 Good evening to you and thank you for joining us on Y254. My name is Patricia Murioki. Tonight it's going to be hot in here. I already feel the hotness. Tonight we're talking about male involvement in contraception. For the longest time it has been a conversation only targeted or a conversation that we have revolving around women. Tonight we just try to see how can men get involved in family planning because at the end of the day it takes two to tango. So if as a man you want two children you should not leave the burden only to your partner that the other ones were supposed to make sure that it's the two children or three or four or five and we are just going to try and understand what is the role of men in contraception. We also try to see how can we be able, at what point we talk, we do start conversations around contraception and safe sex and at the same time how can different institutions looking at the religion community and also looking at the society. How can we all come together and make sure that we are having a very educative and informative conversation around contraception. Talk to us across our social media platforms. That is at Y254 channel. You can also reach me at Patricia Murioki and introducing the manel. I'm calling it the manel because we're talking about men issues. We're also talking to some amazing men. So we are talking tonight to Peter Ngurew is the founder of Pabu's Policy Institute. He also deals with a lot of reproductive health work. We also have Gideon Makumi who is a human resource and administration manager at Beather Network. He has also done a lot as far as reproductive health is concerned. Welcome guys. Thank you. You've had a good Wednesday, I believe. It has been great. When you hear, when I called you, okay I know Peter has had this conversation in different platforms and I know it's something that you found yourself engaging in constantly. What comes to your thought when someone gets to talk about male contraception? Thanks. Most of the time when we talk about male contraceptives, they have this conversation in the female context. So all the time, nini mna tumiyanga nini. As in no one asks you like, do you take care, have you ever thought about planning your family or who is in charge of planning your family? So most of the time, the first thing that comes to your head when someone tells you about contraceptives, you think, so what is my woman using? It doesn't immediately come to your head like, what is my responsibility or what am I using to ensure that we don't get pregnant. Most of the time when we talk about male contraceptives, then the conversation moves beyond not the commodities that we are used to, but mainly to condom or to male methods that we will discuss maybe in a few minutes. But the first thing that comes to the head is a woman, not me, not me, the chick. So what is she using? Is she safe or not? So what do I need to do if she's not safe? Okay, Gideon, how about you? I think this is a conversation of contraceptives for a long time, predominantly it has been a conversation of the woman. And I think this is because of the limited available methods for men because there are very few, though I'm glad the technology is now advancing. But men, they fear the discussion of contraceptives because you hear that kama ni kuendaku to male contraceptives maybe when they find you have a sex with me, who wants that? Because that's a permanent method. On the other hand, we have the use of condoms and with time and age, especially in a marriage context, the use of condom in itself is controversial because it looks like there's something wrong or one of the partners is cheating and therefore you don't want to have that conversation. So it's predominantly on the women, they are the ones who really bears the responsibility of family planning. Reproductive responsibility is not a women's issue. Being responsible for planning and raising a family is a universal issue that doesn't fall on gender lines today. I know the issues with the Pew research is still going on to really see, I've seen the trials that were done and I found something on the internet that says during the trials, the few men who are peaked, they experienced mood swings, they don't go to even, they were like, ah no, we don't want that being, but women have to deal with it. So would you take it, would you be willing to play a part and support your partner by not only being like, ok babe, it's ok, this is what is good for you, but you now are being to be the one on the peel. Would you take that bold step? It's a bold step. That's a good thing you brought up about why the male methods have taken so long to come to be and I know that's a myth and I like discussing myths because that's one of the myths that is being brought out by a lot of conservatives who are against contraceptives that the reason why the male contraceptives are not out is because men are afraid of the side effects that have seen their women go through. Like mood swings. Yeah, like who wants a man with a mood swing, who wants a man who has added weight or has lost weight, who wants a man who is, you know, for instance if for women you use contraceptives and maybe you need a shot too much, who wants a man who has exactly the same kind of side effect like is he spamming too much That's not the truth. The truth of male contraceptives is that the original concept of contraceptives was a women rights issue. The conversation was not about planning families, was not about taking care of a conversation in a family setup. It was how do we empower women to ensure that they get children when they want and how they want and the number of children they want. And it was very focused on the women. In the 70s and 80s it became a human rights, a women rights issue. And actually if you look at the conversation we had in 2012 in FP 2020 commitment in London, we said let's have an additional 120 million women using contraceptives. We said let's have an additional 10 million men using contraceptives. The fact that men have been left behind in the conversation but that