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Global Action on Men’s Health Study Exposes Widespread Neglect of Men in Primary Health Care Policies

A new report from the Global Action on Men’s Health (GAMH) says men’s use of primary care is almost completely overlooked in global health policy.

Of the 27 primary healthcare-related policy reports reviewed in No Man’s Land: How men are considered in global primary health care policy, only two explicitly engaged with men’s health needs.

“While the reports commonly acknowledged gender as an important social determinant of health this was not translated into an analysis of men’s needs and recommendations about how they can be addressed,” note the authors, Dr Natalie Leon and Prof Christopher Colvin.

“Our research provides GAMH and the men’s health sector, nationally and globally, with the evidence base to make the case for a new approach to policy. This has to be an approach that takes proper account of gender, and which works to improve the health of everyone, males and females as well as gender-diverse people.”

Examples of how a gender approach could translate into practical reforms include offering services at times that fit around full-time work, going to where men are (workplaces, sports venues, faith organisations, etc), developing targeted health promotions, setting up male-specific clinics and inviting men to attend health checks.

“The potential role of community pharmacy services, which are far easier to access than general practice, should also be explored,” says the report.

No Man’s Land states that gender equality strategies in global health policies have largely addressed social and structural determinants of women’s health, such as income inequity, sexual violence and exploitation, unpaid care and domestic work.

“Gender-specific surveillance of the health problems of men, however, has not been prioritized, and inequities in men’s health have mostly been overlooked by global, regional, and national health organisations.”

The study cites the vast range of health problems where men experience persistent inequities in the burden of disease, and which require early access to effective primary care-level preventative, promotive, diagnostic and curative health services.

For example, men have a higher prevalence of high blood pressure and diabetes and are four times more like to die by suicide. Men account for 64% of TB cases globally. Noncommunicable diseases such as cardiovascular disease and cancers (especially colorectal and stomach cancers) account for 70% of all deaths in men globally.

Men also have higher exposure to risk factors for poor health outcomes such as harmful alcohol and tobacco use, along with higher mortality from injury and violence, including from homicide.

The policies analysed in the study were drawn from the World Health Organisation (16), UNICEF, the World Bank, the United Nations and related organisations.

No Man’s Land outlines recommendations in three areas for moving men up in the global PHC policy agenda.

1. Better understand the problem: generate, make accessible, and use robust, nuanced, and diverse evidence that recognises the diversity of men’s health needs.

2. Develop, implement and evaluate evidence-informed policy options that are holistic, integrated, feasible and scalable. This requires both consolidating and building on emerging evidence of best practices for men and leveraging lessons from the growing number of national and regional level men’s health policies.

3. Form alliances and opportunities for advocacy and political support to make strategic use of both predicted and unpredicted situations to move men up in the PHC policy agenda. This involves engaging in the political environment, building long-term coalitions and networks with individuals and institutions working across public health issues, which may include leveraging parallel policy developments for women and in priority health conditions.

The study also notes that several countries have developed national policies that focus on improving male health, notably Australia, Brazil , Iran, Ireland, and more recently, Malaysia, Mongolia, the Philippines, and South Africa.

“These male health-focused policies are a major step forward. This momentum should be extended to key areas where men face a specific inequitable burden of disease, including in PHC services, where there is opportunity for illness prevention, health promotion, and treatment at the first point of care for majority of the population.”

No Man’s Land: How men are considered in global primary health care policy was published by the Global Action on Men’s Health at a special webinar on 12th December 2024.

 

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