How men can become partners in maternal health

What is a common factor in ensuring that women do not marry too young, do not have more children than they can cope with, do not die giving birth — and contract HIV in smaller numbers? The answer is men.

That is the message for World Population Day 2007, which is being marked on Wednesday under the theme Men as Partners in Maternal Health.

“Experience shows that men’s involvement and participation can make all the difference,” notes Thoraya Ahmed Obaid, executive director of the United Nations Population Fund (UNFPA), in a statement for World Population Day. “By discouraging early marriage, promoting girls’ education, fostering equitable relationships and supporting women’s reproductive health and rights, progress is made.”

The difficulties of breaking down gender stereotypes to free men to play a more positive role in the lives of their partners are well known. But to what extent are institutions being reformed to assist men?

According to Bafana Khumalo, co-founder of the Sonke Gender Justice Network, an NGO based in Johannesburg, there is some way to go.

“When you talk about sexual reproductive health, for example, and you go to the hospital, you find that the system targets women. The environment is not friendly to men. The majority of the nurses are women,” he says. “Some of the men come back complaining that they have been chased away by nurses. The nurses tell them that it’s not a man’s place.”

In a bid to improve gender relations, the network holds regular workshops around South Africa. “We encourage men to accompany their women to antenatal clinics. We tell them to continue with the process until their partners give birth,” Khumalo says. “We need to change the system and the mindset.”


However, women on the front lines of changing mindsets may face obstacles, says Lisa Vetten, a researcher at the Tshwaranang Legal Advocacy Centre to End Violence against Women, also based in the economic hub of Johannesburg.

“It’s difficult talking to men, especially when you are female,” she says. “But of course, men are not all the same. One can sometimes have success with older men. This is because older men fear losing their partners, children and property.”

That progress is being made is shown by the Sonke Gender Justice Network’s initiative in a rural farming community in the northern Limpopo province.

“They [male farmworkers] are now helping with dishes. They clean the house — and more men want to join their group. As a result, women from that community have been calling us and asking what we have done to their men,” Khumalo says, laughing.

The network is also trying to include traditional leaders in its work through invoking the concept of ubuntu — a term used in a number of South African languages that can be loosely translated as “humanity”. More broadly, it refers to a traditional belief that a person’s humanity is determined by the extent to which the humanity of others is upheld.

But the NGO has found that approaching the leaders requires considerable tact.

“You don’t start by criticising their way of life as being backward. They will close ranks and refuse to talk to you. It’s safe to talk to the elders, for example, about the problems of women who have been kicked out of their matrimonial homes. Kicking out women goes against the spirit of ubuntu,” Khumalo says.

Gender equity

The theme of this year’s World Population Day echoes that of the UNFPA’s annual State of the World Population report for 2005, titled The Promise of Equality: Gender Equity, Reproductive Health and the Millennium Development Goals.

“Partnering with men is an important strategy for advancing reproductive health and rights, which are so closely linked to the MDGs,” notes the document.

“Husbands often make decisions about family planning, their wives’ economic activities and the use of household resources, including for doctors’ and school fees. These decisions influence the well-being and prospects of the whole family,” it adds.

“The care and support of an informed husband also improves pregnancy and childbirth outcomes and can mean the difference between life and death in cases of complications, when women need immediate medical care.”

According to the 2006 Human Development Report, produced by the UN Development Programme, 84% of deliveries in South Africa occur in the presence of skilled health workers — the personnel who can ensure that complications do not result in maternal death.

This figure rises to 98% for deliveries in the richest 20% of the population — and sinks to 68% for the poorest fifth of society.


The fact that many women give birth under dangerous conditions is reflected in maternal mortality statistics. The Human Development Report notes that 150 female deaths are reported annually for every 100 000 live births in South Africa — compared with six for Norway, the state that ranks top of the report’s human development index (HDI).

The HDI lists countries around the world according to how they succeed in providing their citizens with a long, healthy life, knowledge and respectable living standards.

Contraceptive prevalence for South African married women aged 15 to 49 is 56%, while in Switzerland, The Netherlands and the United States — countries that rank in the top 10 of the HDI — it is 82%, 79% and 76%, respectively.

South Africa was placed at position 121 of the 177 countries evaluated for the 2006 HDI. However, in the report’s Gender-related Development Index, where HDI rankings are adjusted to reflect inequalities between women and men, South Africa ranks 92nd.

This does not appear to compare positively with figures released just five years previously. In the 2001 HDI, which listed 162 nations, South Africa came in at number 94 — and 85 on the gender-related development index.

Of the 5,3-million adults living with HIV/Aids in the country, more than half — 3,1-million — are women, according to the Joint UN Programme on HIV/Aids. — IPS

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Moyiga Nduru
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