peer education programs may introduce the concept of alternative and flexible gender roles to youth and create an enabling environment within the classroom setting where those alternative roles are reinforced and encouraged. This is largely due to the historical neglect of gender-sensitive approaches specifically purposed to alter gender norms in global health programs.

Men and Reproductive Health Programs: Influencing Gender Norms can have haphazard or unintended effects on gender norms. For example, between 1993 and 1994 in Zimbabwe, the Male Motivation and Family Planning Campaign affected many Zimbabwean men. The planners integrated language from competitive sports and images of local soccer heroes into some of the campaign’s materials. As intended, the messages appealed to the male target audience and contraceptive use increased. The action-oriented and assertive imagery and messages reinforced gender stereotypes, however. According to surveys, not only did men become more interested and involved in selecting a family planning method, men tended to dominate and even assume full responsibility for this decision. Rather than endorsing shared decision-making between both partners in a couple, the mass media campaign had the effect of sanctioning and encouraging male-dominant behavior.

The relative newness of this interest in changing gender norms and the lack of long-term, large-scale evaluation efforts means that we cannot state with much certainty that the attitudinal changes reported by participants in preliminary and post intervention data are sustainable. Moreover, whether or not the reported attitudinal changes have been exhibited as behaviors is left to speculation and confirmation by forthcoming evaluations.

This review describes programs specifically designed to change social norms related to gender roles. It explains the methodologies each employed to achieve this goal and presents findings from evaluations conducted to assess their efficacy. The information provided herein attempts to compile information necessary to describe the best-evaluated approaches to altering entrenched gender norms.

The Zimbabwe Male Motivation and Family Planning Method Expansion Project, 1993–1994. Available at the following Web address: www.africa2000.com/PNDX%5CJHU-zimbabwe.html. Accessed October 9, 2003.

Men and Reproductive Health Programs: Influencing Gender Norms

Over the past ten years, the calls for involving men in reproductive health issues have emphasized the role of men in improving the health of their families and themselves, and the importance of addressing the gender inequities underlying poor reproductive health. In response, many male involvement programs have been created. Most of these health interventions have tended to be oriented toward changing behavioral outcomes (e.g.,

condom use or the use of health services). Yet, shaping these outcomes and guiding much of what we do in our everyday lives are social norms, and central among these are gender norms. Gender norms are some of the strongest social influences shaping men’s and women’s lives. They provide the values that justify different and often discriminatory treatment of one or the other gender. Widespread social discrimination against women is

visible in lower levels of investment in the health,2  nutrition,3  and education of girls and women.4  Institutionalized legal disadvantages for women underpin laws that keep land, money, and other economic resources out of women’s hands,5  and by foreclosing protection and redress, they contribute to violence against women.

Sexual and reproductive health is strongly affected by gender norms. Norms favoring male children and promoting women’s economic dependence on men contribute to high rates of fertility in many settings. Inability to negotiate sex, condom use, or monogamy on equal terms leaves the majority of women and girls worldwide at high risk for unwanted pregnancy, illness and death from pregnancy-related causes, and sexually transmitted infections. Research has consistently shown that men play key roles in the spread of sexually transmitted disease, and that women bear greater reproductive health hazards.

One widely known example of the relative effectiveness of considering norms and not just behaviors can be observed in Uganda where efforts to reduce HIV prevalence in the

1990s encouraged behavior change from many angles. One such angle encouraged men in particular to reduce the number of sexual partners they had through “zero grazing,” a reference to the tradition of tethering an animal to a stake and allowing it to graze in a circle. In the context of gender norms that permit and often encourage men to have multiple sexual partners, the message about caring for and respecting their wives and themselves went far beyond a simple behavior change.

Altering social norms is vital to the equitable distribution of resources and rights between the sexes. Oftentimes, men act as the gatekeepers to health care for women. They can either impede or facilitate women’s health service–seeking behavior. Gender roles adversely affect men as well. Men may engage in high-risk behaviors more frequently in order to meet the perceived expectations of social norms related to gender. Men may also repress desires to display effeminate characteristics due to social prohibitions on homosexuality or social definitions of masculinity. These realities have been highlighted by the AIDS epidemic and the combination of men’s greater likelihood of having

multiple partners and women’s difficulty in negotiating condom use or the conditions of sexual encounters. Men’s involvement in military campaigns and the myriad risky behaviors associated with warfare especially contribute to the cycle of infection in areas of Africa ravaged by military conflict. Altering gender norms will be particularly imperative in this context, as successive waves of demobilized troops inculcated to adopt detrimental constructions of masculinity are reintegrated into society. Furthermore, women’s socialized and coerced dependence on men both financially and emotionally, as well as women’s relative ignorance of the interplay of socioeconomic factors that

increase their vulnerability to infection, further exacerbate the epidemic. These social, gender-related, and economic issues, among others, contribute directly to the epidemic and can be addressed through altering the socialized paradigms of masculinity and gender norms.

The purpose of this review is to present programs that have effectively altered social norms regarding gender. Norms are perceived shared values that are often the underlying principles motivating an individual’s outward behavior, which in turn, set the social climate. Debunking the idea of a single hegemonic masculinity is imperative to addressing the unhealthy repercussions of socially defined “maleness.” This entails the introduction of multiple and concurrent masculinities that can be assumed in various contexts to enable men to adapt to social situations with versatility to increase the probability of positive and gender-equitable decision-making. This review presents a purposive sample of programs that have affected social norms regarding gender in a manner that has been captured in an evaluation. Examples were drawn from regions throughout the world in order to present a balanced and accurate sense of current efforts to change social norms related to gender.

Most of these programs do not describe their theoretical underpinnings. However, the process of normative change—as opposed to individual behavior change—is well captured by the theory of Diffusion of Innovations (DOI) by Everett Rogers; the programs described follow this process and are at one or another of its stages. “Diffusion is the process by which an innovation is communicated through certain channels over time among the members of a social system… [leading to] social change.”8  Initially, individuals who are open to (and sometime seeking) innovation are influenced by the new ideas and practices of opinion leaders whom they respect. These early adopters of the new behaviors tend to be leaders within their own peer groups, and therefore they bring many others to the new way of thinking and acting. When a critical mass of

adopters emerges, the mainstream social group follows. Some people are late adopters, of course, and some never adopt the innovation. Successful efforts to combat AIDS have followed this approach,9  as have organized family planning programs.10  It should be noted that theories of individual behavior change are not incompatible with DOI theory. However, until a critical mass of individuals who have changed attitudes and behaviors emerges, society itself, and therefore social norms, will not change.

As the DOI theory well articulates, normative change hinges on the adoption of an innovative idea by individuals until a critical mass of adopters is achieved. Given this, the programs presented in this review must be viewed as methods to prompt individuals and societies to progress through the stages outlined in the DOI theory.

