Zimbabwean culture, like many cultures in sub-Saharan Africa, places a high value on procreation. Child-bearing is regarded as a rite of passage into becoming a normal adult member of society.

As a result, reproductive health choices and practices often play second fiddle to pressures to reproduce that are exerted by traditional and cultural norms. Usually, these pressures are covert so they tend to be ignored in the design of reproductive health programs and interventions.

Reproductive health generally implies that people are able to have a responsible, satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so.

But in Zimbabwe, men and women's ability to exercise this right is curtailed by the unseen force of tradition and culture.

In many parts of the country, a woman is expected to have been married at roughly age 24, and within two years of marriage is expected to have a child. Young women, in spite of their educational status, are under immense pressure to fulfill this social expectation. On the other hand, a man who goes beyond 30 without getting married or having a child attracts significant social ridicule.

Failure to procreate especially in a marriage, even if it is by choice, is interpreted in negative light and is equated to reproductive health failure. For a man, becoming a father is associated with a sense of achievement, and failure to reproduce severely undermines the sense of masculinity. A woman's place within a marriage is regarded as secure when she reproduces. If she fails to do so, she can become ostracized within the household and community.

"Failure to reproduce can strain family and other social relationships, particularly when the negative views of extended family members are taken to heart," says a study conducted in Zimbabwe in 2001 titled Culture, Identity and Reproductive Failure in Zimbabwe.

"Generally speaking, about one year after entry into marriage or a stable sexual partnership, others expect there to be a child, irrespective of the reproductive choices of the partners."

It is clear that traditional and cultural attitudes play a significant role in how both men and women construct their reproductive capabilities and choices.

As Danielle Toppin notes "given the often covert nature of socialization, certain gendered behaviours are often left untouched, resulting in reproductive health policies that fail to meet the specific needs of women, and of men".

In Zimbabwe, the family, a primary unit of socialization, is often the root of pressure for men and women to prove that they can reproduce. The desire to conceive in order to gain social acceptance is given preference to adopting tools and methods that promote safe sex.

The social pressure on women to become pregnant and give birth leads them into conditions of vulnerability, where they have to acquiesce to their partner's sexual demands. It can also lead men to have multiple sexual encounters exposing them to a high risk of contracting HIV.

Put simply, the effectiveness of sexual and reproductive health tools is inhibited by culturally and socially constructed layers that define people's sexual behaviors.

However, instead of being an impediment, culture can be used as a stepping stone to promote reproductive health rights. To have effective reproductive health programs, therefore, a full understanding of a given society's values and beliefs is required.

There's need for an approach that is sensitive to contextual, cultural, traditional and gender practices that impact on reproductive health choices.

The traditional, spiritual and cultural beliefs that shape and define sexual identities and attitudes towards sexual and reproductive health need to be given serious attention in the design of programs and interventions. Traversing the cultural and traditional can be very difficult and requires a lot of sensitivity, investment and patience.

It's imperative to involve the target communities in the design and implementation of reproductive health policy, planning and practice in order to challenge cultural norms that may put women and men at risk.