Engaging Afghan men at a societal level to increase women’s access to contraception

Andrew Macnab,Josephine De Freitas,Wais Aria

doi:10.17157/mat.6.4.732

Abstract

Mother and child mortality rates in Afghan internally displaced person (IDP) camps are high. Most women have unplanned pregnancies; many are child brides. Contraception can lower maternal mortality/morbidity from unintended pregnancy and short birth intervals, but in Afghan culture men make health decisions. Using knowledge of Afghan society gleaned from Afghan health workers, we trained respected elders and imams to start men’s groups to share practical, financial, and religious facts about contraception and promote discussion. The aim was to inform and allay misconceptions and fears so informed spousal conversation could occur; the overall objective was to allow women wanting spaced pregnancies or smaller families to gain spousal understanding and approval for use of contraception. Societal responses were monitored for one year among nine hundred families in three IDP camps where weekly men’s groups were conducted. Taking photographs captured unique ethnographic aspects of the intervention especially for those involved in this research who were not in Afghanistan and hence missed being directly engaged with the community. The maternal and infant health challenges and cultural issues addressed are global in nature; this model is globally applicable to other camps and Islamic societies.

Highlights

In many societies, the cultural norm is for men to be the predominant decision makers
Tabish staff were ideally placed through their prior involvement in health support roles while working with internally displaced person (IDP) to undertake the training of respected elders from the camps; men’s group leaders were taught what facts to share, how to lead discussion, and to engage imams to add doctrinal clarity and religious endorsement
We found that learning of the economic benefits of using contraception to achieve longer birth spacing and smaller families was more compelling to these men, as an argument for change, than any maternal or child health benefits

Summary

Introduction

The cultural norm is for men to be the predominant decision makers. A team from Rose Charities Canada collaborated with the Tabish organization in Afghanistan to design a societal intervention targeting men, with the objective of improving women’s access to contraception in IDP camps in Afghanistan.

Results

Conclusion