Ask a man why he did not go to the clinic for a check-up or consultation for a mild illness, and he'll point to his watch, not his heart. Studies have shown that men are less likely to consult than women. In the UK, for every 100 women who consulted, there were only 68 men (32% less). ALSO READ: Why are men reluctant to seek help for mental health issues? Many men might feel like clinics are not for them, not out of stubbornness, but because of health services-related inconveniences. Clinic hours clash with work. Queues are long. The visit might end in a lecture in a crowded room. Studies across Africa have revealed similar barriers for men: work clashes, waiting, stigma, and unfriendly services. ALSO READ: Men over 45: ‘Even if you feel fine, get screened since early prostate cancer detection can save your life’ – medic Meanwhile, the problems men carry are quiet. High blood pressure, for example, rarely hurts until it harms. The World Health Organization estimates 1.28 billion adults live with hypertension, and nearly half of them are unaware. You may be well today and have a stroke tomorrow. However, a two-minute blood pressure check could change that path. ALSO READ: What new health law means for patients, doctors and families So, how do we turn the tide around for men and increase their health service utilization? Start by going where men are. Take quick checks to worksites, bus parks, markets, construction sites, football pitches, and barber shops. When care reaches places where men feel safe, they show up. One landmark trial in U.S. barbershops showed significant blood pressure drops when pharmacists treated patrons right there instead of after a referral to a clinic. Trusted places, timely, and on-the-spot health services improve health. Next, fix the clock. Clinics should offer early-morning, evening, and Saturday men's hours with an explicit promise, in and out in 30 minutes. In addition, bundling multiple services in one stop will encourage men to consult: blood pressure, blood sugar, TB symptom screen, optional HIV self-test, brief alcohol counselling, and a clear next step if anything is off. Men respond better to speed, privacy, and straight talk. Make discreet signals that don't intrude on privacy. A quick SMS, Men's check Sat 7:30–9:30. No queue. can increase attendance when the place is near and fast. Randomized trials among men in Kenya improved follow-up with simple texts. Reminders are most potent when structural barriers (distance, high cost, hours) are removed. Clinics should create a male-friendly environment. It might be a corner with privacy. Staff who avoid criticism and communicate clearly. Offering choice: a male provider if preferred, a self-test facility, or an appointment that fits round shift work. When men feel respected, they engage. Respect opens the door; convenience keeps it open. Last, we should invest in men's health promotion through men's influencers, coaches, pastors, supervisors, cooperative leaders, and barbershop owners. Statements like I did my check, do yours from someone respected by men can make a difference. In the case of HIV, where in most of the world, men still test and start treatment later than women, trusted messengers and late hours can close deadly gaps. The government's role is pragmatic in encouraging men to use health services. It should establish policies that allow flexible hours, count men's checks towards facility targets, and subsidize outreach costs from current primary health care without bureaucracy. There are different indicators to measure how men utilize health services, including: percentage of clinic visits by men (by age), numbers screened (BP/diabetes/TB/HIV) and referred to care within 7 days, average visit time (aim ≤30 minutes), return-visit rate at 3 and 6 months. In addition, we can measure men's satisfaction scores (Would you recommend this to a friend?), coverage of worksites, teams, markets, and barber shops reached each month. A man will wait two hours to get a car part fixed, but not 20 minutes to check his blood pressure. Not because he doesn't care, but because the system requires him to give up a day, his privacy, and sometimes his dignity. If we take an interest in his world, keep it private, and take only 30 minutes, he will appear. He will return when we thank him and plan a clear next step. That's health promotion in real life that saves lives. The author is a passionate public health advocate committed to advancing community health in Rwanda.
