Male Responsibility In Safe Motherhood

Male responsibility in safe motherhood By DR C.E ENYINDAH

Dr C.E Enyindah

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Introduction High maternal mortality rate in developing countries lead to safe motherhood initiative – Nairobi Kenya 1987, Abuja Nigeria 1990 Uptil now there is no significant improvement. Nearly 600,000 women die each year from complication of pregnancy and childbirth (99% of these deaths occurring in developing countries). 2

33% OF NIGERIAN GIRLS START REARING CHILDREN BEFORE THE AGE OF 18YRS. OVER 60% OF NIGERIAN GIRLS AND BOYS ARE SEXUALLY ACTIVE BEFORE THE AGE OF 17YRS

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definition Safe motherhood means ensuring that all women receive the care they need to be safe and healthy during pregnancy and childbirth.

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Lack of progress: can male involvement help? During 1st ten yrs of safe motherhood initiative, no reduction in annual number of maternal deaths related to pregnancy. Intervention rarely tried to counsel male partners of pregnant women. A few studies have shown promise, but more research is needed. 6

Causes of maternal deaths severe bleeding infection 20%

25%

8%

eclampsia obstructed lab

15%

13% 8%

12%

unsafe abortion other direct causes indirect causes

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Consequences of maternal mortality Effect of morbidity on women and families Physical disability Psychological trauma Social isolation Infertility Increased care-giving responsibilities Reduced economic productivity. 8

Safe motherhood: human rights and social justice Women have limited: Exposure to information about danger signs during pregnancy/delivery. Power in decision making Access to education Financial resources and mobility.

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Why involve men? Men are key decision-makers regarding pregnancy and childbirth. Men have generally not been involved in trying to make pregnancy and childbirth safer.

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Safe motherhood: male involvement

Safeguarding women’s health during pregnancy – antenatal care and nutrition. Arranging for skilled care during delivery. Men often control decisions Respond to complications Seek medical help Pay for transport Allocate family and community resources

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Concept of fathers club Voluntary organisation formed towards increasing awareness and knowledge of reproductive health among men. The goal of the formation of fathers club is to increase the understanding and participation of Nigerian men in reproductive health issues and services 12

Members of the club Local government councillor (supervisory councillor for health) PHC co-ordinators Religious leaders Transport organisation Male dominated trades e.g butchers, cattle rearers Community development associations Traditional council member Other interested male e.g headmasters, principals

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Criteria for membership Must be a father Must be resident in the community concerned Must be married (in stable relationship) Must have a credible and feasible source of income Must be a respectable person in the community.

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Research needed on benefits of fathering Involving men in fathering may lead to: Better communication, stronger bonding between couples and among family Better role modelling for children. Increased commitment to contraceptive use and practice of prevention behaviours Increased support during pregnancy. Reduced violence in the home. 15

Initial lessons learned Egypt post-abortion care study Women whose husbands were counselled had better outcomes India pre-natal care study Involving men in pre-natal care increased their involvement in their wives and children’s health care Jamaica teenage father study Reaching out to baby fathers helped young men stay involved with their child. 16

Promising research efforts Midwives in Mexico are training men as community health workers to teach other men about reproductive health. Projects in 7 countries are focusing on improving communications and joint decision-making between men and women about reproductive health. 17

conclusion Men’s role in safe motherhood cannot be underestimated May be the “tonic’ to reduction in annual number of maternal mortality and morbidity.

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