Reproductive Health Services for Men: Is There a Need?

There are many problems inherent in trying to provide reproductive health services for men. An example of a San Francisco male clinic is presented. In February, 1976, a pilot program for men was opened at a satellite clinic of the San Francisco District Health Center Number 4. The clinic was open for 2 hours a week, did not require an appointment and served an average of about 6 walk-in patients per session. A grant proposal was then submitted to the US Department of Health, Education, and Welfare (DHEW--now Department of Health and Human Services). In July, 1976, DHEW awarded a 1-year renewable grant of $43,000 to the family planning program. The clinic opened in October, 1976. The program consisted of 2 parts: 1) an evening clinic, and 2) an education and outreach program. Between 1977 and 1981, the total number of visits to the clinic averaged about 1200 a year. However, it is difficult to assess whether the programs broader health goals were really attained. Clinic evaluation records showed satisfaction with the services offered. There was always some conflict between the 2 separate program components. There was lack of clarity as to who felt the need for the program. What men wanted were primarily job physicals and free condoms. There is debate about whether men should be offered separate reproductive services or whether these services should be incorporated into primary health care. Emphasis in the original proposal was on training male staff. There was much turnover. The funding history of the clinic was "checkered." The general conclusions to be drawn from this example are discouraging.