THE involvement of a woman's partner in the prevention of mother-to-child transmission (PMTCT) of HIV is of fundamental importance and many programmes focusing on this have strived to do this, but found it difficult to achieve.
This is due to cultural beliefs and practices entrenched in various communities and societies that place the responsibility of pregnancy and child delivery on women. There is a widespread belief in most African countries, Tanzania inclusive, that women's reproductive health is their own business and not the responsibility of men.
This is due to the patriarchal set up of the societies that assign roles to members of the community and forget the fact that some of the roles transcend. These beliefs and practices put both the mother and the child's health at risk.
Additionally, the man's health is compromised when he avoids attending initial antenatal care and PMTCT visits for fear of stigma and getting tested for HIV, which is part of the PMTCT service offered in our country.
Evidence shows that male involvement in antenatal care and PMTCT is critical, but their will to change behaviour and improve the health of families is still lacking among majority of them. According to a study done in 2010 by Engender Health's CHAMPION Project in Iringa, Kinondoni, Mwanza, and Mtwara Districts, only 3 per cent of 9,062 women accessing PMTCT services were accompanied by their partners.
Reasons given by men for their low participation included feeling shy or ashamed, lacking awareness of services for men, and believing that reproductive health services are for women only.
However, a study done in Nairobi, Kenya (Journal of Acquired Immune Deficiency Syndromes, January 2011) has shown that when men are involved in PMTCT the risk of transmitting HIV to a baby is reduced by up to 40 per cent. Once men are educated and motivated about PMTCT, they are more likely to support their spouse to receive antenatal and postnatal care services, including anti-retrovirals, the drugs needed to prevent mother-to-child transmission of HIV.
E n g e n d e r H e a l t h ' s CHAMPION project - funded by the US President's Emergency Plan for AIDS Relief (PEPFAR) through the US Agency for International Development (USAID) - supports 18 health facilities in Iringa, Kinondoni, Mwanza, and Mtwara Districts with a range of activities that aim to increase the number of men attending antenatal and PMTCT services with their partners.
The project also builds the capacity of health workers on how to create health services that are friendly to men and how to counsel men during antenatal visits. For example, facilities motivate men to attend their clinics by offering priority service to women that come with their partners; and health workers attend meetings organized with local leaders to promote and discuss the importance of male involvement in antenatal services during community outreach activities.
Additionally, clinics display billboard signs that invite both men and women to receive services and distribute educational materials that address men's health concerns and questions. CHAMPION-supported clinics in Mtwara have shown that efforts to increase male involvement in antenatal care and PMTCT are making a real difference.
Partners testing during PMTCT services in six facilities in Mtwara Urban District jumped from 4 per cent in August-October 2010 to 22 per cent in January- March 2011. During this same period, all of the men attending antenatal care with their partners agreed to be tested for HIV.
In addition to ensuring the health of the couple's baby, couple testing has an important additional positive effect: HIV-positive pregnant women that test with their partners are more likely to stay on the needed lifesaving HIV treatment. Mtwara District Nurse Officer, Veronica Mwenda, agrees as she explains:
"The success of involving men in antenatal services has made me realize that the prevention of mother-to-child transmission is about more than the health of the baby; it is about the health of the family. I have seen that more women are staying on HIV treatment because they no longer have to hide from their spouse. Their spouse is now a source of support."
It is time for health facilities, communities, and individuals alike to recognize that men should also be responsible for supporting their partners in the prevention of mother-to-child transmission of HIV. Service providers, friends, family members, religious leaders, and local authorities should encourage men's participation in PMTCT services for their partners or spouses. Ultimately, men, as responsible fathers, need to accompany and support their partners in PMTCT.