Changing times? Gender roles and relationships in maternal, newborn and child health in Malawi

INTRODUCTION

Men's roles in MNCH

• This article explores the reasons why men in Malawi do not play a more active role in maternal and child health services (MNCH)
• It identified three themes for how male engagement in MNCH is enabled or hindered, including: gender roles at home; policy changes to improve male involvement; and community/ local initiates within the local community
• The involvement of men in the MNCH journey contributes to addressing gender attitudes towards maternal and newborn outcomes

Involving men in the MNCH journey

In Malawi, men tend to stay minimally involved with maternal, newborn and child health (MNCH) services for their families, as there is a stigma against men becoming involved because it is commonly seen as a woman’s domain, unimportant or uncomfortable. However, evidence suggests that men’s involvement is important for positive MNCH outcomes and programs to educate men and incentivise their involvement in Malawi have been implemented in the last couple of years. Chief leaders, for example, have attempted to implement policies to mandate fathers’ attendance at antenatal care appointments showing an interest in involving men more in MNCH.

Overall, what is critical to catalysing social change are approaches that view men as partners or view men as agents of positive change.

KEY TAKEAWAYS

1. Community leaders are key for change

   Community leaders should be involved in MNCH health care providers program initiatives as they play an imperative role in the promotion of MNCH services knowledge and men’s role in supporting women accessing these.

2. Limiting gender norms prevent men's involvement

   Health care provider initiatives must create gender-inclusive programs to reduce gender barriers that prevent men from involving in MNCH services.

3. Positive strategies were successful with men

   Use positive strategies to involve men as full partners in MNCH such as involving them in peer groups that promote messages on the benefits of using MNCH services and encouraging their active participation in their partner’s maternal journey.

4. Incentives in health increases involvement

   The use of incentives by health providers in the form of priority health care encourages men involvement in MNCH services. Furthermore, men are more likely to get involved in MNCH when policies, community and health care providers initiatives to transform gender relations are stimulated.

5. Engagement strategies must be gender-inclusive

   Efforts to involve men in MNCH in Malawi should be gender-inclusive so as to not reinforce patriarchal norms.

While most participants in our study expressed general agreement that men should accompany women to ANC, it is clear that in Malawi, dichotomous tensions exist between men being viewed as the providers and decision-makers in their families and men being supportive of and engaging in women’s health-seeking practices.

Read the full case study here.