The salient place of men in maternal health

WHEN Jackie (not real name) requested her husband to escort her for the regular antenatal check-up and to test for HIV as required for pregnant mothers, she had no idea what reaction she would get from her husband. “Am I the one who is pregnant? Do I look like I have HIV/Aids to go for testing?” he shouted at the shocked two-month pregnant woman. However, this experience is not unique to Jackie. It is common in many families as most men are still ignorant about the importance of getting involved in maternal health issues of their spouses. Men, generally, do not accompany their partners to family planning, antenatal or postnatal care services and would not be expected to attend the labour or birth of their child. Traditionally, couples and providers alike have considered family planning (FP) a woman’s issue. However, recent research shows that the trend in Rwanda is changing. Not only do women want their male partners to be more actively involved, but also men themselves are more interested than previously believed. As is a policy in Rwanda, men’s involvement in maternal health is important in promoting safe motherhood. Access to prenatal and postnatal care is a necessary requirement to safe delivery.It speeds up progress towards meeting Millennium Development Goal 5 (reducing maternal mortality and universal access to reproductive health by three quarters by 2015.)One of the strategies Rwanda is taking to achieve this MDG target is putting men at the forefront of the fight against maternal mortality. Globally, an estimated 287,000 women die during pregnancy and childbirth annually. Most of them die because they have no access to skilled routine and emergency care. Since 1990, some countries in Asia and Africa have more than halved maternal mortality. It’s more than a responsibilityDr John Rwibasira Muganda, an obstetrician and gynaecologist at King Faisal Hospital, says involving men in antenatal care and post natal care procedures is very important. “The man’s involvement in obstetric matters is important because there are many complications that may occur and the man has to help. The man has to be involved in making certain decisions,” Dr Muganda says. He said on average, only 30 per cent of men come with their wives for one or two antenatal care appointments. “Although in critical situations when a man is needed, he will come. During the time for HIV testing and counselling, the couple always shows up together. There is still a weakness of men not accompanying their wives for the post natal care yet it’s a very vital appointment. It’s during this appointment that a couple can know which family planning method they can use,” Dr Muganda said. He also said if a man is well informed about the maternal health issues, he will use the knowledge he has to help the woman in case of critical situations or complications at home. While walking through the maternity ward at King Faisal Hospital, I talked to some couples who had come for antenatal care.Peter Claver Bazamutima, an accountant at Kamonyi district, who had escorted his wife to hospital with their eight-month-old baby for treatment, said he attends all the antenatal care visits with his wife because it is his responsibility as a husband. “My wife’s life is important to me. That’s why I escort her for all the antenatal care sessions or when she is sick. If she gets any complication during pregnancy or after, it affects us as a family. So maternal health issues are not for only women; men have to get involved,” Bazamutima said.