Involving men in maternity care South Africa.

The 1998 South Africa Demographic and Health Survey reported high utilization (94%) of antenatal care by pregnant women. Although sexually transmitted infections (STIs) are a major public health problem pregnant women rarely receive information on this topic. The limited information given by health providers on reproductive health including STIs and condom use is primarily aimed at women yet they are not financially or culturally positioned to make decisions about these issues. In addition women are often not in a position to talk about sex or condom use with their partners yet they are often expected to modify risk behavior for STIs which in most cases cannot be done without some degree of partner involvement. It is becoming increasingly clear that every pregnancy in South Africa faces an element of risk because men as partners and decision makers are not informed about reproductive health issues. In addressing men’s involvement in reproductive health it is important to consider how to frame their contact with the health system so that it will encourage their future and continued involvement. The rationale behind choosing the pre- and post-natal periods as good times to encourage male participation is that evidence suggests that men may be more interested in their partners’ well-being than is usually the case because of their shared role in producing a healthy child. Research also indicates that men themselves as well as their partners would prefer that they play a more active role during pregnancy delivery and infant care but that societal and health system norms often mitigate against this. Unpublished data from the focus groups discussions conducted during the planning phase of the study reported here indicate that some of the nurses as well as women clients were concerned about male involvement as culturally men were not expected to participate in maternity issues. This finding was not unexpected as in this traditional Zulu community men have not been welcomed in antenatal clinics in the public sector. The structure of antenatal clinics in the public sector does not promote attendance as a couple and this is further reinforced by a provincial policy guideline that suggests that women should be attended in groups. (excerpt)