does not mean that there is no research. Male contraceptive initiative in North Carolina has done a lot of research and they have grants all over the world around male contraceptives and we had condoms which was the original thing which is a barrier method and men and women use condoms. Then we moved to the jail which now is starting to work. We had the patch which had vasectomy which is reversible up to a certain, up to five years. After five years it's really difficult to reverse, you know there was a difference when it's cut but that's how far we are but now we have so many other methods that are coming up for men but the core of male contraceptives are you as a guy, because I look at this conversation because it's not a family planning conversation but a contraceptive conversation. A young guy in campus he's not planning a family so he needs to take care of himself not to get children when he's still this young how can he do that? You know when you have that conversation with that young man and tell him by the way it's not the responsibility of your woman and I tell young men if you don't want to be put in this box where you keep telling your boys there is no trapping you trapped yourself go out there take care of yourself because you had sex without a condom you trapped yourself so it's the young man to take care of himself use a condom have a sex with me of course it's not advice for guys who don't have children I use the patch which is coming up use this anyone call type and don't which is the Chinese hub which helps you reduce your sperm count so that your sperm are not active to be able to and you can't withdraw but it's for old man but anyway okay Peter you didn't answer our question would you take it would you be open? yes anytime would you be open to being probably on the peel or any other method of family planning or contraception that's a tricky question to just respond to directly and say yes or no but I think I think this is kind of a talk that we need to have with my wife for instance on what works because really like Peter has said a lot of trials are going on I'm not sure whether I want to get involved in the trials probably when it's so sure now I have a few pitas I will say directly then take it then we come to it and if a female is working and we are in agreement you are the one my wife is doing this I think I will be very supportive and I can have that conversation of what works for you but we are fighting for this support to go beyond unsupporting being that it's something that is still in its initial stages I think for now to be honest with you my answer will be no until I know about the results until you have like a research paper this is the way however if it's something that is of benefit to both of us I think it's something to consider but let's start this continue being done we are happy to continue research and learning I know anyway I know in a few minutes that you had this conversation we were trying to talk we probably one or two drone a point how we can be able to take this burden from women because for the longest time women have carried the burden of being the past people who are making sure that if you sit down as a couple and you're like okay I think we want to have children in three years it's the woman who goes out to try and see how easy I cannot get pregnant so now how do we involve men because we are never trying to see how do we involve men in that how do we convince them this support you can give more than just saying okay baby because I really would like us to get to that point but I think how I see it and I'm happy because nowadays it's something that is common in a marriage setup and allow me to speak within that limit because I'm in it already I realize that right now it's very very important when your wife is expecting to go with them even for the clinics because there's a lot of information that is given to them and for us men we end up missing it out because we think the responsibility of a child is solely on the woman mine is to provide after that whatever happens to the baby it is her responsibility but now at the time of birth and I'm speaking from experience I realize depending on which hospital you go to they are able to sit you down tell you now the baby is here this is what will be happening these are some of the changes to expect probably you don't even need to engage sexually for a certain period of time because you see if you're not there for instance when that conversation that advice is being given for us men we know naturally we are ready for sex anytime you can imagine it's a day 2 after they've come from the hospital and you are going and you have your expectation how about yeah I realize that they are now able to advise the doctors there tell you that we have this method we have this other one and they even give you time to go and discuss out there and come back to them and tell them which one works for you and when you're ready then after you've agreed you are now able to advise father because they even tell you the side effects of each one of them the ones that are homono the ones that are non-homono so I think the first support in the time managed we are in before we get to that time when now the pill for the men has been proven to work I think I'm happy if men would join their wives their partners for those clinics and even those gynaecological visits because they help I like that Gideon has talked about men getting involved but now not like has me the man making the decision because as I was doing research for this I saw someone say that most of the times even when a woman is going in to get whether it's the ejection the implant or whatever a method of family planning that they're using the people at the facility will be like and the person being told is the man so from that moment we've already started including the men trying to show them that this is a woman's issue it's like you're not supposed to be involved as a man the same thing with clinics the way Gideon has talked about it if you don't go to the clinic maybe you'll be told