THE majority of men in Zimbabwe, raised in a society that panders to the dictates of patriarchal notions of male superiority, view involvement in maternal health as “sissy”.
BY PHILLIP CHIDAVAENZI
Maternal health experts contend that this has hampered efforts to ensure effective delivery of tailor-made health packages to expecting mothers. They say pregnant women often fight lone battles during pregnancy and soon after giving birth.
Women and gender rights activist, Madeleine Kaseke said pregnancy and childbirth are often regarded as foreign territory by men, contributing to their little or no participation in maternal health.
“Pregnancy and childbirth are traditionally seen as the domain of women. For the majority of men, these events are mysterious, hence, they are not comfortable with involving themselves,” she said.
“So you have a situation where the men are afraid of losing face when they are asked to participate in solving problems associated with this area.”
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In a 2001 World Health Organisation (WHO) report titled Programming for Male Involvement in Reproductive Health, Alexis Ntabona noted that despite efforts to rope in men into maternal health programmes, effectiveness is often hampered by circumstances beyond their control.
“Although safe motherhood interventions are reportedly cost-effective, public investment in this area has always been lagging,” he said.
“Consequently, whatever the goodwill on the part of men, their participation in tackling safe motherhood issues is constrained by externalities, such as widespread poverty, multiplicity of physical barriers to access to maternity care, inadequate health infrastructure (and) low morale of personnel.”
A snap survey by NewsDay revealed that in many instances, married men are reluctant to engage maternal issues due to cultural factors and women who dared broach the subject are regarded as being “too forward”.
“What is needed is a change of attitude, especially among men,” a medical doctor, Lennon Matsika said.
“Sometimes you have cases where a woman is advised not to have more children due to a health condition, but the next thing they are pregnant, risking either their own life or that of the baby.”
Matsika said a lot of men hardly accompanied their expecting wives to the doctor or ante-natal clinics, as these are viewed as “women’s places” so they often have little regard for the information passed on to their wives by health personnel.
Kaseke concurred, saying “a kind of cultural re-orientation” is needed to have men understand that they have a role to play in maternal health.
“They need to understand that in the event that their wife or child dies during child birth, it’s equally their loss, which also has far-reaching social and emotional repercussions,” she said.
Maternal health complications have been for many years witnessed in cases where mothers are HIV positive.
Kaseke observed that traditionally, men have been presented as an obstacle rather than part of the solution.
“The majority of interventions and services to promote sexual and reproductive health, including care during pregnancy and childbirth, have been exclusively focused on women,” she said.
Nemamwa Clinic, close to Great Zimbabwe monuments in Masvingo, has demonstrated the positive impact male involvement can have on maternal health, as this has significantly complemented the prevention of mother to child transmission (PMTCT) of HIV.
Nemanwa Clinic has been recording close to zero HIV-positive babies born from parents living with HIV since 2012.
Out of the 450 pregnant women, who got tested for HIV and received their results, 421 male partners followed suit in 2014.
One of the nurses at the clinic, Revai Baloyi, said male involvement had helped them achieve tremendous results.
“In this small community, being diagnosed with HIV is like being diagnosed with any other disease,” she said.
According to WHO, following a survey carried out in Zimbabwe in 2001, the majority of men misinterpreted campaign messages promoting male involvement to mean that decisions should be solely left to men, as the images and metaphors used to communicate them were “macho” and, therefore, “reinforced deeply-rooted, traditional gender stereotypes and attitudes towards decision-making.”
In many other African countries, including South Africa, family planning, pregnancy and childbirth have long been regarded as exclusively women’s affairs.
Kaseke said men generally do not accompany their partners to family planning, antenatal or post-natal care services and are not expected to attend the labour or birth of their children.
According to the results of a Men in Maternity study carried out in KwaZulu-Natal, South Africa, to evaluate the feasibility of involving men in antenatal and post-natal care, 81% of the population has strong cultural beliefs around the role of men in antenatal and post-natal care.
According to the findings, men are culturally not expected to be involved in maternity-related issues.
There have been calls for government to incorporate paternity leave into the amended Labour Act to allow men to be more involved in maternal health issues when their wives are expecting.
Labour minister Prisca Mupfumira said the issue of paternity leave is yet to be discussed by the Tripartite Negotiating Forum. “Right now, we are still discussing the issue of maternity leave and its benefits. Once that has been brought to the table, we will begin deliberations,” she said.
There have been efforts, through the Women’s Action Group (WAG), a non-governmental organisation focusing on the prevention of violence against women, to rope in men in maternal health issues.
The programme to engage men in maternal healthcare started in 2014, with an initial 714 men.
“We have since realised that men are critical partners in maternal issues. We decided to include men in our dialogues, where we hold regular discussions on maternal health issues and gender based violence. Once we equip them with information, they go back to facilitate discussions at community level and these have turned out to be fruitful,” WAG director, Edinah Masiyiwa, was quoted saying.