Review of Literature

For many years, reproductive health programs simply did not address men,11  in part because women’s centrality to reproduction was taken for granted (an assumption that itself reflects social norms) and in part because so little was known about men. Recent years have provided much useful information about men. A 1999 review by the Panos Institute provided extensive evidence on the special role that men were playing in spreading HIV and linked men’s behaviors to underlying gender norms.12  A comprehensive analysis of men’s reproductive health needs worldwide by the Alan Guttmacher Institute provides much-needed information about men, though it does not strongly address the ways in which gender norms constrain reproductive health for both men and women.

Over the past decade, numerous programs involving men have been developed and documented. These programs involve men in safer motherhood, offer diagnosis and treatment of sexually transmitted infections, develop men’s parenting skills, encourage men’s support of women when they seek services, and provide basic information and counseling, among the range of their offerings. The wide universe of programs can be glimpsed in the pages of several important reviews. For example, a United Nations Population Fund review effectively divides male involvement efforts into those that promote family planning, serve men’s needs, or attempt to address gender inequity, but does not dwell on evaluation efforts.14  A UNICEF review similarly includes a wide variety of programs, some of which attempt to change social norms. But whether these programs have been evaluated is not discussed for the most part.

Inspirational, life-changing, informative: these words can describe nearly the entire myriad of programs designed to change gender norms. Unfortunately, “evaluated” and “demonstrably effective” are not on that list of descriptors. Several promising programs that are widely recognized as being innovative and influential in their work to change perceptions of gender roles have not been evaluated in ways that would make their replication possible. For example, Fathers Inc., in Jamaica, is a training and support program that teaches and encourages men to nurture their roles as fathers and to assume the position of a gender-equitable role model for their children and communities. PAPAI works with adolescent fathers in Brazil, stimulating public discussion on the importance of young men’s participation in sexuality, reproduction, and parenthood. The organization creates a space for young fathers, who are an invisible and undervalued group, where they are appreciated and challenged to assume greater responsibility by developing their parenting skills and expanding their concepts of gender, rights, and citizenship.16  In Mexico, the Male Collective for Equitable Relationships (CORAIC) supports creative, emotional, and respectful constructions of masculinity through programs focused on nurturing men as fathers and preventing gender-based violence. It also galvanizes community support to address these issues politically.17  Salud y Género, based in Mexico, sensitizes men to the detriments of socialized masculinity, especially violence, and how they affect both men and women. The organization emphasizes working with men facing social and economic issues in all-male or mixed-gender groups.

The Society for Integrated Development of Himalayas focuses instead on achieving social justice through educational programs with youth and network-building between commensurately empowered men and women. In the Dominican Republic, the Catholic Institute for International Relations has conducted gender workshops to explore and address the social and cultural processes that enable gender-based violence. The institute has also been involved in similar efforts in Haiti, facilitating discussions analyzing cultural impediments and enablers that affect the power balance between men and women that in turn influence issues of gender and development.18  The Botswana National Youth Council works with youth broadly by addressing their needs and anxieties about male sexuality, including intimate partner relations, through a program focused on preventing HIV infection. Thandizani, a Zambian nongovernmental organization, engages communities in meaningful dialogue on the interconnectedness of gender, sexuality, and vulnerability to HIV in order to stimulate change in community norms.19  The University of Edinburgh has worked with the Meru ethnic group in Kenya, providing education on gender issues to men undergoing the initiation rite of circumcision.20  These are just a few of the worthwhile programs affecting the lives of men of all ages in different contexts. Unfortunately, it cannot be stated definitively whether the above-mentioned programs have been effective enough to be expanded or replicated in other settings.

Influencing deeply entrenched social norms, such as those addressing gender, is not easy, but clearly, it has already been done. One-hundred years ago, women in the United States could not vote, and very few went to college or worked outside the home. Women’s emancipation, like all great social changes, was in part due to organized efforts and in part due to economic and other forces. Given the worrying state of reproductive health throughout the world, including HIV/AIDS, we do not have 100 years to wait. Good programs—given sufficient reach—can accelerate the pace of progress. The programs described here meet the criteria of successfully challenging gender norms as well as improving reproductive health behaviors as outlined in the Framework for Men in Reproductive Health programs.21  Adoption of the highest criterion—that which changes socially defined male-female roles for the better—will avoid problems of some male involvement programs that have unintentionally reduced women’s autonomy or increased violence in their efforts to recruit men to use family planning.22

The following review describes evaluated programs in developing countries specifically designed to address social norms related to gender roles. It explains the methods each employed to achieve this goal and presents findings from various kinds of evaluations conducted to assess their efficacy.

Overview

In English the name of this organization is synonymous with “quarry,” meaning a rich or productive source. The work of CANTERA, which stands for Population Education and Communication Center, has indeed been a rich resource for the people it has served. This organization began its work on masculinity and gender with men in 1994. Since 1989 the organization has been a leader in popular education. It fuses gender relations and women’s personal experiences in its societal analyses. Nicaragua, where CANTERA is based, is a predominantly Catholic and male-dominated society.

Scope

Two-hundred fifty men in Costa Rica, El Salvador, Guatemala, and Nicaragua.

Objectives

Through its workshops, CANTERA seeks to facilitate internal transformative processes by examining social attitudes, values, behaviors, and the social construction of masculinity using men’s own life stories as a starting point rather than theoretical frameworks. Ultimately, through introspection and the recognition of the contradictions and injustices related to gender roles, the program encourages men to generate their own proposals for specific change and to take responsibility for making these changes.

Implementation

Over the span of a year participants attend four 3½-day workshops centered on the following themes in the order presented: 1) male identities; 2) gender, power, and violence; 3) unlearning machismo; and 4) forging just relationships. During the first workshop the men engage in exercises to help them question their own discriminatory practices, reflect on the social construction of male identities, and consider the methods men employ to exercise power. The second workshop builds on the previous analysis of the roots of men’s violence, its effects on men and their families, and its relationship to the current socioeconomic situation in Nicaragua. Men then brainstorm ways to reduce violence in their families. In the third workshop, processes that would allow men to change are identified, strengthened, and outlined in the form of a methodology that can be employed to train other men. Men and women alike participate in the last workshop in order to share what they have learned and to deepen their individual analyses by taking into account the other’s perspectives.

Promoting change in the familial and personal spheres is the highest priority. The religious nature of the society is integrated into the workshops; facilitators often quote or elicit passages from religious texts considered holy by Nicaraguans of Spanish descent and indigenous peoples. Feature films serve as entry points for discussions to deconstruct hegemonic definitions of masculinity (e.g., the film Once Were Warriors, a graphic depiction of the negative effects of violent masculinity on men and women; and Marta and Raymond, which inverts gender roles to enable men to witness the mechanisms used to subjugate, humiliate, and abuse women).

