Men Key to Reducing Maternal Deaths in Developing Countries
FrontLines - May 2010
Reducing maternal deaths by 75 percent
throughout the world by 2015 will take the
involvement of men in countries where it
matters most, health experts say.
“In many of the countries
where we work, these are male
dominated cultures,” said Lily
Kak, senior maternal and neonatal
health advisor in USAID’s
Bureau for Global Health. “We
need to involve men in our programs
since they are the decision
makers about health care
in the family.” These decisions
include determining family size,
timing of pregnancies, and
whether women have access to
health care. |
In male dominated cultures, USA ID programs are helping to decrease maternal deaths by
encouraging men to become involved in pregnancy and childbirth matters. Pictured: a man and child
in Pakistan.
|
To improve maternal health
outcomes for women in developing
countries—one of the targets
of the United Nation’s Millennium
Development Goals—men
must be equal partners. “Men
need to see the advantages for
themselves,” Kak said.
The USAID-funded Maternal
and Child Health Integrated Program
(MCHIP), now in its second
year, seeks to reduce maternal
deaths while encouraging
men to take an active role in
their partners’ pregnancies.
“We have definitely seen better
outcomes when we engage
men in our programs,” said Koki
Agarwal, director of MCHIP. The
program, which currently operates
in 27 countries, integrates
men into maternal health programs
at the community level.
In Afghanistan, a largely male
dominated society with a dismally
high maternal death rate,
USAID-supported projects have
been training community midwives
in an 18-month resident
training program with the help
of the shura, the local council of
male village elders who have
consented to let the women
attend training and then assist in
births when they return to the
community.
“These women have become
change agents themselves,”
Agarwal said.
In some areas of Nigeria—
where a woman can’t leave the
home without her husband’s permission—
MCHIP sends in male
motivators, community volunteers
trained in communications,
to help local men achieve their
vision for a healthy family.
In Kenya, Tanzania, and
Malawi, women enrolled in
MCHIP programs that teach them
to prevent HIV transmission to
their child are encouraged to
bring their male partners to clinics
for follow-up treatments.
And in the conservative
eastern region of Bangladesh,
MCHIP trains male groups to
deal with the unexpected complications
that can arise during
pregnancy using drawings of the
human body, a practice that
Agarwal says allows for open
talk about these issues.
“For husbands to support,
they must be well-informed and
sensitized,” said MCHIP team
leader Steve Hodgins.
Bangladeshi men have set
aside funds for transportation to
hospitals in case of emergencies
during pregnancy. “It would
have been more difficult without
male involvement to have these
systems in place,” said Joseph
de Graft-Johnson, MCHIP’s
newborn and community health
team leader.
Engaging men means reaching
out to community elders,
leaders, and religious groups,
Agarwal said. But there’s
always a fear that these initiatives
could be rejected, mainly
because of traditional cultural
values and perceptions that
maternal health is the responsibility
of women only.
In April, the medical journal
The Lancet reported that, since
1980, annual maternal deaths
have significantly dropped worldwide.
The study cites lower pregnancy
rates in some countries,
higher income, and more education
for women as some of the
reasons for the sharp decline. And
though maternal health outcomes
are improving globally, the need
for the involvement of men during
pregnancy and childbirth
persists.
Several barriers exist across
the developing world that prevent
the full participation of
males during pregnancy. In
many labor wards, men aren’t
present during birth because of
lack of privacy for the several
women who use the wards. And
often, there are challenges in
reaching the men, Agarwal said.
When pregnancy counseling
happens during the day, men
often are away at work.
The solution? “Get them
where they are,” Agarwal said.
“Go to mosques and engage
them,” she said. Or to job sites
such as the mines in South
Africa. “Opportunities to
engage men at different times is
critical.”
★ — B.J.
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