where we're going in a candle so how now do we also send the message to different facilities to different health practitioners to understand that when you're giving this talk about contraceptive to the women please also try to find a way or now you can involve the men Peter That's a dual question and it's interesting because originally we were saying women go to seek family planning when they're hiding from their husbands because their husbands don't support family planning Ya, they are some who don't Yes, so for a long time women have been the reason why men used to be told where Goja Parle is because the doctors or the nurses think that the husband maybe again is family planning and most women actually would come and leave their cards in the facility and say injection three months I don't want to carry my injection cards the next date we will fill it up so that has been the tradition and that has been the reason why men have been sort of excluded but increasingly when we started talking about male involvement and the first one was on the clinics and in this country we passed across the policies because it's not a government direct police that if a man comes to the clinic with his wife if a man escorts his wife to the clinic they don't queue so this was an incentive because most men were saying ah women go to the clinic and take the whole day so at all bring her and she will not take the whole day she will take that minute it was the first incentive to getting men to the facility because men don't go to hospitals so that was the first initial thing to bringing men but then increasingly now men are being involved at the birth because most of these family planning methods are postpartum so what's the conversation so you are there and you are sort of educated on what does your woman require for you to ensure that ah she does not get pregnant until she's done with exclusive breastfeeding until she's done with the three years of the two years of breastfeeding and then an extra year of recovery so that after three years then you can now be ready for it but a lot of men of course have a lot of myths about family planning and they need to get to the facility for them to learn because they will not understand their wives when their wives tell them you ask okonu na nyesha 2 weeks continuously and that guy will not understand so until he's told maybe a woman was given a method a homono method that did not work well for her she needs to change her method he'll start feeling but all those who lose libido and the guy is like he doesn't like me anymore so this in fact if there is someone who should be involved more in the contraceptive conversation it's the guy who is in charge of his family and that's for a family man for a young man Gideon has tasted the family man me I talk for the young men in Kampu who are not ready to get married but they just out there that guy will not come to the clinic with a girl because he's not he's interest is not that he's just having fun so he also needs avenues in which he needs to learn about contraceptive what works for him as a person and so that he starts seeing we tell girls when they get into campus use this method it's 5 years so you'll be done with your campus life and you'll have one year of getting a job what do we tell a guy because he has no method that can last in 5 years so we need to really encourage facilities policy makers to have a different approach to involving men and young men so according to some statistics among the 1.9 billion women of reproductive age group that is of 15 to 49 years worldwide in 2019 1.1 billion have a need for family planning of these 842 million are using contraceptive methods and 270 million have an unmet need for contraception this now brings me to the question have we invested enough do you feel we have invested enough as a country as far as family planning is concerned have we gone into getting probably making sure that we have good research because you hear people talking about the long term effects of the contraceptives you hear some you can be on a contraceptive and you still get pregnant so have we invested enough in family planning I would say that we are somewhere compared to a few years ago the 80s the 70s right now we are I think we are around 56 penetration of the family planning and when you look at what is happening especially in the health centers you'd appreciate that something is being done about it however I would say we are not yet there but the journey where we are so far it's promising and a lot more is still happening even at a personal level nowadays contraception is available you can just walk into a hospital as a woman and say for me I'm here I want a jadella insertion I want a coil and should be available at a very affordable cost so that is something that is really promising as far as the future of hitting the target of about 80% use of that is concern so I must admit that a lot has been done and still working progress but we are good above 50% somewhere Pita being because I believe under pathways you able to do a lot of research around contraceptive you get to talk to a lot of people about it how would you say we doing as a country as Guido mentioned we are doing okay we can say we are okay because what we need to reduce I am glad you brought up that statistics what we need to reduce is the unmet need for family planning unmet need for family planning means women who want to use family planning but cannot get it because either they can't access it they can't afford it, they don't have the right choices and it's not equitable so they can't find it the places where they would want to get because countries like Nigeria are at that 6% but you look at the unmet need for family planning which is at 20% looking at ours we are at 38% unmet need meaning Nigeria is actually doing better than us because people don't need to take up contraceptives by the way we should not look to emit 80-90% because the aim is not to have every woman using contraceptives the aim is to ensure that when a woman wants to have contraceptives they can