Evaluation and Outcomes

One-hundred twelve of the original 250 men who participated in any of CANTERA’s workshops between September 1994 and September 1997 were surveyed. The men’s questionnaire consisted of 312 questions divided into seven sections. Program evaluators overcame the lack of baseline data by creating a “subjective approximation” and a “subjective appreciation” (i.e., a surmised quantification and estimated trend) of the men’s perceived internal changes. They accomplished this by separating the questions related to the men’s pre- and post-participation behaviors into sections.

When compared with data that had been gathered from surveys of women who knew the male participants, both groups tended to agree that the men had changed in the following ways: they reflected less “macho” perceptions of masculinity, they participated more in domestic chores, their relationships in the workplace had improved, they had reduced their discriminatory practices, and they had demonstrated greater solidarity with women. There was a significant increase in the number of men actively seeking sexuality education, from 36 percent to 55 percent.

The pool of respondents was not a representative sample of the general populations in their respective countries, which may explain their high levels of seeking health education. Like the other 138 participants, they were generally older, educated, and employed. This could be explained by the fact that most of the men who took part in the workshops were referred by their employers, usually nongovernmental organizations.

Funding Sources

CANTERA receives the majority of its financial support from European and U.S. voluntary organizations, development agencies, and religious congregations. Some major financers include NOVIB and Van Leer Foundation in The Netherlands; Swedish International Development Agency; CAFOD, in England; Catholic Women, in  Austria;

OXFAM America; and Friends of CANTERA, in the United States. CANTERA also

generates revenue by selling its publications and local goods.

Contact Information

E-mail: cantera@nicarao.org.ni www.oneworld.org/cantera

Sources

Welsh, Patrick. 2001. Men aren’t from Mars: Unlearning machismo in Nicaragua.

London: Catholic Institute for International Relations.

CANTERA Web page: www.oneworld.org/cantera. Accessed October 13, 2003.

Overview

The New Visions Program for Boys and Young Men, located in Upper Egypt, is an informal educational program of basic life skills and reproductive health developed in recognition of boys’ distinct needs and rights, and men’s and boys’ influence on the enabling environment for girls’ rights. A one-year pilot phase of this project, which was sponsored by the Centre for Development and Population Activities (CEDPA) took place in 2002. The program is currently in its implementation phase, which is projected to end in 2004. Beni Suef (the evaluation site) is a relatively poor region of Egypt. Many of its socioeconomic indicators were substantially lower than those for Egypt as a whole in

2001. For instance, the female literacy rate was 35 percent, versus the national average of 54 percent; and 51.2 percent of its residents are poor versus the national average of 20 percent.

Scope

While serving 1,900 young men in Beni Suef in 2002, the program is expected to serve 8,500 participants in eleven governorates by 2004.

Objectives

To influence gender norms related to reproductive and sexual health, affecting the rights and needs of girls and boys alike.

Audience

Literate adolescent boys between the ages of 11 and 20 in Upper Egypt. The overwhelming majority of the boys in Beni Suef lived with both their parents at the time of the evaluation.

Implementation

In 65 educational sessions, facilitators provide participants with information and discussion issues on a range of topics: gender, gender roles, interpersonal relationships, and legal rights, among others in a 17 unit schedule. The program is implemented through 180 partnering Youth Councils and nongovernmental organizations. Facilitators use both interactive and noninteractive methods. Tapes of drama and poetry, role-plays, puzzles, posters, and games are among the session aids.

Evaluation and Outcomes

The evaluation was conducted in three rural villages in Beni Suef. One of these villages served as a control. Knowledge, attitudes, and practices surveys were conducted at baseline (T0), immediately following the last educational session (T1), and one year after the sessions (T2). Qualitative data were collected in the two intervention villages through interviews with facilitators and focus groups with participants. Only preliminary baseline and T1  findings are available. These indicate not only increased awareness of the potential flexibility of gender roles, gender equity, and gender violence, but also more positive attitudes toward these issues among boys who underwent the intervention.

Specifically regarding gender equity, there was a statistically significant decrease in the number of boys who thought that boys and girls should be treated differently in terms of food, work, marriage age, and movement outside of the house. There were also large and significant increases in the proportion of boys who believed that responsibilities should be shared between husbands and wives in both society and within the household. More sensitive issues historically entrenched by cultural and religious values were not as amenable to change, but results were hopeful. Some evaluation items indicated that boys displayed significantly more negative attitudes toward female genital cutting. For example, the percentage of boys who would prefer to marry an uncircumcised woman increased from 22 percent to 37 percent. Moreover, those who agreed that the “benefits of female circumcision outweigh any of the damages” decreased from 70 percent to 55 percent. Equally important, those who remained ambivalent began to question the utility of the practice. Not all data were available to contrast these findings with those of the control group.

Funding Sources

This is a USAID-funded program implemented by CEDPA’s Egypt office.

Contact Information

Centre for Development and Population Activities

53 Manial Street, Suite 500

Manial El Rodah Cairo 11451, Egypt Tel: 2-02-365-4567

E-mail: cedpaegypt@cedpa.org.eg www.cedpa.org/egypt

Sources

Abstracts approved for presentation at the Global Conference on Reaching Men to

Improve Reproductive Health for All September 2003. Available at the following Web address: http://www.rho.org/reaching_men_09-03/9-03conf_accepted_abstracts.pdf. Accessed October 9, 2003.

Selim, Mona. 2003. Preliminary findings from the New Visions Program Pilot Evaluation in Egypt (PowerPoint and oral presentation). Presented to the Reaching Men to Improve Reproductive Health for All Conference, Dulles, Virginia.

Overview

In 2000, the Centre for Development and Population Activities (CEDPA) began the Better Life Options Program for boys, based on an existing CEDPA program that works exclusively with girls. Like other similar programs, it evolved as a response to the need to work with boys, as identified by girls in the female-specific program. It was developed using CEDPA’s “Better Life Options and Opportunities Model,” which integrates social mobilization with self-efficacy in order to empower young people. A manual for adolescent boys was developed in 1999 and the boys’ project was planned and executed

in a two-year period, between 2000 and 2002.

Scope

Ten nongovernmental organizations partnered to implement the project across eleven

Indian states affecting 8,397 youth.

Objectives

To challenge gender inequities and broaden the life options available to adolescent youth through the use of an empowerment model in the context of a holistic program.

Audience

Adolescent boys, 10 to 19 years of age, took part in the program. The majority of the young men were unmarried students who generally felt they were not empowered. Preliminary profile data indicated that few believed they could make an autonomous decision about when to marry (27 percent), whom to marry (36.1 percent), and the

number of children to have (40.7 percent). Moreover, some of the boys stated that peer

pressure, early marriage, and high family expectations were obstacles to achieving their dreams, which further detracted from their sense of autonomy.

