Gender responsive programming

Changing men’s support to

women during pregnancy,

delivery, and post-partum.

Use of a modified

TIPS methodology

Elena McEwan, MD

Senior Technical Adviser

Catholic 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:

1. Don’t know how to do it

2. Lack of communication with

wife regarding pregnancy

3. Lack of motivation due to

feeling left out by the health

staff during care

4. They feel embarrassed to be

seen by other women when

taking care of the newborns

Developing community counseling strategies

During pregnancy:

1. Collect firewood and water.

2. Support wife with household work

3. Go with wife during at least 3 ANC

visits and

4. Ask questions during care.

During childbirth and delivery:

1. Find someone to take care of the

house while he goes with wife to HU

for delivery.

2. Assist wife to go to maternity house 2

weeks before delivery.

3. Go with wife to HU and stay in room

during labor and delivery.

4. Agree with wife to stay at the maternity

waiting home seven days post partum.During post-partum period:

1. Alternating take care of newborn during the day and the night.

2. 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:

1. Collect firewood and water.

• 76% (practiced at least 4 times)

2. Support wife with household work.

• 100% (practiced at least 4 times)

3. 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:

1. Find someone to take care of the house while he goes with wife

to HU for delivery.

• 80% practiced

2. Assist wife to go to maternity house 2 weeks before delivery.

• 50% practiced

3. Go with wife to HU and stay in room during labor and delivery.

• 40% practiced

4. Agree with wife to stay at the maternity waiting home seven

days post partum.

• 75% practiced

During post-partum period:

1. Alternating with wife taking care of the

newborn during the day and the night.

• 71% practiced at least 4 times

2. 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

1. Changes in recommended practices are feasible.

2. It will be possible to overcome resistance encountered.

3. It is critical to involve the Ministry of Health personnel in

support of recommended practices that involve Health

Units / Hospitals.

Step 5

Thank you!