have it and our biggest challenge as a country has been first domestic investment in family planning our commodities have been donor driven 100% we have been having DFID, UNFPA USAID, KFW giving us commodities of about our budget for contraceptives in 2018-2019 was about 2.1 billion shillings and Kenya invested only 800 million donors invested more than a billion in our and as we moved to what the journey for self reliance around contraceptives Kenya does not invest in commodities in buying family and they are not cheap that's why you hear 2-3 billion if we don't invest in that then we will continue having a bigger unmet need for family planning we have what we call the costed implementation plan now we are launching the third one costed implementation plan between 2022 and 2025 we need about 9 billion shillings to invest in family planning if we are to reduce our unmet need for family planning up to close to zero but if you look at how much and then the other challenge is that health is devolved so counties are the ones as much as the national government will work around the CIP and buy commodities this work is being done at the counties if counties have no costed implementation plans if counties are not accountable to how much they invest in budgets for health then we will just be having the same conversation and it's quite expensive as I mentioned it's expensive for women ordinarily a woman living her house to go and buy a coil or a pill when we talk about safe, what is it probably the best time to start talking about safe sex to start talking about safe contraception what do you think is the best time for people to start embracing that conversation around our communities, talking to young girls talking to young men because I know there are limitations some of which I feel we can surpass but what do you think is the best way Pashisha this is a question that has different dimensions when we are looking at the religious limitations we talk about when you are married however the reality of the matter is our girls and our boys are getting involved in sex at a very early age including in primary school so I think that empowerment should start as soon as possible as soon as you think say as a parent or as a community that the your girls and your boys are growing and they are able to understand the risks and the dangers involved in sex I think that is the right time to start I would say it is 10 years it is 15 years because the exposure comes at different times and the sooner these boys and girls get the information about the risks of it the pregnancy, the STIs the better for us as a community because if we remain silent for a long time and assume that it is a taboo talk about sex if it is ungodly to tell your daughter or your son sit down let's talk about sex then you will only have yourself to blame when they indulge in it because they would rather sorry they would rather learn from us as the adults than they learn from their friends who are as much uninformed as they are so the sooner we do this the better Peter Gideon has talked about we know that contraception conversations around safe sex and all that if something that the religious community has really come out so strong against how do we try to also bring them on board because I believe for us to get to a point where these things are normalized we need every institution involved how would we get the religious community to understand that we are not telling these young people we are not educating them about sex or informing them about sex with an intention of promoting immorality but rather at least being aware you are able to make a better choice we always tell people, religious institutions or even political leaders or even parents that the earlier you speak to your child about sex the more they delay their sexual debut actually we have researchers showed that uninformed kids start getting curious about sex 9, 10, 11 and they do have sex at 12, 13 informed children delay their sexual debut to 15, 16 and so this is proven that the more you talk to them about sexuality because when you talk about a lot of people say when you say about comprehensive sexuality education we are saying let's teach our kids how to have sex we are talking about age appropriate sexuality education when a kid is 5 years you are telling them what is this thing you have between your legs clearly who should touch it who should consent and you see that conversation about consent starts early and if you can have this conversation as early as 5 years it's better for them and we have religious groups I always laugh about marriage counseling people are doing marriage counseling they are telling all this conversation we can't tell you earlier they should start telling them just hold on if you can't wait let's get you married religious leaders have a big role to play around 30 seconds each run out of time 30 seconds each your parting shot the whole conversation about family planning contraception method I think in a marriage setup I think it's a conversation between a husband and a wife let it not be a burden of the wife that should be a conversation that both of us know that of kusif to marry people you are so well represented man take charge of your relationships you are the guys leading this families you are the heads of these families you are the heads of your relationships don't come to us telling us I was trapped take control of your contraceptive needs thank you very much guys I feel conversations around family planning contraceptive safe sex education we can sit here and talk the entire night we can have another show and still talk and not exhaust but for people watching as I hope that you've learnt one or two take it upon yourself to really understand more contraception what family planning is all about if you are not in a family setup please if you are not ready to be a father if you are not ready to be a mother figure out ways that are going to work for you or now you can protect yourself thank you very much my name is Patricia Morioki do have yourselves a very good night good stuff