Implementation

CEDPA implemented its training module in three settings for differing lengths of time: intensive camps lasting ten to 14 days; classroom settings; and various social and educational settings for three to six months, including vocational and remedial classes, clubs, and gyms. The training module consisted of the following materials in both English and Hindi: the “Choose a Future!” training manual, facilitators’ handbooks, posters, videos, and supplementary materials such as anatomy models, exercises, training aids, and games.

The “Choose a Future!” manual specifically addressed gender issues and engaged youth in issues surrounding awareness of self and gender, communication skills, and interpersonal relationships among other topics. Facilitators included health professionals, educators, and community members.

The Summit Foundation provided $100,000, which was used to fund the entire project.

Contact Information

Centre for Development and Population Activities

50-M Shantipath

Gate No. 3, Niti Marg

Chanakyapuri

New Delhi, India 110021

Tel: 91-11 2467-2154

Tel: 91-11-2688-6172

E-mail: bsood@vsnl.net

Sources

Mishra, Arundhati. 2003. Enlightening adolescent boys in India on gender and reproductive and sexual health (PowerPoint and oral presentation). Presented to the Reaching Men to Improve Reproductive Health for All Conference, Dulles, Virginia.

Youth Development Project. Available at the following Web address:

www.cedpa.org/projects/youth.html. Accessed October 28, 2003.

Overview

One impetus for the Conscientizing Male Adolescents Program, sponsored by the International Women’s Health Coalition, is the perception that Nigeria is a country poised on the brink of an extensive HIV/AIDS epidemic fueled by gender inequity. Its

current HIV rate is almost 6 percent among adults aged 15–49. At 130 million, Nigeria is the most populous country in Africa, and 50 percent of Nigerians are under the age of 20. As in other countries in Africa, the youth population will be the hardest hit, and young women will be affected most of all. Cultural norms support egregious gender inequities, both in the Christian south and the Muslim north. Economic and social turmoil generally override the importance of health issues in daily life.

Implementation

CMA employs structured dialogues, a method inspired by Paolo Freire’s pedagogy of the oppressed. CMA is entirely operated by male community members. Some field officers, who lead the dialogues, are adolescents and alumni of the CMA program. The curriculum is structured in two levels. The first level consists of weekly two-hour meetings at secondary schools and covers the following topics: fundamental concepts of biological differences between the sexes; gender oppression; gender-based violence as both a social and personal phenomenon; and men’s responsibility in sexual relationships. Following a graduation ceremony and promotion to the second level, the following topics are covered in monthly one-day meetings at a Calabar hotel: communication skills; logical thinking methods; and critical and anti-sexist introductions to Nigerian society, world history, and human rights.

Participants are stimulated through dialogue techniques to critique the world they live in and to brainstorm feasible remedies for gender-related societal vices. Unlike the traditional rote learning process, discussions are facilitated by probing questions, and the boys actively engage in deconstructing their usual way of thinking about gender issues by considering inherent contradictions. The discussion groups involve several elements: dialogue, logical argument, information transfer, role-playing, brainstorming, “true or false” exercises, and “myths and realities.” The boys are not trained as peer educators per se; rather, their cognitive processes are challenged until they suggest solutions to the issues they analyze during discussions.

The program has expanded in response to demand to include counseling services for participants, community advocacy work, and a third section for university youth.

Evaluation and Outcomes

To date, CMA has yet to conduct a quantitative evaluation of its effect on participants. Program staff gathered qualitative data using pretests and posttests in the form of questionnaires with participants and in-home interviews with participants’ families or other caretakers. Data from the questionnaires have not been analyzed, and the data collected from the interviews are limited by the lack of adherence to a uniform methodology. Separate in-depth interviews with CMA staff, community members, and ten CMA participants, however, provide anecdotal evidence of positive changes in attitudes and behavior. Unfortunately, a satisfactory redefinition of masculinity has not yet taken place. For instance, many boys still blame the victim for rape and do not understand the concept of marital rape. An evaluation unit was developed in 2002.

Funding Sources

International Women’s Health Coalition has funded CMA since its inception in 1995. The MacArthur Foundation has provided support since 2000. The total budget for 2002 was $100,000.

Contact Information

Calabar International Institute for Research, Information and Development/CMA

90B Goldie Street

P.O. Box 915

Calabar, Nigeria

Tel: 087-234704

E-mail: ciinstrid@hyperia.com

Sources

Irvin, Andrea. 2000. Taking steps of courage: Teaching adolescents about sexuality and gender in Nigeria and Cameroun. New York: International Women’s Health Coalition.

Girard, Françoise, and Gary Barker. 2003. My father didn’t think this way: Nigerian boys contemplate gender equality. New York: The Population Council.

Whitaker, Corinne. 2003. Challenging inequities: The story of an anti-sexist and rights- based program for Nigerian adolescent males (PowerPoint and oral presentation). Presented to the Reaching Men to Improve Reproductive Health for All Conference, Dulles, Virginia.

Men and Reproductive Health Programs: Influencing Gender Norms

Mobilizing Young Men To Care Project

(South Africa)

Overview

This project implemented by DramAidE (Drama-in-AIDS Education), a South African nongovernmental organization operating in KwaZulu-Natal since 1991, has the overarching goal of promoting gender responsibility to prevent HIV/AIDS among youth in response to school-based violence. The second phase of this project began in 2001. KwaZulu-Natal is the epicenter of the HIV/AIDS epidemic in South Africa. The target schools are disadvantaged ones in rural areas of the eThekwini, uMhlathuze, and Amahlubi regions in KwaZulu-Natal. Unemployment rates are very high, and most families sustain themselves through small-scale farming, informal trading, and factory labor. Traditional Zulu culture dominates the regions, which are highly stratified and patriarchal. Some more conservative elements of Christianity also have taken root in these areas. People typically do not openly discuss high-risk sexual behaviors with their children. Previous work conducted by DramAidE Youth Clubs, which had been established by the Act Alive project in the same schools, facilitated the work of the Mobilizing Young Men to Care (MYMTC) project.

Scope

More than 2,000 students and teachers were affected by this program. Volunteers were accepted from the student bodies of three secondary schools in KwaZulu-Natal: one in the Matubatuba region, one in the Hlabisa region, and the other in the Amatikulu region.

Objectives

The project has four main objectives:

1.   To create an environment in which young men can become more caring and socially responsive—which entails changing stereotypes, misconceptions, and value systems related to gender norms.

2.   To sensitize young men in order to improve their communication skills.

3.   To encourage boys to make healthy lifestyle choices in relationships.

4.   To galvanize boys’ resolve to be involved in health-related projects.

Audience

Male secondary school students in a poor urban area of South Africa.

