A qualitative study of men’s involvement in maternal and newborn health in rural Malawi highlights the fact that fathers’ roles are changing in relation to infant nutrition, and their increasing involvement needs to be factored into policy. The authors commend peer initiatives, whereby men engage other men.

The researchers organised focus groups and interviews with a total of 70 people: 26 professionals and 44 community members. Of these, 63% were women and 37% were men. The researchers recorded the following findings.

1. When men recognise the benefit of their involvement, they respond positively to information about infant nutrition, using the knowledge to improve their baby’s health.
2. Some men take pride in being part of local campaigns to promote maternal health.
3. Advocacy by NGOs around gender roles has a positive effect in encouraging men to get involved in maternal and newborn health and also to challenge traditional gender norms, for example, around housework. Men attending clinics does not necessarily lead to changed gender norms in the home.
4. Socio-cultural beliefs about separate roles of men and women inhibit the involvement of fathers in caring. There is a risk of insult and ridicule for men who engage in what are considered to be women’s tasks. An example is given of a song sung at antenatal education sessions that mocks men for avoiding responsibilities for children by running away and by eating rat poison.
5. There are some practical barriers to the involvement of men: work, long waits at health facilities and unwelcoming practices when they arrive.

Misgivings were expressed about the practice of incentivising the involvement of men by penalising women who arrive at health clinics without a male partnerw, for example, being sent to the back of the queue. A woman with no husband/partner has to get an exemption letter from the village chief and she may have to pay money for this. The researchers point out that this practice is contrary to the Constitution of Malawi, which specifies that healthcare must be free.

Malawi implements peer communication among fathers.

There are male champions in Malawi who are “secret”. They travel from house to house, directly encouraging men to be involved in maternal and child health. This is the kind of private activity that goes on within on-line social networks for fathers in developed countries.

Malawi also has care committees, set up to provide chid health, nutrition and care information to households. These committees include men so as to facilitate their influence of their peers.

Mkandawire E & Hendriks SL (2018), A qualitative analysis of men’s involvement in maternal and child health as a policy intervention in rural Central Malawi, BMC Pregnancy and Childbirth 18

Photo: Union to Union. Creative Commons.