Since the 1994 International Conference on Population Development in Cairo, the importance of male involvement in reproductive health programs, including maternal health, has come into focus. In their roles as fathers, partners or healthcare workers, men influence not only their own health but also women’s reproductive health. Men tend to be the decision-makers within families and often take the lead in issues regarding the allocation of money, transport, women’s workload and access to health services, family planning and use of contraceptives.
A range of programmes and interventions, such as fathers’ clubs, or Men’s Groups, peer education initiatives, community mobilization campaigns and workplace-based initiatives, were developed and implemented around the globe with an intention to encourage active involvement of men during the prenatal and postnatal periods as well as during the delivery.
These studies demonstrated that engaging future fathers during the antenatal period can improve birth preparedness, contribute to better couple communication, increase assistance when complications arise during birth, facilitate more equitable relationships and improve attendance at postnatal care.
In Malawi, a study concluded that merely accompanying a wife to first antenatal visit and having an HIV test is not sufficient enough to change the behavior of men towards maternal health care.
This means barriers and challenges to male involvement exist at different societal and health system levels. At the health service delivery level, challenges include health providers’ attitudes, inadequate staff training, insufficient staff numbers, long waiting times, regulations in health care facilities, cultural and gender norms and men’s lack of knowledge regarding maternal and child health.
In fact, as the study demonstrates, accompanying a wife to antenatal is viewed as an act of love in most Malawian communities. The findings also revealed that the concept is viewed by most communities as foreign, and a little unfair to those women without husbands.
There is therefore a significant need to scale up men’s participation in maternal health and to provide them with the sufficient information to help them make decisions, and support their partner’s decisions, concerning their family’s health.
In addition to measures taken to encourage and motivate men to participate, special attention has to be paid to the obstacles they face and complex approaches to overcome them.
More rigorous evaluations of male involvement initiatives, attention to vulnerable and disadvantaged families, acknowledgement of heterogeneity of fathers’ groups, revision of policies and laws and closer collaboration between different sectors are needed in order to strive for better maternal and newborn health outcomes and well-being.