Implementation

MYMTC uses a mixed-gender approach implemented in each school over the period of one month. A drama technique known as forum theater is used to facilitate discussions in an intensive series of fifteen workshops. This technique involves the audience in the outcome of the drama. One of the exercises involved the production and recording of an improvised three-scene play, with interchangeable outcomes to each scene, at one of the schools. This technique is called “stop-start” theater, and in the video the protagonist is stereotyped as the “typical Zulu male,” a powerful and dominant character, dismissive of any external criticism, with a number of sexual partners. A professional actor played this character and the boys and girls complemented his performance as well as those of other actors in the play. The audience and other actors are encouraged to challenge the Zulu male’s role. In order to achieve a multiplier effect at relatively low cost, recordings of the production were featured in other schools accompanied by discussions facilitated by staff from the University of Natal.

Evaluation and Outcomes

Three focus groups were held (one male-only, one female-only, and one mixed-gender) in an informal evaluation of the project, using the Johns Hopkins University Center for Communication Program’s model of behavior change. Participants provided structured feedback after a period of introspection and reflection. The evaluation consists of an analysis of the participants’ feedback gathered during the focus groups and the facilitator’s observations. A specific outcome for each focus group is not given, and it appears that only the observations from the mixed-gender focus group are reported. This makes it difficult to understand the transformative processes undergone by the boys, because the facilitator’s perceptions and insights were likely to have been affected by input from the female participants. However, interviews with the boys did reveal that they became more open to ideas of gender equity.

An interesting finding was the facilitator’s observation of the phenomenon of “role reversal” and its effect on group dynamics. Some of the young girls took on “masculine” attributes as they felt more empowered, such as being more expressive and performing dances traditionally reserved for males. In turn, young boys became less open and vocal during discussions about sexuality in the presence of the girls. Therefore, despite the focus on boys, the project also had an effect on the girls.

Funding Sources

The United Kingdom’s Department for International Development funded this project

through the British Council.

Contact Information Professor Robert Morrell Interim Co-Dean

Faculty of Education

University of Natal

Durban 4041, South Africa

Tel: (031) 260 1127

E-mail: morrell@nu.ac.za www.nu.ac.za/DramAideE

Men and Reproductive Health Programs: Influencing Gender Norms

Men As Partners Program

(Several countries in Africa and Asia)

Overview

Outlined in 1996, Engender Health’s Men As Partners (MAP) program is an initiative to assist stakeholders in global health to constructively involve men in reproductive health and family planning. In 1998, EngenderHealth and the Planned Parenthood Association of South Africa (PPASA) began a collaborative effort to respond effectively to the synergistic epidemics of gender-based violence and HIV/AIDS in South Africa.

South Africa suffers from a number of social and economic woes; in 1999, for example, it had the highest per capita rape rate in the world. According to 2001 figures, the national HIV/AIDS prevalence rate for adults aged 15–49 was greater than 20 percent. South Africans have, however, proved their mettle when fighting for human rights. The country’s rich history of grassroots activism, which can be harnessed to galvanize communities around other issues, provides hope for combating HIV/AIDS and gender inequity.

Scope

Launched in all but one of South Africa’s nine provinces, MAP serves urban, semi-urban, and rural communities.

Objectives

MAP has the following aims:

1.   To mobilize men to become actively involved in countering the HIV/AIDS

epidemic and gender-based violence.

2.   To confront the deep-seated patriarchal beliefs and attitudes that place the health and safety of men, women, and children at risk.

Audience

Older and younger persons of both genders, in male-only and mixed-gender groups.

Implementation

Trained PPASA community health educators conduct the workshops in a variety of settings such as workplaces, trade unions, prisons, and faith-based organizations. The workshops vary in length from one hour to seven days. Community health educators are prepared for the workshops through a training-of-trainers model. After identifying institutions in which the intervention will take place, master trainers participate in training-of-trainers workshops, gaining skills in facilitation, leadership, and conflict resolution. This gender-focused training complements many of the community health educators’ experiences as activists in the anti-apartheid struggle. Male and female educators range in age from 20 to 35.

Workshops are based on three core elements of constructive male involvement:

1)   A recognition that men usually have control or influence over the reproductive health choices made by their partners.

2)   An appraisal of how current gender roles negatively affect men by promoting risky behaviors as “manly” and health-seeking behaviors as indications of frailty.

3)   An appreciation for both the personal investment necessary to confront current gender norms and the positive health consequences for men and women of a redefinition of gender roles.

Activities incorporated in the workshops include gender boxes, courage activity, storytelling, role-plays, and discussing the effect of HIV and gender-based violence on children. The discussions are formed and led in the context of South Africa’s socioeconomic circumstances (i.e., in the local histories of apartheid, unemployment, rapid urbanization, and poverty).

MAP seeks to sustain its effect through an adaptation of the “Spectrum of Prevention” approach developed by Larry Cohen23  to galvanize community involvement and approval through marches, education, network building, mentoring, and the development of theater pieces, as well as the distribution of condoms.

Evaluation and Outcomes

EngenderHealth recently conducted a longitudinal evaluation of MAP that included pre- and post-intervention interviews with 200 male workshop participants, in addition to a three-month-follow-up inquiry. Fifty female partners of the male participants were interviewed as well. Interviews with participants and nonparticipants in a control group demonstrate the effects of the program:

•    Seventy-one percent of participants believed that women and men should have the same rights, versus 25 percent of men in the control group.

•    Eighty-two percent of participants thought that it was unacceptable to rape sex workers, versus 33 percent of nonparticipants.

•    Eighty-two percent of participants believed that it was not right to beat their wives at times, versus 38 percent of the men in the control group.

Program implementers reported differences in their work with men of different ages. Older men tended to respond better to in-depth sessions of longer duration. On the other hand, adolescent boys were more amenable to accepting alternate views that challenged traditional constructions of masculinity.

Monitoring and evaluation are ongoing, and a promising opportunity to conduct a multiyear study will provide further insights on the effectiveness of MAP’s work.

Funding Sources

The U.S. Agency for International Development, the MacArthur Foundation, and other funders financed this program. However, program implementers cite inconsistent and unpredictable funding as one of the contributors to their difficulty in providing follow-up for former participants.

Contact Information

Men as Partners Programme

EngenderHealth

440 Ninth Avenue

New York, NY 10001

Tel: (212) 561-8394

E-mail: mmehta@engenderhealth.org www.engenderhealth.org

Sources

Peacock, Dean. 2003. Taking a stand for gender equity and positive male involvement in sexual and reproductive health and rights and against men’s violence against women

(PowerPoint and oral presentation). Presented to the Reaching Men to Improve

Reproductive Health for All Conference, Dulles, Virginia.

EngenderHealth. 2002. The Men As Partners Program in South Africa: Reaching men to end gender-based violence and promote HIV/STI prevention (a Men As Partners briefing paper). New York: EngenderHealth.

Men’s work working with men, responding to AIDS: A case study collection. London: International HIV/AIDS Alliance. 2003.

