By Gift Kunimba, White Ribbon Alliance-Malawi, Citizen Journalist/Midwife
At Kwitanda Health Centre in Balaka District, seven women are attending their initial antenatal clinic. Three have come with their partners. And at Dziwe outreach antenatal clinic, also in Balaka District, out of the four pregnant women who are attending antenatal classes for the first time, two are with their spouses. As is the rule, these partner-accompanied expectant mothers are attended to first and do not have to wait their turns in the queue.
While this may seem unfair to those who arrived earlier, attending to expectant mothers who come with their partners first is done to encourage and appreciate the men who are heeding the call by health advocates to actively participate in the affairs of their pregnant spouses.
This concept of having men involved in reproductive health issues such as attending antenatal clinics with their partners is part of the male involvement initiative. Piloted in the districts of Mwanza and Mchinji, the main aim of this initiative is to integrate men into sexual and reproductive health issues, an arena that was previously viewed as "female issues."
Previously, it was a cultural norm that when a woman got pregnant, she single-handedly sought the help needed to ensure that she stayed healthy throughout her pregnancy and delivered a healthy baby, safely. It was believed that the woman carries the pregnancy and the man doesn’t have much he can do about it. However, reports from areas where men are actively engaged in the sexual and reproductive issues of their families indicate that there are numerous benefits of male involvement.
For example, during the first antenatal visit, it is compulsory that an expectant mother does HIV counseling and testing. When women came alone to their appointments and discovered that they were HIV-positive, it turned out that they usually failed to disclose this status to their partners for fear of divorce.
However, if both attend the antenatal visit, they get an opportunity to do the HIV counseling and testing together. And, if the results are positive for them both, it has been found that the husband will be supportive and will give the woman the emotional assurance, physical support, reminders about taking her medication timely instead of hiding or not taking it at all, financial support and personal understanding needed to help her deal with her HIV status. In this case, male involvement greatly reduces the prevalence rate of HIV through prevention of mother-to-child transmission of HIV by encouraging couples to go for HIV testing and counseling together.
To implement this initiative in Balaka District, the Ministry of Health through their Reproductive Health Department has the support of partners like FOCUS, Village Reach, UNICEF and DREAM.
The program first trains men who are known as male motivators. It is these male motivators who move around encouraging fellow men to take part in sexual and reproductive issues, such as escorting their spouses to antenatal clinics. Couples are also encouraged to deliver in health centers because this reduces the rates of maternal deaths and neonatal mortality as women are assisted by skilled birth attendants. Delivering in a health facility also ensures that women with danger signs of pregnancies are quickly attended to.
Male motivators also encourage men to actively participate and escort their spouses when taking their children to under-five clinics. When a couple is given information together, this helps them prevent some of the infections and ailments that children suffer due to ignorance.
The program through the male motivators also encourages couples to go together for family planning services. Since men are culturally considered the decision makers, when they are properly convinced about the benefits of a sizable and manageable family, they quickly get on board to make sure that their family planning decisions are implemented in their marriages.
Village chiefs in Balaka District have also joined the drive to get men involved in sexual and reproductive issues. They are encouraging their subjects to embrace it. Some chiefs have actually gone ahead to set up by-laws where they ask each and every pregnant woman to go to the antenatal clinic with their spouses - and in cases where the woman has no husband, she gets a letter from the chief to confirm that she is single.
Gift was trained by White Ribbon Alliance as a citizen journalist. By equipping midwives with the skills and confidence to tell the stories of mothers, citizen journalists shine a light on vital maternal and newborn health issues, and ultimately, improve the health and lives of mothers and babies in their own communities.