Gender responsive programming
Changing men’s support to women during pregnancy, delivery, and post-partum.
Use of a modified TIPS methodology
Elena McEwan, MDSenior Technical AdviserCatholic Relief Services
Core Spring meeting, May 2011
What is a key problem in seeking care?
0
10
20
30
40
50
men together women
Who makes the decision
Pregnancy
Birth
For newborn
Step 1: Gather information on: •existing knowledge and decision-making, •Motivation and perceived benefits of recommended practices•Possible barriers to recommended practices
Step 1
Focus Group Discussion
14 FGD:•80 men with pregnant wives•16 men with postpartum wives.•16 postpartum women•36 men with children age 40 days to 2 yr
Home visits with individual interviews, husband and wife
32 interviews in 16 homes with children age 0 to 40 days
Step 2:
a) Debrief and analyze information
b) Develop community “counseling” strategies
Step 2
We can take care of our newborn during the day and the night
Motivation for recommended practices
Child will grow up to have more love for the father than is typical.
Newborn will be healthy and the family will save money not treating sickness.
Infant will grow easily and be happy.
After work, I find time to share quality time with my family
Potential barriers to male supportive care practices
Potential barriers:
3. Don’t know how to do it4. Lack of communication with
wife regarding pregnancy5. Lack of motivation due to
feeling left out by the health staff during care
6. They feel embarrassed to be seen by other women when taking care of the newborns
Developing community counseling strategies
During pregnancy:
3.Collect firewood and water.4.Support wife with household work5.Go with wife during at least 3 ANC visits and 6.Ask questions during care.
During childbirth and delivery:
3.Find someone to take care of the house while he goes with wife to HU for delivery.
4.Assist wife to go to maternity house 2 weeks before delivery.
5.Go with wife to HU and stay in room during labor and delivery.
6.Agree with wife to stay at the maternity waiting home seven days post partum.During post-partum period:
3.Alternating take care of newborn during the day and the night.4.After work, feed other children (one snack and dinner).
Step 3:
Negotiate “trial” practices (3 men per each practice)
Note: Negotiation done at group level
Step 3
Step 4:
Follow up home visits to gather information on experience with trial practice: results, response, reactions
Step 4: Results, response, reactions
Step 4: Gather results
During pregnancy:
3.Collect firewood and water.• 76% (practiced at least 4 times)
4.Support wife with household work. • 100% (practiced at least 4 times)
5.Go with wife during ANC visits and ask questions.• 66% (practiced at least during 3 ANC visits)
Step 4: Gather results (continued)
During childbirth and delivery:
3.Find someone to take care of the house while he goes with wife to HU for delivery.
• 80% practiced
4.Assist wife to go to maternity house 2 weeks before delivery.• 50% practiced
5.Go with wife to HU and stay in room during labor and delivery.• 40% practiced
6.Agree with wife to stay at the maternity waiting home seven days post partum.
• 75% practiced
During post-partum period:
3.Alternating with wife taking care of the newborn during the day and the night.
• 71% practiced at least 4 times
4.After work, feed other children (one snack and dinner).
• 98% practiced at least 4 times
Step 4: Gather results (continued)
Step 5: Recommendations for the program
3.Changes in recommended practices are feasible.
5.It will be possible to overcome resistance encountered.
7.It is critical to involve the Ministry of Health personnel in support of recommended practices that involve Health Units / Hospitals.
Step 5
Thank you!