A study in a rural area of Bangladesh makes three recommendations for engaging men in order to improve maternal and newborn health:
- don’t just seek to inform fathers, but tackle barriers, such as social stigma, men’s work commitments and the treatment of men by health services
- promote dialogue within families about maternal and newborn health
- understand men’s motivations and preferences and how gender influences roles of men and women.
The study took place in the rural Netrokona district in Bangladesh. It used interviewer-administered questionnaires with 317 couples, interviewed separately. The level of education was low. Half the women and two-thirds of the men had less than four years schooling. 6% of the women and 5% of the men had more than 10 years of schooling.
The study shows that most fathers are aware that pregnant women have special rights and that using health services is important (even more so than women on both counts). Most men are also knowledgeable about newborn danger signs.
|Aware of women’s special pregnancy and childbirth rights||65%||>||55%|
|Aware of importance of using MNH services||65%||>||59%|
|Know 3+ newborn danger signs||60%||63%|
Knowledge about women’s health risks is much less, perhaps because, in this society, women’s health is regarded as women’s business only and because health problems for babies are much more common than problems for mothers.
|Know 3+ pregnancy danger signs||27%||42%|
|Know 3+ post-delivery danger signs||27%||>||25%|
|Know importance of at least 4 antenatal visits||22%||24%|
|Know 3+ delivery danger signs||18%||26%|
The researchers noted the high correlation between the knowledge of danger signs between women and men, hence the recommendation about promoting dialogue within households.
The attendance of men at health facilities was as follows.
|Childbirth (at facility, not in birthing room)||50%|
|For emergencies during the entire process||38%|
Some positive correlations were found between men’s level of knowledge and the degree to which they participated.
|Presence at antenatal care||Presence at facility during childbirth
|Presence at postnatal care|
|Aware of women’s special pregnancy and childbirth rights||✓|
|Aware of importance of using MNH services||✓|
|Know 3+ newborn danger signs||✓|
|Know 3+ pregnancy danger signs||✓||✓|
|Know 3+ post-delivery danger signs||✓|
|Know importance of at least 4 antenatal visits||✓||✓|
The participation of men in decision-making varied considerably across different activities.
|Discussion about birth and emergency preparedness with wife||78%|
|Selection of a person for delivery||73%|
|Saving money for emergency||56%|
|Discussion about birth and emergency preparedness with health worker||25%|
|Arrangement of home delivery kit||23%|
|Arrangement of emergency transportation||21%|
|Identification of blood donor for emergency||12%|
Rahman AH et al (2018), Knowledge and involvement of husbands in maternal and newborn health in rural Bangladesh, BMC Pregnancy and Childbirth 18