Where are the Husbands? Male Participation in Maternity Care in Sub-Saharan Africa

The importance of male participation in maternity care in Sub-Saharan Africa is becoming increasingly important. This is because husbands have a role to play in ensuring that their wives’ obstetric care needs are met. The involvement of husbands in their wives maternity care is especially critical in Sub-Saharan Africa because in many settings of the region, husbands decide when and where obstetric care is sought, even during complications. It is therefore essential to understand and increase men’s involvement in their wives’ care in Sub-Saharan Africa. Since husbands are important decision-makers, an important first step is to increase their knowledge and awareness of obstetric care, to enable them to make informed decisions about where and when to seek care.

In Sub-Saharan Africa, cultural perceptions and gender norms often constrain men’s involvement and participation in maternity care. Maternity care in Sub-Saharan Africa is still seen by many as women’s business, and the role of husbands is often limited to providing financial and material support. This historically female-centered view of maternity care has led to lack of space to accommodate men in maternity care units in many health facilities. Further, maternity care providers easily exclude husbands from the education provided to wives prior to discharge from health facilities. Thus, male participation often ends at accompanying the wife to a health facility. As a result, husbands tend to have very little knowledge of the care their wives actually receive at health facilities, since they usually have to wait outside the health facility.

As part of my research on postpartum care in rural Malawi, I found that most husbands are unaware of routine postpartum clinical assessments such as blood pressure, temperature, abdominal, vaginal, and breasts exams their wives 20151006_143527receive in health facilities after delivery. Husbands who are aware of some of these services get the information from their wives. Also, many husbands do not usually attend postpartum care visits with their wives. Even for husbands who accompany their wives for care, they seldom enter the health facility.

An important finding was that the lack of knowledge of husbands and non-attendance at postpartum visits did not mean the husbands were not interested in the well-being of their wives. Many husbands permitted their wives to return for their postpartum visits because they were interested in her well-being. The non-attendance and lack of knowledge of postpartum care may be due to limited opportunities for husbands to participate in their wives care, because of the female-centered view of maternity care.

It is important to encourage husbands to support their wives in seeking postpartum care for the well-being of the wife. It is also important for health care providers to welcome husbands as partners in their wives care, when they accompany them to a health facility, by allowing them into private examination rooms (where available). For health care facilities without private examination rooms, health care providers can provide husbands with information on the status of their wives health. Maternal health education should be provided to both men and women, so that they are both equipped to make prompt, informed decisions about concerns that may arise, especially during obstetric complications. Further, women should be encouraged to have open discussions with their husbands about care they received in health facilities, and any health issues or concerns from visits.

Husbands’ participation in their wives maternity care, beyond accompanying wives to a health facility, could result in more knowledge and awareness of their wives health, and could enhance communication between husbands and wives related to obstetric care. This improved knowledge and communication may help in prompt decision-making for seeking emergency obstetric care, especially given the economic dominance and decision making power of men in Sub-Saharan Africa.

Published by

Yenupini Joyce Adams

Yenupini Joyce Adams is an Assistant Professor of the Practice and the Global Maternal Research Lead at the Eck Institute for Global Health, University of Notre Dame. Her research passion is to improve maternal health, promote safe motherhood, and decrease maternal mortality and morbidity, especially in Sub-Saharan Africa and U.S, where the burden of maternal mortality is greatest.

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