Africa: Will Men Respond to COVID-19's Health Call?

(file photo)
1 May 2020
guest column

The   latest data from New York tells us that the novel coronavirus is killing men at twice the rate of women. Death rates are higher around the world, including China, France, Italy and South Korea.

Reasons for the gender disparity are unknown, although possible explanations have begun to emerge. However, whatever the underlying cause turns out to be, this disparity will likely be made worse by the differences in men and women's help-seeking behaviors.

We need to prioritize messaging that puts men at the center of the COVID-19 response or communities across Africa will pay a heavy price.

As cases continue to rise on the continent, the   United Nations   warns that at least 300,000 people in Africa could die from COVID-19.

My   work   over the past 15 years has included breaking down complex and technical concepts and translating them into local languages. Indeed, all pertinent information on this novel coronavirus (prevention, transmission, symptoms and, mitigation) should be explained in simple and localized terms.

But simply enhancing knowledge does not necessarily influence behavior change, especially among men. For example, many men in sub-Saharan Africa do not take up   HIV services — such as medication or circumcision —   even though they are aware that they need to take the necessary steps to either prevent HIV or ensure it does not eventually kill them.

We also know that men interact with the health system   far less   than women. This may be made worse by masculinity-related beliefs which equate help-seeking with being "weak". These patterns of behavior spell trouble in efforts to fight COVID-19.

Importantly,   research   has shown that men in African countries underplay the importance of a chronic cough (cough lasting at least two weeks -- a possible tuberculosis symptom). Men trivialize this possible tuberculosis symptom and often want to portray chronic cough as a minor health problem. When men have a chronic cough, they still partake in their usual recreational activities such as socializing, drinking and smoking to portray an image of being "in control".

In   Malawi   and   Zimbabwe , men with chronic cough also reported using home remedies (including drinking warm water with lemon) in part to determine the strength (and likely significance) of a cough and partly to fight it.

In the context of COVID-19, this is concerning particularly as a   dry cough   is a critical symptom and a sign to immediately self-isolate to prevent onward transmission.

In addition to emphasizing the link between a dry cough and COVID-19, aw areness programs   need to dispel myths that home remedies can either prevent or treat COVID-19.

Another crucial step will be to ensure men understand the importance of  social distancing   – creating distance between people to prevent or halt transmission.

As a global health practitioner, I appreciate why social distancing is such an important strategy in controlling the spread of COVID-19. Many people do not show symptoms as it can take   five to 14 days   for these to develop. Transmission studies show that one case can lead to infection in nearly 60,000 people in just   two months .

An important consideration for the COVID-19 response in Africa is the   difficulty   that many will have in social distancing. Many people are self-employed and their earnings are directly related to the time they put into their work.

Simply announcing social distancing measures will not work. In a setting where men have to choose between scrounging a meal and staying at home to avert a pandemic, many will likely choose the former.

However, unless we ensure that men are engaged, seeking help early and, practicing social distancing, we will never flatten the curve.

Importantly, while men want to be perceived as strong, they also want to protect their families. Therefore, to get them to engage with the importance of social distancing and early help-seeking, it will be necessary to appeal to their sense of familial duties and responsibility. We know that a key   motivator   for voluntary medical male circumcision uptake among men is own and female partners' protection against HIV and cancers (including cervical cancer).

Let's ensure we're thoughtfully engaging men in ways that will alter their behavior, because if we cannot get everyone on board, it won't be possible to defeat this pandemic.

Webster Mavhu is a linguist-turned social scientist and global health practitioner who has been conducting research to inform programming for the past 15 years. He is a 2020 @aspennewvoices fellow. Follow him on twitter @webstermavhu

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