Country by Country: South Africa. Available at the following Web address:

http://www.engenderhealth.org/ia/cbc/south_africa.html. Accessed October 28, 2003.

between the two. By involving the community from the outset and submitting “requests for change” to the community, everyone is made aware of the requirements for establishing a supportive environment. This program also suggests establishing work- based programs in which men are paid to attend intervention workshops in order to enroll and retain male participants. This strategy would require negotiations with employers to convince them that participation in the program makes practical business sense.

The Conscientizing Male Adolescents Program achieves sustainability through its recruitment process. The program is an opportunity to nurture bright young men who may otherwise find their ambitions stifled in a society with limited career opportunities. Because leaders are the only participants, the program must expand to a new location

once the pool of willing participants is exhausted. The addition of a project for university students demonstrates this program’s commitment to sustainability in a practical sense.

The work of Instituto Noos in Brazil highlights the need and utility of partnerships with the judicial system to provide more effective and holistic forms of punishment for crimes attributable to negative and unhealthy characteristics of masculinities. It also draws attention to the need to bolster the authority of the justice system as well as citizens’ resolve to reform it.

Both of CEDPA’s featured programs integrated workshops into the curricula of educational centers. Although this tactic is difficult to initiate, it reduces the need to recruit facilitators to sustain the program’s aims. It also ensures the incorporation of modules on gender equity into the normal curriculum, that is, assuming that the instructors perceive the information presented as worthwhile and beneficial to both themselves and their students.

Sustaining changes and networks is a reoccurring difficulty lamented by all of the programs. Programs using peer education techniques are particularly prone to this shortcoming. With Stepping Stones, for instance, the peer educators often failed to maintain relationships with their peer groups, thereby effectively thwarting the continuance of the support group. The trust and relationships established during the project’s implementation phase are then severed. Projects that impart problem-solving and critical-thinking skills avoid this problem to an extent.

Conduct Intervention with Males Separate from Females

Often, in order to solidify an innovative way of thinking, individuals have to be sequestered and allowed time and space to think about the implications of adopting a new pattern of thinking. The Mobilizing Young Men to Care project in South Africa can serve as a cautionary tale on this issue. Its workshops included females in its focus groups in order to engender genuine change in the male students that would not be misinterpreted. This strategy proved to be counterproductive in that the gender dynamics in the focus groups changed as a result of female participants increasing an exhibition of “masculine” traits in the mixed-gender focus groups. The female students began to feel more empowered as the project progressed. It can be inferred that any change exacted in the young men may not have been captured and may possibly have been overshadowed by

the achievements of the female students. The environment created by the project did not provide sufficient space for the males to analyze their behaviors without the input of the opposite sex.

A possible suggestion to improve the project design could be to conduct focus groups with males only as a separate phase of the project so that the self-reconstruction process can solidify into self-actualized attitudes and behaviors free from the input of the opposite sex. Another phase can include young women in the focus groups in order to challenge the strength of the young men’s resolve to adopt more gender-equitable attitudes and behaviors. The young women’s sense of empowerment will then serve the objectives of the project, rather than confound the results. Or the workshop sequence used by Stepping Stones could be emulated, whereby males and females participate in separate but concurrent workshops that are combined for the final workshop session.

Suffuse Mass Media with Images of Gender-Equitable Relationships

In order to counteract unhealthful messages propagated through the mass media, equally appealing positive messages have to be disseminated. Nuances such as the placement of the hands, eye contact, and body language communicate volumes without words. Keeping this in mind, the Strength Campaign, for instance, plans to modify its leaflets and posters to more accurately portray images of couples in which both partners are mutually valued. The campaign strives to offer an alternative to the mainstream images of women as ornaments for men and the sole gatekeepers of sex. Zero Tolerance’s Respect Campaign, as well as Soul City, artfully portray dramatic scenarios to stimulate discussion of the interconnectedness of different social ills and gender issues and the necessity of redefining gender roles.

Integrate Unidirectional and Bidirectional Vehicles of Communication Essentially, programs involving interactive groups and those using mass media approaches differ in two ways. First, mass media or marketing campaigns allow only unidirectional delivery of information, whereas group-based methods allow bidirectional exchange of information. This is a strength of the latter program type. Group-based methods provide participants with an accessible source of information, a soundboard for comments and feedback, and a reified entity to reinforce intended messages (at least during the program implementation phase). Marketing campaigns may, however, possess a greater capacity to create an enabling environment due to their ability to reach a wider audience.

Second, the messages presented by mass media campaigns must be in the form of sound bites discretely packaged to deliver simplified information. Through discussions and dialogue, group-based methodologies allow participants to delve into and think about the subjects presented. Group-based methodologies do require the personal commitment of more individuals rather than corporations in order to sustain the intervention, however. Both approaches require sensitivity to local culture and linguistic diversity, in addition to repetition.

Men and Reproductive Health Programs: Influencing Gender Norms

Given the limitations of both approaches as channels to induce behavior change, the most efficacious approach may be a multi-pronged one in which mass media campaigns simply foster the creation of an enabling environment for exercising the desired behavior and a group-based methodology reinforces the messages presented. Program H’s field-tested project in the Caribbean and Latin America would serve as a suitable model for this type of multipronged approach

Quasi-scientific Evaluations are the Most Compelling

Sound evaluations not only provide feedback on the efficiency and efficacy of a program for internal use, they also provide informative data on specific methods that can be adapted by posterity to improve and enrich future programs. Unfortunately, much of the evaluation data analyzed for this review would have allowed greater latitude for comparison between programs if the results had been more keenly scrutinized and systematically collected. Several recommendations follow.

Stratify results by socioeconomic status, previous exposure to gender-equity programs, participants’ ethnicity or racial group, marital status, number and gender of children, etc., to allow more in-depth analyses of data provided. Puntos de Encuentro conducted a thorough and impressive evaluation of its initiative among men in geographical areas affected by Hurricane Mitch. It controlled for confounders such as previous exposure to gender equity campaigns and men’s perceived level of equitable behavior. Soul City has also evaluated its mass media campaign and has made available on its Website a number of evaluations of each component of its initiative.

Precisely describe how the respondents in the evaluation differ from the remaining participants. Also include postulations of whether or not the pool of participants is a representative sample of the general population (i.e., accounting for any selection bias). CANTERA transparently described the limitations of its intervention in Nicaragua in a CIIR publication. After reviewing the post-intervention surveys collected from participants, programmers realized that the majority of the participants were referred to the program by their employers. This, of course, skews the ability to generalize their results.

Use time-sensitive indicators to chart the progressive impact of the program from the individuals who participated to society at large. Short-term and long-term indicators will measure the effect on both gender equity and health behaviors, as well as the transition from adoption of an innovative definition of masculinity, to behavioral change at the individual level, to the creation of an enabling environment by a critical mass adopting the innovative gender norm, to the establishment of a new social norm. Nearly all the programs featured in this review adopted this approach; however, not much can be stated to elaborate on this, because most of these programs have existed for a short time period due to budgetary constraints or recent implementation.

