Jhpiego is actively engaging men and promoting partnerships for healthy decision-making among couples accessing services for reproductive, maternal, newborn, child and adolescent health (RMNCAH). Men play a key part in their own and their family’s health, yet they are often neglected in outreach and service delivery. The involvement of fathers before, during and after the birth of a child has been shown to have positive effects on violence reduction, maternal health outcomes, breastfeeding, use of contraceptives and health services and fathers’ long-term support for their children.
Since the 1994 International Conference on Population and Development, it has been widely recognized that “special efforts should be made to emphasize men’s shared responsibility and promote their active involvement in responsible parenthood, sexual and reproductive behavior, including family planning; maternal and child health; [and] prevention of STIs, including HIV.” And in 2013, the World Health Organization identified engaging with fathers as a global priority for maternal health care. Thus, for Jhpiego, addressing gender inequalities means not just working with women but with women and men together to question and change gender norms and, ultimately, reverse the imbalance of power in relationships that results in negative decisions and impacts for health.
In many countries, men make most decisions about sexual behavior, family size, whether to give birth in a facility or at home, care for children, allocation of household assets and division of household labor and caregiving. Engaging men as clients, supportive partners and champions of gender equality can contribute to improvements in gender equality, couples decision-making and the utilization of maternal health services. This in turn leads to better health outcomes for men, women and their families.
- Building the capacity of providers to engage men in counseling and health services and to work with their partners to decide on family size and create birth plans;
- Encouraging facility improvements such as privacy screens in labor and delivery wards, and sensitizing providers to allow women to bring their partners into the delivery room if they choose to do so; and
- Facilitating couple and community dialogues to transform harmful gender norms that act as barriers to positive RMNCAH outcomes.
Across our programs, Jhpiego encourages health care facilities to allow partners into the delivery room, facilitates couple and community dialogues to transform gender norms that act as barriers to health, and builds the capacity of health promoters to engage men in birth preparedness planning. As the leader of the Maternal and Child (MCSP), Jhpiego empowers providers to engage men as supportive companions. This male engagement fosters joint participation in antenatal care to understand the stages of pregnancy, caregiving responsibilities and postpartum family planning options.
- Under MCSP, Jhpiego co-chairs the Male Engagement Taskforce of the USAID Interagency Gender Working Group which grew to 177 members within one year. In this role, MCSP facilitates dialogue and exchange of lessons on male engagement in RMNCAH. In 2018, MCSP hosted a workshop, “State of the Art and Advancements in Male Engagement Programming,” highlighting successful and promising approaches, as well as lessons in engaging men as clients, partners and champions for change in programming for HIV, RMNCAH, violence prevention, child marriage and economic empowerment.
- In Tanzania, Jhpiego incorporates gender into community social and behavior change communication efforts led by community health workers. In Mara, Tanzania, 91% of men who participated in gender dialogue sessions led by community health workers indicated that they are willing to educate others at community and church meetings.
- In Mozambique, MCSP reached 31,424 community members through community dialogues conducted by 758 community health committees in Sofala and Nampula Provinces. These dialogues encourage couples to practice positive gender norms such as: sharing household labor and caregiving; ensuring pregnant women have rest, nutritious food and access to health services; and preventing GBV. MCSP trained 1,358 health providers and facility managers from 86 health facilities on gender-sensitive service delivery and male engagement. These providers helped 5,185 couples develop joint birth preparedness plans, deciding where to deliver, arranging transport and saving money. Over a 15-month period, more thanr 190,000 men accompanied their partners to RMNCAH services, leading to increased rates of facility delivery.
- In Rwanda, MCSP built the capacity of 173 trainers and 1,500 health providers on gender, GBV and male engagement, thereby improving gender-sensitive RMNCAH service delivery and GBV identification, care and referral. MCSP reached 4,267 individuals through community dialogues on transforming harmful gender norms, engaging men and preventing GBV. MCSP also engages individuals in Rwanda through community dialogues on transforming harmful gender norms, engaging men and preventing GBV through an adaptation of the successful Bandebereho Curriculum developed by Promundo. A randomized controlled trial of this intervention found that participants had significant increases in contraceptive use, sharing of housework, involvement of women in household financial decision-making, and reductions in physical and sexual violence.
- In Nigeria, MCSP promotes the engagement of men and couples in RMNCAH by ensuring that health providers and facilities are “male-friendly” and educating clients. MCSP developed awareness-raising posters, a pamphlet and job aid to help providers counsel clients on how men can contribute to their family’s health. In addition to building the capacity of 41 pre-and in-service providers as training facilitators on male engagement, MCSP provided privacy screens in key facilities to improve respectful care for pregnant women, and to ensure men could support their partners during labor and delivery. These interventions resulted in a four-fold increase from one quarter to the next, with 6,529 males accompanying their partners in the second quarter.
Nigeria Male Engagement Materials
Information, education and communication materials for providers and clients on effective ways men can be involved in reproductive, maternal, newborn and child health