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Why gender is vital in maternal and child health programming

 By Lynette Kamau, Senior Policy and Communications Officer

The World Health Organization defines gender as socially constructed characteristics of women and men – such as norms, roles, and relationships of and between women and men. Gender varies from society to society and can be changed. People are taught appropriate norms and behaviors – including how they should interact with others of the same or opposite sex within households, communities, and workplaces.

Gender norms, roles, and relations have a bearing on people's access to and uptake of health services and on the health outcomes they experience throughout their lives. In this article, I will share how gender is affecting the adoption of kangaroo mother care (KMC) - a life-saving intervention for newborns and preterm births.

More than 2.5 million newborns die each year, accounting for 47% of children dying worldwide before the age of five. Complications of preterm birth are the leading cause of death among newborns. Globally, Every Newborn Action Plan (ENAP) has emphasized on KMC as an essential component of neonatal health initiatives. In developing countries, KMC is a safe and inexpensive procedure that has proven benefits for mothers and children compared to an incubator caring method. It plays a significant role in infant survival, neurodevelopment, and the quality of mother-infant bonding.

KMC includes early and continuous skin-to-skin contact between the newborn's front and the caregiver's chest, exclusive breastfeeding, early discharge from health facilities, and supportive care and follow-up (World Health Organization 2003). Skin-to-skin contact should ideally start at birth, but is helpful at any time. It should ideally be continuous day and night, but shorter periods are still beneficial.

As the name suggests, in most settings, KMC is done by women. However, male involvement in maternal, newborn, and child health is encouraged to engage men as caregivers. Though there are innovative approaches to enhance male engagement, some of them face challenges as they do not have a gender lens or perspective to them.

In the case of KMC, research studies done in Botswana, Malawi, and Zimbabwe, noted that its implementation experienced challenges linked to gender norms. Specifically, researchers supported by the Innovating for Maternal and Child Health in Africa Initiative in Malawi have been analyzing to learn the difficulties of implementing KMC in rural areas. The lessons are also derived from efforts to involve men in implementing KMC.

From the research, one of the lessons is that fathers are not comfortable with performing KMC because traditionally, childcare is a mother's role. This example demonstrates the sociocultural context and constructs of gender within households. Such cultural norms are a barrier to the successful implementation of KMC.

Research shows that paternal involvement plays a significant role in the uptake of KMC – either by the division of labour or by helping the mother feel comfortable. For this reason, we must invest more in changing social perceptions around childcare in communities as this will enhance men's confidence to practice KMC as caregivers and support their female partners. Such a focus will help in saving more infant lives.

Studies have also shown that societal acceptance of paternal participation in childcare promotes the uptake of kangaroo mother care. Therefore, there is a need to engage men in a reflective way keeping in mind that we are asking them to unlearn sociocultural norms that have defined gender for a long time. We need to show them that they do not have to be bystanders, but they can play a role in saving the lives of women and children.

One way to get buy-in and enhance male involvement in implementing life-saving services such as KMC is to have an inclusive name. So instead of kangaroo mother care, how about kangaroo care?

Gender norms, roles, and relations have a bearing on people's access to and uptake of health services and on the health outcomes they experience throughout their lives. In this article, I will share how gender is affecting the adoption of kangaroo mother care (KMC) - a life-saving intervention for newborns and preterm births.

More than 2.5 million newborns die each year, accounting for 47% of children dying worldwide before the age of five. Complications of preterm birth are the leading cause of death among newborns. Globally, Every Newborn Action Plan (ENAP) has emphasized on KMC as an essential component of neonatal health initiatives. In developing countries, KMC is a safe and inexpensive procedure that has proven benefits for mothers and children compared to an incubator caring method. It plays a significant role in infant survival, neurodevelopment, and the quality of mother-infant bonding.

KMC includes early and continuous skin-to-skin contact between the newborn's front and the caregiver's chest, exclusive breastfeeding, early discharge from health facilities, and supportive care and follow-up (World Health Organization 2003). Skin-to-skin contact should ideally start at birth, but is helpful at any time. It should ideally be continuous day and night, but shorter periods are still beneficial.

As the name suggests, in most settings, KMC is done by women. However, male involvement in maternal, newborn, and child health is encouraged to engage men as caregivers. Though there are innovative approaches to enhance male engagement, some of them face challenges as they do not have a gender lens or perspective to them.

In the case of KMC, research studies done in Botswana, Malawi, and Zimbabwe, noted that its implementation experienced challenges linked to gender norms. Specifically, researchers supported by the Innovating for Maternal and Child Health in Africa Initiative in Malawi have been analyzing to learn the difficulties of implementing KMC in rural areas. The lessons are also derived from efforts to involve men in implementing KMC.

From the research, one of the lessons is that fathers are not comfortable with performing KMC because traditionally, childcare is a mother's role. This example demonstrates the sociocultural context and constructs of gender within households. Such cultural norms are a barrier to the successful implementation of KMC.

Research shows that paternal involvement plays a significant role in the uptake of KMC – either by the division of labour or by helping the mother feel comfortable. For this reason, we must invest more in changing social perceptions around childcare in communities as this will enhance men's confidence to practice KMC as caregivers and support their female partners. Such a focus will help in saving more infant lives.

Studies have also shown that societal acceptance of paternal participation in childcare promotes the uptake of kangaroo mother care. Therefore, there is a need to engage men in a reflective way keeping in mind that we are asking them to unlearn sociocultural norms that have defined gender for a long time. We need to show them that they do not have to be bystanders, but they can play a role in saving the lives of women and children.

One way to get buy-in and enhance male involvement in implementing life-saving services such as KMC is to have an inclusive name. So instead of kangaroo mother care, how about kangaroo care?

ECSA Maternal Health Infographic
Delayed provision of services in hospitals is a ba...