Involve other community members in the evaluation process. Persons in the participant’s social sphere can serve as informants on the participant’s adoption of gender-equitable behaviors and actual transformation in daily life. Also, their feedback will facilitate Men and Reproductive Health Programs: Influencing Gender Norms

Mundigo, Axel I. 1995. Men’s Roles, Sexuality and Reproductive Health. International Lecture Series on Population Issues. Chicago, Ill: The John D. & Catherine T. MacArthur Foundation.

Murphy, Elaine. Forthcoming. Organized family planning programs: A diffusion of innovations success story. Journal of Health Communications Vol. 8(6).

Prevention Institute: The spectrum of prevention: Developing a comprehensive approach to injury prevention. Available at: www.preventioninstitute.org/spectrum_injury.html. Accessed October 28, 2003.

Programa PAPAI: Abstract. Available at the following Web address:

http://www.ufpe.br/papai/Traducao/english.html. Accessed November 13, 2003. Rogers, Everett M. 1995. Diffusion of Innovations. 4th edition.

Singhal, Arvind, and Everett M. Rogers. 2003. Combating AIDS: Communication

Theories in Action. Thousand Oaks, Calif: Sage Publications.

Summerfield, G. 1998. Allocation of labor and income in the family. In: Women in the Third World: An Encyclopedia of Contemporary Issues, edited by Nelly P. Stromquist. New York: Garland Publishing. (Garland Reference Library of Social Science Vol. 760) pp. 218–226.

Watkins, S.C. From Provinces into Nations: Demographic integration in Western

Europe, 1870–1960. Princeton, N.J., Princeton University Press; 1991:xvii.

Men and Reproductive Health Programs: Influencing Gender Norms

Annotated Bibliography

Bankole, Akinrinola, and Susheela Singh. 2003. In Their Own Right: Addressing the Sexual and Reproductive Health Needs of Men Worldwide. New York: Alan Guttmacher Institute.

Few recent works address the sexual and reproductive health needs of men independent of their relationships with their female partners. The Guttmacher Institute provides an overview of men’s sexual and reproductive behavior worldwide and highlights health and program implications of that information. It identifies needs for health information and related services, obstacles that prevent men from receiving services, and offers approaches to enhance men’s sexual and reproductive health and benefits to their partners and children. Available at the following Web address: http://www.guttmacher.org/pubs/itor_intl.pdf

Foreman, Martin, ed. 1998. AIDS and Men: Taking Risks or Taking Responsibility?

London: Panos Institute/Zed Books.

This book examines the relationship between men and HIV/AIDS, arguing that the epidemic cannot be contained until men are persuaded to change their traditional concepts of masculinity. It suggests one in four men worldwide have sexual and drug- taking behavior that places them and their partners at risk. Not online; available by order: http://www.panos.org.uk/resources/bookdetails.asp?id=1023

International HIV/AIDS Alliance. 2003. Working with men, responding to AIDS, Gender, sexuality and HIV—A case study collection.

Case studies from 13 countries aim to stimulate thinking and strategies for reaching men with project interventions to help them to change their attitudes and behavior. Lessons from the field offer ideas and models for working in a broad range of contexts. Available at the following Web address: http://www.aidsalliance.org

United Nations Population Fund. 2000. Partnering: A New Approach to Sexual and Reproductive Health. New York: UNFPA. Technical Paper No. 3. Available at the following Web address: http://www.unfpa.org/upload/lib_pub_file/170_filename_partnering.pdf

United Nations Population Fund. 2003. Enlisting the Armed Forces to Protect Reproductive Health and Rights: Lessons Learned from Nine Countries. New York: UNFPA.

Taking advantage of the organizational and human resources of military institutions to protect reproductive health and rights is emerging as a powerful strategy in both peacetime and conflict situations. For decades, UNFPA has worked with the military sector to reach men with information, education, and services for family life and family planning. This experience now is being applied to a wider spectrum of reproductive and sexual health concerns, including maternal health, HIV/AIDS prevention, and reduction of gender-based violence. This digital document offers lessons learned from reproductive health projects in nine different military organizations. Available at the following Web address: http://www.unfpa.org/rh/armedforces/index.html

United Nations Population Fund. 2003. It Takes 2: Partnering With Men in Sexual and

Reproductive Health. New York: UNFPA.

“Partnering with men” is emerging as an important strategy for improving reproductive health. UNFPA offers guidance on effective gender-sensitive ways to engage men in the reproductive and sexual health of themselves and their partners, including examples of successful strategies and programming and lessons learned. A checklist summarizing key points makes this program advisory note useful for designing and evaluating projects. Based on Partnering (2000), below. Available at the following Web address: http://www.unfpa.org/upload/lib_pub_file/153_filename_ItTakes2.pdf

U.S. Agency for International Development, Inter-Agency Gender Working Group. July

2003. Involving Men to Address Gender Inequities: Three Case Studies. Washington, DC: USAID.

Profiles of three innovative programs—Salud y Género, Society for the Integrated Development of the Himalayas, and Stepping Stones—that involve men and youth to improve the reproductive health and well-being of both men and women. Available at the following Web address: http://www.measurecommunication.org/Content/NavigationMenu/Measure_Commun ication/Gender3/InvolvMenToAddressGendr.pdf

Barbiturates Home Drug Testing

Barbiturate home drug testing is simple and offers accurate results in a relatively short time. Barbiturates are central nervous system depressants that can induce sedation and are also used for anesthesia. They are regularly used for getting a high and as an alternative to other recreational drugs.

Barbiturate drug testing has become increasingly common in recent years as the use of the drug has increased. Employers and law enforcement agencies use these tests to determine the extent of use and signs of addiction in a person.While they aren’t regarded as serious as other drugs, they are still regarded as intoxicants and are open to action by the employer or agency.

Barbiturate home drug testing is the easiest way of assessing yourself before an official test. It can be done in the privacy of your home, and results are revealed quite quickly. Barbiturates are detected with the help of a saliva and urine tests which is easy to do and non-invasive.

Urine drug tests remain the most common type of test as it’s simple to do and yields quick results. Barbiturates are present in urine for up to three weeks if used occasionally. Habitual usersare more likely to test positive, even after a month of use. The presence of the compound builds quickly as is present for a while after use. The individuals metabolism rate and other factors play a role but detection period remains valid for at least 15 days.

You can test yourself for the presence of barbiturates by dipping a tester panel into a sample of urine. This testing kit is available from drug stores and from websites s anonymity is assured. The kit has a simple user interface that resembles the one used for the detection of pregnancy.

You dip it in your urine for 30 seconds and then wait for a few minutes. The panel should then become illuminated with a red or green signal depicting the presence, or absence of barbiturates.

