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Malawi: Men - Architects of Change in Promoting Maternal Health
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The Chronicle Newspaper (Lilongwe)
4 September 2007
Posted to the web 4 September 2007
Cedric Nkungula
Lilongwe
The day when Nasibeko began her labour pains to deliver her fifth child, her relatives were all helpless, as they were unable to take her to a health facility without the permission of her husband's uncle for fear of repercussions.
Every one is anxiously waiting for her uncle to come back from his trip to give consent to enable his nephew to take Nasibeko to the hospital. According to their traditions, it is only the uncle who decides what to do on such matters and the relatives can do nothing but wait.
He arrives five hours later - and starts to organise transport to take Nasibeko to the hospital that is about 10 kilometres away.
Upon arrival at the hospital, the woman is in a very serious condition because of the length of time in labour and complications that have arisen during labour. The doctors try everything to deal with the complications to save her life, but to no avail. After some time both Nasibeko and the baby die. Another tragic and unnecessary death has occurred.
"You brought her here rather too late. We tried our best but we could not save her life and that of the baby...am sorry for you, she has died," says a nurse narrating the ordeal to the disbelief of the relations.
To them, the doctors are negligent or Nasibeko had been bewitched
Most tradition in Malawi has it that men have decision-making powers in their different roles as husbands, fathers, traditional and religious as well as political leaders.
Their decision-making powers transcend all the spheres including health matters. In this respect it is essential that men, as decision makers, need to take an active role in ensuring that maternal health outcomes are favourable for a healthy mother and baby.
"Men often make decisions about family planning, their wives' economic activities and the use of household resources, including doctors' and school fees. These decisions influence the wellbeing and prospects of the whole family.
"The care and support of an informed husband improves pregnancy and child birth outcomes and can mean the difference between life and death in case of complications," says UNFPA representative to Malawi Esperance Fundira during the commemoration of this years' World Population Day whose theme was 'Men as partners in maternal health'
Fundira explained that men could also ensure that all women have access to contraception to avoid unwanted pregnancies and properly plan their families.
She noted that most women would like to use family planning methods but they lack the support of their husbands and communities.
"Men could also help ensure that all pregnant women have access to skilled care at the time of giving birth. The single most critical intervention for safe motherhood is to ensure that a health worker with midwifery skills is present at every birth, with transportation available to a more comprehensive level of obstetric care in case of an emergency," emphasised Fundira.
She says pregnancy related mortality and morbidity is a social injustice, a neglected tragedy and a health indicator with the largest discrepancy between developed and developing nations, and between the rich and the poor.
The UNFPA representative therefore observed that the reduction of maternal and neonatal mortality is a moral and human rights imperative as well as a crucial international development priority.
Fundira concluded, "Partnering with men is an important strategy for ending this social and moral injustice."
Minister of Economic Planning and Development Ted Kalebe elaborated the need for men to play an active role in saving the lives of mothers saying the loss of a woman's life has a direct effect on the family structure and society as a whole, which he said must cope with the orphaned children.
He observed that although issues of maternal health primarily deal with the health and well-being of mothers, they could not be addressed by involving women alone.
"Children whose mothers' die are more likely themselves to suffer increased vulnerability to diseases and death. This tells us how important women are to sustain human and social- economic development. Therefore, the death of a woman due to pregnancy and child birth related causes is tantamount to social injustice," he said.
Kalebe expressed concern that although the maternal mortality ratio has decreased from 1,120 per 100,000 live births in the year 2000 to 984 per 100,000 live births in 2004, too many women still die because of pregnancy related causes.
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"This means that about 6,000 women in Malawi die of pregnancy complications in pregnancy and child birth every year and this means approximately 16 maternal deaths occur every day.
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