A study from Uganda has recommended a ‘bottom-up’ approach to organising the engagement of men in maternal and newborn health, drawing on the cultural resources and elders in the community, and the experiences of fathers. The study reports a general sense of enthusiasm for the idea of engaging men in the study areas. However, it found a series of barriers to engaging men effectively: (1) inadequate training for health workers to support men, (2) dependence on international donor funding, which is not sustainable, (3) omission of community and religious leaders and men themselves from the design and management of services, and (4) top-down communication of policies without empowering grassroots implementation.
The study also recommends a change in health systems to embed engagement of men, through human resources, infrastructure, and financing, health management information systems, technology, and governance.
The study, which took place in Kasese and Kampala in Uganda, involved 17 one-hour interviews with professionals (policymakers, academics, healthcare workers, representatives of international organisations) and two focus group discussions for fathers. The fathers were participants of the Emanzi (“champions”) project, implemented by Engender Health International. This project involves learning and knowledge sessions for fathers and expecting fathers.
There is a practice in Uganda to emphasise just one thing: husbands accompanying their spouses to health facilities. This is ‘incentivised’ by giving priority to women who come with their husbands. This practice does not lead to the effective engagement of men in supporting health. Furthermore, health centres are not equipped to welcome men – no privacy for other women, no training for health workers, no practice guidelines, congestion, and overworked staff. Inadequate efforts are made to alleviate any issues fathers and husbands might face concerning pregnancy, childbirth, and infant care.
Uganda has various gender equality policies, including Male Action Groups to train and deploy men at the grassroots level to teach their peers about family planning, reproductive, and maternal health. At the national level, even the President and his wife have supported male involvement in maternal and newborn health. But despite such policies, initiatives are patchy across the country.
Gopal P, Fisher D, Seruwagi G & Taddese HB (2020), Male involvement in reproductive, maternal, newborn, and child health: Evaluating gaps between policy and practice in Uganda, Reproductive Health 17
Header photo: WorldRemit Comms. Creative Commons.
