Marcos Nascimento

12. How do we know if men have changed? Promoting and measuring attitude change with young men: lessons from Program H in Latin America

‘Program H’ is an initiative developed in Latin America to promote more gender-equitable attitudes among young men. It works in both group educational settings and at the community level to change community norms about what it means to be a man. The initiative is called Program H because of the Spanish word for man – hombres, and the Portuguese homens. In addition to educational sessions and community campaigns, the initiative also includes an innovative evaluation model for identifying and attempting to assess changes in attitude resulting from project activities.

VIOLENCE AGAINST WOMEN AND GIRLS

“Violence against women is not a new phenomenon, nor are its consequences to women’s physical, mental and reproductive health. What is new is the growing recognition that acts of violence against women are not isolated events but rather form a pattern of behaviour that violates the rights of women and girls, limits their participation in society, and damages their health and well-being.” (World Health Organization, 2013)

Ensuring a rights-based health sector response to women affected by Zika

In March 2016, the Brazilian Ministry of Health published its most recent guidelines for the health care response to Zika-related microcephaly (the “Protocol”) 1. The Protocol provides recommendations for provision of care in the contexts of family planning through prenatal and infant care. Unfortunately, although the Protocol emphasizes the importance of access to information and contraception, it fails to appropriately acknowledge the practical challenges that many individuals face in obtaining and using contraception, particularly poor, black and brown and young women, living in areas most affected by the epidemic. It also entirely ignores the fact that unsafe abortion is a public health reality in Brazil and one that is likely to worsen in light of the Zika epidemic and its uncertainties. As we discuss below, in order for Brazil to meet its constitutional and international obligations to protect women’s health and rights, the Protocol must acknowledge the legal and socio-economic constraints that affect women’s health and orient health professionals on how to best support women in a context of difficult choices. The Protocol ignores the challenges many women, especially poor women, experience in obtaining and using contraception

Reflecting on twenty years of Masculinities: an interview with Raewyn Connell

Raewyn Connell is very well known for her work on social theory and gender studies, and more specifically on masculinities. She was one of the founders of masculinities research and her 1995 book Masculinities is considered one of the most important references on the topic. Connells concept of hegemonic masculinity has been particularly influential and has attracted much debate. She has written extensively about its applications to education, health, and violence prevention. Our conversation was about her trajectory as an intellectual, her commitment to gender justice, and the development of her work from Australia to the global scale.

Linhas de cuidados masculinos voltados para a saúde sexual, a reprodução e a paternidade

The article seeks to propose principles for male care geared to sexual health, reproduction and paternity, as well as present a blueprint for the involvement of men in prenatal care. The proposal of the authors was submitted to a consensus building process with invited experts. The main results presented include: (a) the principles of lines of male care geared to sexual health, reproduction and paternity; and (b) a blueprint for the involvement of men in prenatal care. The conclusion drawn is that the cultural preconceptions of how males should lead their lives, including their social relations and roles as fathers interfere in health care actions and touch on three main points: (a) the idea of man as a collaborator in the promotion of the health of his partner while pregnant and/or his offspring; (b) the idea of paternity being strongly linked to being the financial provider;The article seeks to propose principles for male care geared to sexual health, reproduction and paternity, as well as present a blueprint for the involvement of men in prenatal care. The proposal of the authors was submitted to a consensus building process with invited experts. The main results presented include: (a) the principles of lines of male care geared to sexual health, reproduction and paternity; and (b) a blueprint for the involvement of men in prenatal care. The conclusion drawn is that the cultural preconceptions of how males should lead their lives, including their social relations and roles as fathers interfere in health care actions and touch on three main points: (a) the idea of man as a collaborator in the promotion of the health of his partner while pregnant and/or his offspring; (b) the idea of paternity being strongly linked to being the financial provider; (c) the hiatus generated between the traditional concept of paternity and the new family and gender patterns.

Garantindo uma resposta do setor de saúde com foco nos direitos das mulheres afetadas pelo vírus Zika

In March 2016, the Brazilian Ministry of Health published its most recent guidelines for the health care response to Zika-related microcephaly (the “Protocol”) 1. The Protocol provides recommendations for provision of care in the contexts of family planning through prenatal and infant care. Unfortunately, although the Protocol emphasizes the importance of access to information and contraception, it fails to appropriately acknowledge the practical challenges that many individuals face in obtaining and using contraception, particularly poor, black and brown and young women, living in areas most affected by the epidemic. It also entirely ignores the fact that unsafe abortion is a public health reality in Brazil and one that is likely to worsen in light of the Zika epidemic and its uncertainties. As we discuss below, in order for Brazil to meet its constitutional and international obligations to protect women’s health and rights, the Protocol must acknowledge the legal and socio-economic constraints that affect women’s health and orient health professionals on how to best support women in a context of difficult choices. The Protocol ignores the challenges many women, especially poor women, experience in obtaining and using contraception

