Abstract
Male involvement in reproductive, maternal, newborn and child health (RMNCH) is known to improve maternal and child health outcomes. However, there is sub-optimal adoption of male involvement strategies in several low- and middle-income countries such as Kenya. Aga Khan University implemented Access to Quality of Care through Extending and Strengthening Health Systems (AQCESS), a project funded by the Government of Canada and Aga Khan Foundation Canada (AKFC), between 2016 and 2020 in rural Kisii and Kilifi counties, Kenya. A central element in the interventions was increasing male engagement in RMNCH. Between January and March 2020, we conducted an endline qualitative study to examine the perspectives of different community stakeholders, who were aware of the AQCESS project, on the facilitators and barriers to male involvement in RMNCH. We found that targeted information sessions for men on RMNCH are a major facilitator to effective male engagement, particularly when delivered by male authority figures such as church leaders, male champions and teachers. Sub-optimal male engagement arises from tensions men face in directly contributing to the household economy and participating in RMNCH activities. Social-cultural factors such as the feminization of RMNCH and the associated stigma that non-conforming men experience also discourage male engagement.
Highlights
The 1994 International Conference on Population and Development in Cairo and the 1995 World Conference on Women in Beijing marked the significant recognition that women’s empowerment requires the engagement of men to advance positive improvements in reproductive, maternal, newborn and child health (RMNCH) outcomes
Key enablers to male engagement included individual and couple information sharing, and the use of community male influencers, In both Kilifi and Kisii, transportation costs may be a barrier to attend RMNCH health activities, which is compounded with the challenge of balancing informal jobs and prior commitments with attending gender sensitive community seminars
This may imply that men, who are the financial providers for their families, have to choose between losing their income and attending sessions
Summary
The 1994 International Conference on Population and Development in Cairo and the 1995 World Conference on Women in Beijing marked the significant recognition that women’s empowerment requires the engagement of men to advance positive improvements in reproductive, maternal, newborn and child health (RMNCH) outcomes. Male Engagement in Maternal Health to “encourage men to participate fully in all actions toward equality” [1]. This intersectional approach demands meaningful male involvement to uncover and address male attitudes, beliefs and practices that sustain gendered power differentials and reinforce inequalities between women and men. Conventional gender norms that label men with good health service seeking behavior as “weak” may discourage healthy and positive behaviors and affect men’s health-related outcomes [2,3,4]. In many low- and middle-income settings men determine women and children’s access to and utilization of health services with significant implications on their health outcomes [5,6,7,8]
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