In the Iringa region of Tanzania, traditional gender roles are common, where men are financial bread-winners and women raise children and are responsible for cooking and cleaning. Even when a woman is pregnant or has recently delivered a baby, her duties continue.
Unfortunately, men in Iringa are not consistently involved in maternal, newborn and child health (MNCH), including antenatal care (ANC) and delivery. This lack of participation causes them to miss out on important health information regarding their partner’s care.
Many factors contribute to this norm, including:
- A lack of health education for men.
- Fear of HIV testing. As part of the Prevention of Mother to Child Transmission of HIV program, it is a requirement for women and men to be tested before the first ANC appointment. Men prefer their wives to be tested first and assume their result would be the same.
- Traditional gender norms and roles.
- Unfavourable environments in health facilities where families experience long wait times, lack of physical space to accommodate both men and women, and disrespectful language from health workers.
Increasing male involvement in care has been known to improve the health of both women and children. The Innovating for Maternal and Child Health in Africa (IMCHA) project has developed five strategies to engage men in MNCH and ANC.
Strategy #1: Use male champions and gatekeepers
IMCHA is using male champions and gatekeepers to spread important health messages to other men in the community. Training champions and gatekeepers will enable the project to deliver health messages and increase the acceptability of messages to men in the community. Men in positions of authority are highly respected in the community. They are chosen as champions because they can influence other men and breakdown engrained cultural and gender norms in the community. Male champions and gatekeepers may be religious, community, or governmental leaders. The messages are delivered during social gatherings, including football matches, at bars, and other meeting places in villages.
Strategy #2: Use female champions
The second strategy is the use of women as champions to educate other women. Establishing good relationships between couples will facilitate male involvement, while unfriendly relationships will hinder the active participation of men. In this context, women’s groups are important for proving education on best practices to fellow women. Best practices include using effective communication strategies such as being mindful of the tone and language used. Many women have social platforms where they can share information related to couple relationships and communication, pregnancy and childbirth. Effective partner communication may result in improvement of couple relationships and can promote male participation in maternal and child health.
Strategy #3: Partner notification
The third strategy is the use of partner notification. Women who come to their first ANC visit without their partner are provided service but are requested to bring their partner to the next appointment. Health providers coach women about how to invite their male partners to the visit. If a man refuses an invitation from a health provider to accompany his partner to an ANC visit, village leaders can step in and pass along a formal invitation to men.
Strategy #4: Engaging health facility governing committees
The last strategy being used is engaging health facility governing committees. In all public primary healthcare facilities, the committees are made up of representatives from the community and health facilities. These committees oversee the delivery of healthcare services and mobilize community finances to manage healthcare services. Engaging these committees could help address barriers to male involvement including long wait times, disrespectful language from healthcare providers, and lack of physical space to accommodate men and women.
With these strategies, the IMCHA project expects to expand access to health services by encouraging men to be more active in maternal health. The strategies have proven beneficial by many groups in the community. The program identified the root causes of the problem and empowered community members to develop culturally appropriate strategies to address barriers to male involvement in women and children’s health.
HealthBridge Foundation of Canada is working in the Iringa region alongside the Institute of Development, Dar es Salaam and the Iringa Region Health Department to implement the Innovating for Maternal and Child Health in Africa (IMCHA) project. The project focuses on addressing barriers that pregnant women and new mothers in Kilolo and Mufindi Districts of the Iringa region face in accessing health services.