Social and economic impacts of congenital Zika syndrome in Brazil: Study protocol and rationale for a mixed-methods study

Global concern broke out in late 2015 as thousands of children in Brazil were born with microcephaly, which was quickly linked to congenital infection with Zika virus (ZIKV). ZIKV is now known to cause a wider spectrum of severe adverse outcomes-congenital Zika syndrome (CZS)-and also milder impairments. This study aimed to explore the social and economic impacts of CZS in Brazil. Data was collected through mixed methods across two settings: Recife City and Jaboatão dos Guararapes in Pernambuco State (the epicentre of the epidemic), and the city of Rio de Janeiro (where reports of ZIKV infection and CZS were less frequent). Data was collected May 2017-January 2018. Ethical standards were adhered to throughout the research. In-depth qualitative interviews were conducted with: mothers and other carers of children with CZS (approximately 30 per setting), pregnant women (10-12 per setting), men and women of child-bearing age (16-20 per setting), and health professionals (10-12 per setting). Thematic analysis was undertaken independently by researchers from at least two research settings, and these were shared for feedback. A case-control study was undertaken to quantitatively explore social and economic differences between caregivers of a child with CZS (cases) and caregivers with an unaffected child (controls). We aimed to recruit 100 cases and 100 controls per setting, from existing studies. The primary caregiver, usually the mother, was interviewed using a structured questionnaire to collect information on: depression, anxiety, stress, social support, family quality of life, health care and social service use, and costs incurred by families. Multivariable logistic regression analyses were used to compare outcomes for cases and controls. Costs incurred as a result of CZS were estimated from the perspective of the health system, families and society. Modelling was undertaken to estimate the total economic burden of CZS from those three perspectives.

Zika, protagonismo feminino e cuidado: ensaiando zonas de contato

Neste ensaio iluminamos temas lancados ao debate pos-epidemia de Zika Virus (ZIKAV) na vida de mulheres e criancas. Analisamos 23 artigos, publicados entre 2016 e 2017, selecionados em periodicos brasileiros, no campo das Ciencias Sociais e Humanas em Saude. Ha um discurso mestico de reivindicacao por direitos – grandes narrativas de apelo social e explicacao pelas forcas sociais de um Estado negligente – associado a pequenas narrativas de cuidado de um filho com deficiencia. Provisoriamente, concluimos que a zona de contato se da pelo movimento de resgate das pequenas narrativas na traducao das iniquidades produzidas pelo Estado na vida das pessoas comuns.

Experimentação e aprendizagem na trajetória afetiva e sexual de jovens de uma favela do Rio de Janeiro, Brasil, com experiência de aborto clandestino

This paper discusses the topic of first sexual intercourse in adolescence focusing on the course of ten young girls with experience of induced abortion living in a favela in Rio de Janeiro. The analysis uses the description of the process of entry into sexuality as a strategy to elucidate the context of pregnancy and the first clandestine abortion in the affective-sexual path of girls interviewed. The first sexual intercourse is a realm of sexuality and social life involving socialization, interpretation of rules and meanings, system of attitudes, ways of approximation, control and modeling of affections, emotions and gender relationships. The results showed that the age difference between couples in sexual initiation is significant, clarifying the context in which decisions on contraceptive methods, pregnancy and abortion were held. We noted that adolescents subject to difficult decisions about their sexuality and reproduction at a time of life where they still lack sexual and reproductive experience. The data collected show the importance of strengthening of public policies, discussions on gender and adolescent sexual and reproductive rights in many spheres of society, such as schools, family and other institutions.

La importancia de asegurar una respuesta del sector de la salud basada en los derechos de las mujeres afectadas por el virus Zika

In March 2016, the Brazilian Ministry of Health published its most recent guidelines for the health care response to Zika-related microcephaly (the “Protocol”) 1. The Protocol provides recommendations for provision of care in the contexts of family planning through prenatal and infant care. Unfortunately, although the Protocol emphasizes the importance of access to information and contraception, it fails to appropriately acknowledge the practical challenges that many individuals face in obtaining and using contraception, particularly poor, black and brown and young women, living in areas most affected by the epidemic. It also entirely ignores the fact that unsafe abortion is a public health reality in Brazil and one that is likely to worsen in light of the Zika epidemic and its uncertainties. As we discuss below, in order for Brazil to meet its constitutional and international obligations to protect women’s health and rights, the Protocol must acknowledge the legal and socio-economic constraints that affect women’s health and orient health professionals on how to best support women in a context of difficult choices. The Protocol ignores the challenges many women, especially poor women, experience in obtaining and using contraception