In response to Mr. Kakaire Ayub Kirunda’s article titled “To-my-fellow-men–it-s-not-the-government-impregnating our women” published in the commentary section of Daily Monitor 14th August 2013, I thought I should write back and argue out for the men.
Are the men aware of their role in maternal health? Yes it is true that in Uganda, men involvement in pregnancy mothers is still low despite the fact that there have been several studies associating increased male involvement to an increase in women accessing antennal services and improved pregnancy outcomes. Indeed, sir, it is not the government that is impregnating our wives but then, it is not the men who are going to build hospitals, nor equip them with supplies, medication and ambulances, recruit nor pay the gynecologists, midwives and other personnel necessary to provide obstetric care and improve maternal and child health outcomes. All these are expectations we, the men and women of this country, have for the government that we elect and trust with the mandate to provide health services, and indeed the government has tried its very best, reducing maternal mortality from 500deaths per 100,000 in the 1990s to the current 438 per 100,000. Despite this achievement, this is still below the 2015 Millennium Development Goals due to a number of challenges the government faces in providing adequate maternal health care, so perhaps the men still have the right to blame the government.
In addition to this is the critical issue of developing maternal health programs that seek to address the men as well. Yes we have several effective programs that have and still are targeting the women, which have proven successful in increasing ante natal care and reducing maternal mortality; one such program of which you mention in your article. However how many programs have been directed to improve male participation? One of the major reasons men do not participate in Antenatal care is because they feel left out or they are just ignorant of the programs which have now come to be associated only with women. The result is that few men therefore want to just escort the wife to the hospital yet they could be using that time to earn an income and make ends meet for the family. And therefore as long as we continue to address only the women, male involvement will continue to be low, and the maternal health targets that we have set as a country will continue to elude us.
So while we may remind men that it is not the government that is impregnating their wives, we might as well try and ensure that we provide male-oriented programs concurrent with antenatal healthcare to entice the men into playing their roles. These programs can include services such as health education to dissuade early fatherhood, educate the men on their role in maternal and child health, treat the men for sexually transmitted diseases when they escort their pregnant wives to the hospital, and educating the men on the importance of family planning and the various methods available so that they too have the options to prevent unwanted pregnancies, rather than leave the whole burden unto the women. Such services can go a long way to ensuring that the men are active stakeholders in maternal health, and increase their participation while at the same time reducing the tendency to blame the government for everything.
However until the men are included as major stakeholders in maternal health, I see them continue to blame the government for its shortfalls in providing the healthcare services they expect of it as citizens.