Systematic review of reviews on interventions to engage men and boys as clients, partners and agents of change for improved sexual and reproductive health and rights.
There is substantial evidence supporting a range of successful interventions to engage men and boys to improve sexual and reproductive health and rights, with markedly similar principles and approaches emerging across SRHR domains, and it is time to scale up and integrate these strategies.
Key Findings
Methods
Thirty-five systematic reviews were included in this review of reviews, comprising approximately 960 primary studies across SRHR domains in low- and middle-income countries.
Searches were conducted across PubMed, CINAHL, Web of Science, and Cochrane databases between October 2022 and September 2024.
Eligible reviews were published since 2015, covered WHO-defined SRHR domains, and focused mostly on LMIC.
Reviews covered HIV prevention/care, reproductive health, maternal and newborn health, and gender-based violence (GBV).
Cochrane systematic review guidelines were followed for the review of reviews methodology.
Results
Reviews consistently concluded that men were successfully engaged through interventions, yielding benefits to both women's and men's SRHR outcomes.
No adverse intervention impacts on prevalence of SRHR outcomes were reported across the 35 included reviews.
Effective interventions were mapped onto a framework of men as clients, partners, and agents of change.
The framework was presented in a 'programmer-friendly visual' to support practical application.
Benefits extended across multiple SRHR domains including HIV, family planning, maternal health, and GBV.
Results
Person-centred, gender-transformative, multilevel approaches were the most consistently effective intervention strategies for engaging men and boys across SRHR domains.
Similar principles and approaches emerged consistently across different SRHR domains.
These lessons were summarised from across the ~960 primary studies represented in the 35 reviews.
Implementation best practices were extracted alongside effectiveness data by multiple reviewers.
Gender-transformative approaches address underlying gender norms rather than just individual behaviors.
Results
Substantial evidence gaps remain in several SRHR subtopics related to engaging men and boys.
Identified gaps include engaging men as contraceptive users.
Evidence is lacking on sexually transmitted infections other than HIV.
Gaps exist in preventing unsafe abortion.
Sexual and gender-based violence (SGBV) as experienced by men and boys represents another understudied area.
These gaps were identified despite the broad coverage of ~960 primary studies across 35 reviews.
Conclusions
The review authors call for scaling up and integrating evidence-based strategies to engage men and boys in SRHR programming, with attention to monitoring for potential harms.
Authors recommend tailoring strategies to socio-cultural contexts and for specific vulnerable subpopulations.
Monitoring for any potential harms is emphasized as part of scale-up.
The call to action is based on finding 'markedly similar principles and approaches emerging across SRHR domains.'
Data extraction specifically focused on unintended consequences in addition to effectiveness and best practices.
What This Means
This research synthesized findings from 35 prior systematic reviews — themselves covering roughly 960 individual studies — to understand what kinds of programs work to involve men and boys in sexual and reproductive health. The studies came from low- and middle-income countries and covered topics like HIV prevention, family planning, maternal health, and gender-based violence. The overarching finding was that interventions successfully engaged men and boys and produced health benefits for both men and women, with no programs found to have worsened health outcomes. The most effective programs tended to be person-centered, addressed underlying gender norms (not just individual behaviors), and worked at multiple levels of society simultaneously.
This research suggests that regardless of the specific health topic — whether HIV, maternal health, or violence prevention — similar approaches tend to work when engaging men and boys. The authors organized these effective strategies into a practical framework describing men's roles as healthcare clients (seeking services for themselves), partners (supporting women's health), and agents of change (helping shift harmful social norms in their communities). This consistency across topics is notable because it means programmers and policymakers may be able to apply shared lessons rather than starting from scratch for each health issue.
Despite the breadth of evidence, the review identified meaningful gaps where research is still limited — particularly around men's use of contraception, sexually transmitted infections other than HIV, unsafe abortion, and sexual violence experienced by men and boys. This research suggests the evidence base is now strong enough to justify broad scale-up of proven engagement strategies, while continuing to monitor for unintended harms and adapting programs to different cultural settings and vulnerable groups.
Gottert A, Pulerwitz J, Weiner R, Okondo C, Werner J, Magni S, et al.. (2025). Systematic review of reviews on interventions to engage men and boys as clients, partners and agents of change for improved sexual and reproductive health and rights.. BMJ open. https://doi.org/10.1136/bmjopen-2024-083950