A study in rural Zambia investigated why women do not use birth clinics, giving birth at home instead. A key finding was that husbands are influential. Only four husbands were consulted, however, leading to confusion about their views and what could improve the situation.

The researchers found three groups of factors influencing use of birth clinics: family influences, practical barriers such as distance and money, and fear/dislike of birth clinics. We know from other research published this month from Ghana that men are similarly influenced by distance/money and fear/dislike of birth clinics.

The researchers questioned 100 women in focus groups along with 30 other people, including health professionals and 4 husbands.

There are very mixed opinions about how husbands influence the place of birth. Some women said that husbands make the final decision, but it is not reported which way they use their patriarchal privilege to decide, other than one quotation about a husband who decided after family consultation. Also there was no report about how likely the men would change their decision based on receipt of information and advice. The four husbands reported that most husbands support attendance at birth clinics, while health workers disagreed and said men were the main barriers.

The researchers recommend that family and friends are “targets for interventions”, though we at Family Included would prefer a rather softer formulation!

In the 10-point plan for engaging with fathers that we published recently, the second action relates to consultation:

“Ask, don’t assume. Stereotypes of men and fathers, especially in ‘traditional’ families, are often negative and assume that all hold the same views. This is not the case, nor are views necessarily unchanging. Connect with each father as a human being, and explore his story and aspirations.”

This approach opens up a pathway towards knowing how best to bring about the desired change, in this case, better attendance at birth clinics.

Sialubanje C, Massar K, Hamer D & Ruiter RAC (2015), Reasons for home delivery and use of traditional birth attendants in rural Zambia: a qualitative study, BMC Pregnancy and Childbirth 15

Photo: CIFOR. Creative Commons.