Researchers in Malawi have proposed a curriculum for antenatal education for expectant couples. It is the first time that the antenatal information needs of couples have been investigated in Malawi – hitherto, only the needs of mothers have been explored. The researchers make the point that economic pressures, growing individualism and the dilution of social cohesion mean that there is a stronger need for men to be knowledgeable about maternal health issues in Malawi.

Through focus groups and discussions with both parents and professionals, the researchers defined the following topics.

• Description of pregnancy: what happens to a woman.
• Care of pregnant women: for example, nutrition, the need for rest, and the importance of the woman being happy.
• The role of men during the perinatal period: how men can support every aspect of the process from pregnancy to baby care.
• Family life: this covered both parenting and relationships, including abuse and violence in the home.
• Birth preparedness and complications readiness plan.
• Prevention of mother to child HIV transmission and syphilis testing.
• Sex during and after pregnancy: this included both positions for sex, and the timing of sex, particularly given the current conflicting advice from health professionals and community elders on how long sex should be abstained from.
• The signs of labour.
• Giving birth: participants felt that men should know about what happens during labour and childbirth, even though most are unable to be present, particularly in public hospitals.
• Baby care: how to take care of a baby, how to support breastfeeding and how to recognised danger signs in the baby.
• Family planning.

The researchers noted the absence of one topic: emotional support for men during the perinatal period. They surmise that this may be related to notions of masculinity that reject male weakness.

The researchers organised four focus groups discussions with women and men separately, one focus group with nurses/midwives, 10 interviews with couples and 10 interviews with fathers who had attended antenatal clinics with their partners. In all, 66 men and 53 women were consulted. Most had school education (82%) and some had university education (24%).

On most topics, women and men recommended the same. The men recommended the inclusion of men’s roles, family relationships and sex. Women were more interested in birth preparedness.

The researchers are planning to develop a curriculum and test it for acceptability, feasibility and effectiveness in Malawi. They will include the topic of emotional support and also consider including demonstration of skills, rather than only information about them.

Chikalipo MC, Chirwa EM & Muula AS (2018), Exploring antenatal education content for couples in Blantyre, Malawi

Photo: USAID. Creative Commons.