Promoting positive masculinities among young people in Stockholm, Sweden. A mixed-methods study

Abstract Background Despite policies aiming to curtail men’s violence against women (VAW) in Sweden, one in three women have experience physical/sexual VAW. Promoting anti-VAW masculinities among young men is a key intervention to reduce VAW; yet little is known about what actions could be used to effectively do so in Sweden. This study aims to: 1. Identify actions that young people (men and women), and stakeholders believe can be used to promote anti-VAW masculinities and 2. Quantify the relationship, coherence and patterns of importance and applicability between the different identified actions. Methods A mixed-methods study was conducted in Stockholm in 2019. In-depth interviews with young people aged 18-24 years (men= 16, women=12) and stakeholders (n = 12) were used to identify actions to promote anti-VAW masculinities. Then, an online survey with 83 people (77 young people) was conducted asking participants to sort the actions and rate them in terms of importance and applicability. Multidimensional scaling and hierarchical cluster analysis were used to create clusters maps. Each cluster was rated in terms of importance and applicability. Results Six clusters were identified: 1.own self-reflection and change, 2. actions in leisure-cultural spaces, 3. mandatory education on gender-VAW, 4. positive role models in public arenas, 5. support civil society and 6. strengthen government, police, and legal response. The clusters of mandatory education on gender-VAW and own self-reflection and change were rated higher in importance (mean 5.1 and 4.8 respectively). Mandatory education on gender-VAW and actions in leisure-cultural spaces were rated higher in applicability (mean 4.6 and 4.7 respectively). Correlation between importance and applicability was low (rho=0.16). Conclusions Promoting anti-VAW masculinities to tackle VAW should be done in multiple arenas. Mandatory education on gender-VAW in schools and leisure spaces are key strategies to promote anti-VAW masculinities. Key messages • Preventing VAW by focusing on masculinities requires the involvement of various social spheres. • Mandatory education on gender and VAW is considered key in curtailing men’s VAW in Sweden.


Background:
Despite policies aiming to curtail men's violence against women (VAW) in Sweden, one in three women have experience physical/sexual VAW. Promoting anti-VAW masculinities among young men is a key intervention to reduce VAW; yet little is known about what actions could be used to effectively do so in Sweden. This study aims to: 1. Identify actions that young people (men and women), and stakeholders believe can be used to promote anti-VAW masculinities and 2. Quantify the relationship, coherence and patterns of importance and applicability between the different identified actions.

Methods:
A mixed-methods study was conducted in Stockholm in 2019. In-depth interviews with young people aged 18-24 years (men = 16, women = 12) and stakeholders (n = 12) were used to identify actions to promote anti-VAW masculinities. Then, an online survey with 83 people (77 young people) was conducted asking participants to sort the actions and rate them in terms of importance and applicability. Multidimensional scaling and hierarchical cluster analysis were used to create clusters maps. Each cluster was rated in terms of importance and applicability. Results: Six clusters were identified: 1.own self-reflection and change, 2. actions in leisure-cultural spaces, 3. mandatory education on gender-VAW, 4. positive role models in public arenas, 5. support civil society and 6. strengthen government, police, and legal response. The clusters of mandatory education on gender-VAW and own self-reflection and change were rated higher in importance (mean 5.1 and 4.8 respectively). Mandatory education on gender-VAW and actions in leisure-cultural spaces were rated higher in applicability (mean 4.6 and 4.7 respectively). Correlation between importance and applicability was low (rho = 0.16).

Conclusions:
Promoting anti-VAW masculinities to tackle VAW should be done in multiple arenas. Mandatory education on gender-VAW in schools and leisure spaces are key strategies to promote anti-VAW masculinities.

Key messages:
Preventing VAW by focusing on masculinities requires the involvement of various social spheres. Mandatory education on gender and VAW is considered key in curtailing men's VAW in Sweden.

Background:
Improved efficiency is one overall goal in WHO's Health Systems Framework. Efficiency is an important dimension of health system performance assessment (HSPA). HSPA is used as a tool to monitor and evaluate the performance of health systems and to support evidence-based policymaking. In the pilot study for a first German HSPA, efficiency was assessed as one dimension.

Methods:
Indicators were selected based on a systematic search of established instruments in national and international HSPA initiatives. Criteria for the inclusion of indicators were data availability and international comparability. Where possible, indicators were evaluated in terms of their development over time , in comparison to eight European countries (e.g., Austria, Denmark, France), and regarding equity aspects (e.g., age, gender, region).

Results:
Eight indicators to assess the efficiency of the German health system were identified and analysed accordingly. They cover the pharmaceutical sector, outpatient and inpatient care, and system-wide efficiency. Trend analyses were possible for all indicators, and most were also suitable for international comparisons. Overall, results of the chosen indicators indicate a moderate health system efficiency. The volume of generics as share of all pharmaceuticals, e.g., was 83% in Germany in 2019 (country average: 54%) and has been steadily increasing since 2000. In contrast, expenses for pharmaceuticals overall rose from 1.4% of GDP in 2004 to 1.7% in 2019, whereas it declined from 1.3% to 1.1% on average in the other countries.

Conclusions:
Within this first pilot study, a systematic and comparative German HSPA measuring the efficiency of the German health system using eight predefined indicators was proven to be iii422 European Journal of Public Health, Volume 32 Supplement 3, 2022