Another way of home drug testing involves a more complex procedure. Under this method, you will be accorded the same privacy but the results will not be known immediately. With these kits, you provide a urine sample and send it to a lab where they will examine it for the presence of the drug.

Test kits are available for this type of examination come with sterilized bottles and instructions on how to provide the urine sample. The process takes at least 48 hours and this thus not recommended for those who want quick results. The speed of the result varies by kit, so be sure of the timescale if you use this method.

False positives remain a problem in home drug testing. If you are using depressants as prescription medicine then it is highly likely that you will test positive for barbiturates. Drugs used in the treatment of stomach disorders, psychological conditions and other diseases sometimes also contain barbiturates.

This can trigger a false positive result in a drug screen. It is highly important that you discontinue taking such drugs to avoid testing positive, or alert your employer as necessary.

Home drug testing is the easiest way of finding out whether you have any substances in your body. This will help you in deciding on a course of action should you face a drugs test from an employer.

Importance and significance of drug testing

Drug testing is a very important test and its significance is truly immeasurable. Health being an important aspect for everyone, whenever there is a health problem or a minor ailment or chronic illness, there is regular intake of drugs as prescribed by the medical practitioners. As per the dosage, these have to be taken and excessive in take of drugs would lead to abuse of drugs and this is punishable under the US laws and UK laws.  Therefore, this is one side of importance about the drug testing which reveals whether an individual has taken an over dose of a medicine by conducting saliva test, hair test, urine test or blood test. In any case, the lab test will give appropriate result.

Secondly, the use of drugs which include a dose of cocaine and other drugs which severely cause damage and harm to one’s metabolism, is also put to drug test for detecting whether an individual has been under the influence of drug addiction or use of drugs which are not permitted under the law.

This is also another benefit of drug test which reveals about the drug addiction among young children, students and elders. The test has great significance without which nothing can be proved about the drug addiction. Because drug test report is the basic evidence which proves whether or not an individual has been under the influence of excessive dose of alcohol or drug over dose or drug addiction.

It is also important to note that, drug testing in laboratories is done very carefully and analytically with good lab testing equipment to reveal the entire information about the use of drugs and this is very important in order to take care of individual.

Countries in which many unlawful and illegal activities of drug trafficking, drug smuggling and drug wholesale selling is made, if the authorities and federal government agencies, find out about the people who are involved in such activities, they will be immediately considered for drug testing and if they prove to be positive, they will be given a suitable punishment under the court of law. Therefore, drug addiction, drug abuse or excessive influence of alcohol or any over dose of drugs will lead to drug testing and this is not acceptable under the law.

For many decades now, drug testing has been prevalent and as the science and technology are growing, the methods of lab testing are also improving.

Employee Drug Testing, Saving Lives

Recent research by a mixed group of academics from government indicates that up to 20% of employees who die at work test positive for alcohol or drugs. The research first requested by the Bush administration in 2006 studied workplace accidents and deaths in order to support their request for further funding. This research continues today and these statistics are a reminder of why all administrations since Reagan have been so in favor of workplace drug testing.

While the results of these studies are going to be up for scrutiny, the picture they paint is a stark one. In 2009, of the 17.2 million known drug users over the age of 18, 12.9 million of them had jobs, that’s 74.8% of them. It’s reasonable to assume that at least a portion of those are either still going to have substances in their systems when they start work. While the research doesn’t try to say that all these employees are turning up to work incapable, it is saying that judgment and ability is going to be impaired in some of these for at least some of the time. Which is why employers are keen on drug tests, to reduce accidents and lower their insurance premiums.

While there is evidence that a robust set of policies can also reduce the incidents of drug use, there is no doubt that the threat of random testing, new employee, after accident or sickness screening works as a deterrent for some. That said, given the numbers of alleged active drug users in the workplace, there is still some way to go. To gain the most benefit, employers must have a competent, coherent policy for controlling workplace behavior, including substance abuse. This policy must be clear, and communicated to the workforce regularly.

Truly random testing by trained staff is the only way to prevent the drug tests being fooled. There are as many products offering to help employees fool a drugs test as there are tests, and they are becoming increasingly sophisticated. Trained staff should be able to negate most of these techniques by ensuring correct drug testing procedures are implemented at all times. This training should also take into account false positives and have a policy in place where further testing is carried out before any action is taking against the employee. There is a whole list of substances that will trigger a false positive in a drugs test, cold medication, anti-histamines and even some headache tablets.

There is no doubt that drug testing is a preventative measure and seemingly effective against substance abuse. Employees may see it as overkill or an invasion of their privacy, but when almost 75% of deaths in the workplace involves either alcohol or substance abuse, the reasons for it is clear. While it’s difficult to attribute a direct causal link between workplace drug tests and saving lives, it isn’t unreasonable to assume that without it, there would be far more fatalities in the workplace.

Should Schools Be Drug Testing Students?

There is an issue surrounding the use of at home drug tests and trust that should be dispelled. The argument that the bond of trust between parent and child, or partners is broken or damaged when such a test is administered is one that gets a lot of airtime. I think it’s overrated, and shouldn’t play any part in family life. If trust is such an issue, you could say that the person doing drugs has already broken it, if they actually have that is.

Trust is a two-way street and needs effort from all sides to maintain. Many schools such as PC Pro School(site), Harvard, FGCU, and others are questioning if this is the right choice. If an at home drug test is used properly, the circumstances clearly explained and discussed, there should be no problem. Trust is eroded when there is deception and secrecy in a relationship. One side feels lied to if they suspect the other of substance abuse, and that their trust is being broken. On the other side of the coin, the one accused feels their privacy is being invaded and that they aren’t trusted enough to have their word believed. As with anything, there are three sides to every story and this is no different.

When dealing with children, it’s important to know that they think they can get away with anything as long as they don’t get found out. If their actions remain undetected, they think the bond of trust remains unbroken. It’s important for parents to be aware of this when discussing the matter so they can deal with it head on. Dealing with any family member suspected of having a substance abuse problem is a balancing act. But, it’s important to bear in mind that prevention is better than the cure. Laying down the ground rules while children are young, or when you become serious about a partner is the single best way of avoiding this issue altogether. Making it clear that indulging in these substances is a breach of trust and won’t be tolerated puts them clearly in the picture about where you stand.

If you feel it appropriate, mention that you regard drug testing as an acceptable part of maintaining the bond of trust between you. That way everyone knows what to expect and not to take your insistence of having one too personally. Then when you bring out the at home drug test, they shouldn’t be surprised. It’s likely that the test will be regarded as not trusting, and an invasion of privacy but if you warned them long before, they can’t really argue.

Having open, honest dialog within the family about attitudes to drugs and expected behavior is the best way to maintain trust between family members. Talking about at home drug tests and the issues surrounding them will also prepare the ground for if you ever need to use one. That time is going to be stressful enough as it is you don’t need trust issues to compound your problems.