Men’s Role in Safe Motherhood Men’s Role in Safe Motherhood and Family Well-beingand Family Well-being

World Health OrganizationWorld Health Organization

Lack of Progress:Lack of Progress:Can Male Involvement Help?Can Male Involvement Help?

• During first 10-year Safe Motherhood During first 10-year Safe Motherhood Initiative, no reduction in annual number Initiative, no reduction in annual number of maternal deaths related to pregnancy of maternal deaths related to pregnancy

• Interventions rarely tried to counsel male Interventions rarely tried to counsel male partners of pregnant women partners of pregnant women

• A few studies have shown promise, but A few studies have shown promise, but more research is needed more research is needed

Causes of Maternal DeathsCauses of Maternal Deaths

Source: Source: Maternal Health around the WorldMaternal Health around the World , WHO and World Bank, 1997., WHO and World Bank, 1997.

Severe bleedingSevere bleeding(25%)(25%)

Infection Infection (15%)(15%)

Eclampsia Eclampsia (12%)(12%)

Indirect causesIndirect causes(20%)(20%)

Other direct causes Other direct causes (8%)(8%)

Unsafe abortion Unsafe abortion (12%)(12%)

ObstructedObstructedlabor labor (8%)(8%)

Consequences of Consequences of Maternal Morbidity Maternal Morbidity

Effects of morbidity on women and families:Effects of morbidity on women and families:

• Physical disability Physical disability • Psychological trauma Psychological trauma • Social isolationSocial isolation• InfertilityInfertility• Increased caregiving responsibilitiesIncreased caregiving responsibilities• Reduced economic productivityReduced economic productivity

Underlying Gender InequityUnderlying Gender Inequity

U.S. Agency for International DevelopmentU.S. Agency for International Development

Safe Motherhood: Human Safe Motherhood: Human Rights and Social JusticeRights and Social Justice

Women have limitedWomen have limited: :

• Exposure to information about danger signs Exposure to information about danger signs

during pregnancy/deliveryduring pregnancy/delivery• Power in decision-makingPower in decision-making• Access to educationAccess to education• Financial resources and mobilityFinancial resources and mobility

Source: Source: Safe Motherhood Interagency Group Fact SheetSafe Motherhood Interagency Group Fact Sheet , 1998., 1998.

Why Involve Men?Why Involve Men?

• Men are key decision-makers Men are key decision-makers regarding pregnancy and childbirthregarding pregnancy and childbirth

• Men have generally not been Men have generally not been involved in trying to make involved in trying to make pregnancy and childbirth saferpregnancy and childbirth safer

Safe Motherhood:Safe Motherhood:Male InvolvementMale Involvement

• Safeguarding women’s Safeguarding women’s health during pregnancy – health during pregnancy – ante-natal care and ante-natal care and nutritionnutrition

• Arranging for skilled care Arranging for skilled care during deliveryduring delivery

Source: Drennan, Source: Drennan, Popul Rep 1998;Popul Rep 1998;J(46). J(46).

L. RigsbyL. Rigsby

Men Often Control Decisions Men Often Control Decisions

Source: Drennan, Source: Drennan, Popul Rep 1998;Popul Rep 1998;J(46).J(46).

US Agency for International DevelopmentUS Agency for International Development

• Respond to Respond to complicationscomplications

• Seek medical helpSeek medical help

• Pay for transportPay for transport

• Allocate family and Allocate family and community resourcescommunity resources

Male Involvement in the Male Involvement in the Reproductive ProcessReproductive Process

United NationsUnited Nations

MexfamMexfam

Participating in Participating in birthing processbirthing process

Helping after Helping after baby is bornbaby is born

How Do Men LearnHow Do Men LearnTo Be Fathers?To Be Fathers?

B. Genier/World Health OrganizationB. Genier/World Health Organization

Father: ProviderFather: Provider

Salud y Genero/CoriacSalud y Genero/Coriac

Father: Entertainer, Father: Entertainer, Emotionally CloseEmotionally Close

Salud y Genero/CoriacSalud y Genero/Coriac

Salud y Genero/CoriacSalud y Genero/Coriac

Father: Discipline, Father: Discipline, Authority, ViolenceAuthority, Violence

Salud y Genero/CoriacSalud y Genero/Coriac

““Don’t beat me, daddy.”Don’t beat me, daddy.”

Father: Absent or DeadFather: Absent or Dead

Salud y Genero/CoriacSalud y Genero/Coriac

““Heaven for fathers”Heaven for fathers”

Father: Household WorkerFather: Household Worker

B. Thomas/WHO/UNICEFB. Thomas/WHO/UNICEF

Traditional Masculinity Limits Traditional Masculinity Limits the Role of Fathersthe Role of Fathers

• Mostly, father is considered only a Mostly, father is considered only a providerprovider and and authorityauthority figurefigure

• Lack of alternative models – “This is Lack of alternative models – “This is what my father taught me”what my father taught me”

• Limited cultural acceptability of men’s Limited cultural acceptability of men’s emotional expression and involvementemotional expression and involvement

• Little opportunity to learn to care for Little opportunity to learn to care for othersothers

Research Needed on Research Needed on Benefits of FatheringBenefits of Fathering

Involving men in fathering may lead to: Involving men in fathering may lead to:

• Better communication, stronger bonding Better communication, stronger bonding between couples and among familybetween couples and among family

• Better role modeling for childrenBetter role modeling for children• Increased commitment to contraceptive use Increased commitment to contraceptive use

and practice of prevention behaviorsand practice of prevention behaviors• Increased support during pregnancyIncreased support during pregnancy• Reduced violence in the homeReduced violence in the home

Initial Lessons Learned Initial Lessons Learned

• Egypt Post-abortion Care Study Egypt Post-abortion Care Study – Women whose husbands were counseled Women whose husbands were counseled

had better outcomeshad better outcomes • India Pre-natal Care StudyIndia Pre-natal Care Study

– Involving men in pre-natal care increased their Involving men in pre-natal care increased their involvement in their wives’ and children’s health involvement in their wives’ and children’s health carecare

• Jamaica Teenage Father StudyJamaica Teenage Father Study – Reaching out to “baby fathers” helped young Reaching out to “baby fathers” helped young

men stay involved with their childmen stay involved with their child

Promising Research EffortsPromising Research Efforts

• Midwives in Mexico are training Midwives in Mexico are training men as community health workers men as community health workers to teach other men about reproductive to teach other men about reproductive health health ((MacArthur Foundation)MacArthur Foundation)

• Projects in 7 countries are focusing on Projects in 7 countries are focusing on improving communication and joint improving communication and joint decision-making between men and women decision-making between men and women about reproductive health about reproductive health (PAHO)(PAHO)