James Senjura works closely with the Maasai pastoralist community of Laikipia, Kenya, to improve maternal and child health. He is a Project Officer for Mothers’ Union, Anglican Overseas Aid’s partner in The Road Less Travelled project, and also a father and positive role model for other men in his community. The project works with the community to identify key development challenges, and helps to develop locally-appropriate solutions to deliver basic health care and education where access to formal services is limited. James answers some questions about traditions and gender norms relating to maternal and child health within his culture.
In the Maasai community of Laikipia, how would you describe the traditional role of men in maternal and child health?
Traditionally, men’s role in maternal and child care has been passive. Maternal and child health care was in the hands of traditional birth attendants and old women.
Mostly men provide financial support and organise for transportation, and sometimes in consultation with the traditional birth attendant they decide for further action in case of complications or disease occurring. The father would advise on the estimated date of delivery, so that the woman would be prepared.
It was also the role of man to source food (slaughter animals, draw blood) for the mother during and after pregnancy. When a woman was in the last trimester, the man would ready some rams for slaughter after delivery.
It was the role of the man to contact the traditional birth attendant or an older female relative, especially when the woman went into labour.
To allow the baby to grow, men avoid intercourse with wife for about two years after birth. Some men used to discuss this period with women. It was like rule in the community that women breastfeed until the baby walks. Where mother or infant becomes sick, the man prepares some herbal concoctions for both.
Have you noticed any changes or shifts in male involvement or attitudes over recent years?
A considerable number of men allow their wives to attend antenatal care clinics now. Some men (generally the ones with some education) accompany their wives to clinics.
A good number of men are showing a lot of interest in the care of the child by ensuring child is taken to clinics, baby hygiene. Also they will ask the traditional birth attendant or woman how the child is faring. More men now discuss health and other issues with women, unlike before when it was like a taboo to do so.
How do you personally feel about the role of men in maternal health? Are there any changes you would like to see?
There are positive changes being seen. Many men, especially the young, are showing a lot of passion towards caring for their wives and children. Men are starting to show more support to their spouses especially when pregnant or breastfeeding, by attending to some homes chores like fetching water using motor bikes or bicycles.
Apart from the very old men, they are now discussing family planning with their wives. Some men allow their wives to choose a family planning method. Also the rate of domestic violence has greatly reduced among the younger generation.
From your understanding, do men want to be more or less involved in maternal and child health?
Many men are becoming more interested with maternal and child health, especially the ones with some education. With the illiterate or old, things are different. All men accept that some clinics are important for both mother and child, especially immunisation and antenatal care.
Not all have accepted family planning, because of misconceptions and beliefs that pills make women weak and have been associated with cancer and weight gain. Also they believe women who are using family planning methods may become sexually immoral.
Men are more concerned on the delivery process and some care of mother and child. They meet cost of delivery, whether in clinics or with a traditional birth attendant.
The main changes that are seen especially among the middle and young generation, is the improved relationships between wife and husband. Men can discuss reproductive issue with their wives unlike before, when women used to receive instructions only from husband. Wife beating is reducing at a high rate.
It is only in isolated cases that one can find little girls married to old men, unless the girl wishes to. These days when marriage processes are organised, the girl and mother are always consulted before final arrangements are done.
Female genital mutilation (FGM) is now being debated, many have accepted that the law prohibits it. Those who still do not accept, do it secretly. Some families these days consult girls if they want to have FGM. In a family where the mother and mother-in-law refuse FGM being done, men cannot force it to happen.
What are the reasons for these changes?
Main reasons for these changes in men are:
- Education among men and women. This has made both men and women understand each other well unlike before. Love is building among couples.
- Health awareness in community. Men are getting new health information that they did not know before e.g. reproductive health, via Community Health Workers.
- Peer influence, many men will want their wives to be looking good health wise, well taken care of, having healthy children.
- Some government policies, e.g. anti-FGM, inheritance, education have played a big role changing men and women.
How do women you have spoken with feel about the role men play in maternal health?
They want men to be involved in maternal health. Women say they would like to see more men involved in attending maternal clinics, and for maternal health information to also target men. They want health information be given to both men and women, though separately when sensitive sexual issues are discussed.
The women say when men understand the importance of this health information, women will have easier time to access maternal services, family planning will not be done secretly, and men will not prevent their wives from going to health services.