Male involvement in reproductive, maternal, newborn, and child health: evaluating gaps between policy and practice in Uganda
File(s)
Published version
Author(s)
Taddese, Henock
Type
Journal Article
Abstract
Introduction: Male involvement in maternal and child health is a practice wherein fathers and male community
members actively participate in caring for women and supporting their family to access better health services.
There is positive association between male involvement and better maternal and child health outcomes. However,
the practice is not always practiced optimally, especially in low- and middle-income countries, where women may
not have access to economic resources and decision-making power.
Aim: This study investigates how key stakeholders within the health system in Uganda engage with the ‘male
involvement’ agenda and implement related policies. We also analyzed men’s perceptions of male involvement
initiatives, and how these are influenced by different political, economic, and organizational factors.
Methodology: This is a qualitative study utilizing data from 17 in-depth interviews and two focus group
discussions conducted in Kasese and Kampala, Uganda. Study participants included men involved in a maternal
health project, their wives, and individuals and organizations working to improve male involvement; all purposively
selected.
Result: Through thematic analysis, four major themes were identified: ‘gaps between policy and practice’, ‘resources
and skills’, ‘inadequate participation by key actors’, and ‘types of dissemination’. These themes represent the barriers
to effective implementation of male involvement policies. Most health workers interviewed have not been
adequately trained to provide male-friendly services or to mobilize men. Interventions are highly dependent on
external aid and support, which in turn renders them unsustainable. Furthermore, community and religious leaders,
and men themselves, are often left out of the design and management of male involvement interventions. Finally,
communication and feedback mechanisms were found to be inadequate.
Conclusion: To enable sustainable behavior change, we suggest a ‘bottom-up’ approach to male involvement that
emphasizes solutions developed by or in tandem with community members, specifically, fathers and community
leaders who are privy to the social norms, structures, and challenges of the community.
Keywords: Male involvement, Reproductive, Maternal, Newborn, And child health, Uganda, Policy implementation,
Resources, Skill, Community
members actively participate in caring for women and supporting their family to access better health services.
There is positive association between male involvement and better maternal and child health outcomes. However,
the practice is not always practiced optimally, especially in low- and middle-income countries, where women may
not have access to economic resources and decision-making power.
Aim: This study investigates how key stakeholders within the health system in Uganda engage with the ‘male
involvement’ agenda and implement related policies. We also analyzed men’s perceptions of male involvement
initiatives, and how these are influenced by different political, economic, and organizational factors.
Methodology: This is a qualitative study utilizing data from 17 in-depth interviews and two focus group
discussions conducted in Kasese and Kampala, Uganda. Study participants included men involved in a maternal
health project, their wives, and individuals and organizations working to improve male involvement; all purposively
selected.
Result: Through thematic analysis, four major themes were identified: ‘gaps between policy and practice’, ‘resources
and skills’, ‘inadequate participation by key actors’, and ‘types of dissemination’. These themes represent the barriers
to effective implementation of male involvement policies. Most health workers interviewed have not been
adequately trained to provide male-friendly services or to mobilize men. Interventions are highly dependent on
external aid and support, which in turn renders them unsustainable. Furthermore, community and religious leaders,
and men themselves, are often left out of the design and management of male involvement interventions. Finally,
communication and feedback mechanisms were found to be inadequate.
Conclusion: To enable sustainable behavior change, we suggest a ‘bottom-up’ approach to male involvement that
emphasizes solutions developed by or in tandem with community members, specifically, fathers and community
leaders who are privy to the social norms, structures, and challenges of the community.
Keywords: Male involvement, Reproductive, Maternal, Newborn, And child health, Uganda, Policy implementation,
Resources, Skill, Community
Date Issued
2020-07-27
Date Acceptance
2020-07-08
Citation
Reproductive Health, 2020, 17, pp.1-9
ISSN
1742-4755
Publisher
BioMed Central
Start Page
1
End Page
9
Journal / Book Title
Reproductive Health
Volume
17
Copyright Statement
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License,
which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give
appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if
changes were made. The images or other third party material in this article are included in the article's Creative Commons
licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons
licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain
permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the
data made available in this article, unless otherwise stated in a credit line to the data.
which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give
appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if
changes were made. The images or other third party material in this article are included in the article's Creative Commons
licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons
licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain
permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the
data made available in this article, unless otherwise stated in a credit line to the data.
Identifier
https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-020-00961-4
Subjects
Obstetrics & Reproductive Medicine
1114 Paediatrics and Reproductive Medicine
Publication Status
Published
Article Number
114
Date Publish Online
2020-07-27