Summaries Health care researchers have documented that in many settings male social prerogatives powerfully condition women's relationship to health care systems. Particularly in the area of reproductive health care, the decision‐making privileges enjoyed by men fundamentally affect women's health status. Yet population policy and reproductive health programming has been slow to respond to this insight. Unrecognized or unacknowledged assumptions about women's ‘natural’ responsibility for childbearing and child‐rearing, coupled with an acceptance of the rights of men to make family health care decisions have impeded policy responses to these research findings. By accepting these static characterisations of men rather than assuming that gender relations are dynamic and that men are as capable of change as women, research and programmes have often implicitly accepted men's power and women's subordination. Effective reproductive health care programming needs to recruit men's support and participation in creative ways.