Family health programs in developing countries have conventionally targeted women. With deeply entrenched gender-based roles, the health of mothers, newborns, children and their nutrition squarely falls within the purview of women.
Female health workers have also traditionally delivered interventions, particularly those directed toward women. Women are thus both agents and targets of change, and have created phenomenal value for family health. As the world celebrates International Women’s Day, we stand in solidarity with a deep sense of gratitude.
We also continue to challenge ourselves to think of novel approaches to empower women and accelerate progress toward improved survival, health and the well-being of women and children. We are tempted to share a seemingly paradoxical yet integrative approach of “harnessing the power of men to empower women” that we experimented with in rural communities in Shivgarh, India.
In Shivgarh, newborn care practices were entrenched in social norms and traditional knowledge that was passed on from one generation to another, primarily through the discourse and actions of women, as a form of “cultural inheritance.” Some of these practices, such as scrubbing the baby clean with detergents and mud to remove the vernix (a protective layer of lipid-based substances on the skin at birth), carried significant risk to the baby. The challenge before us was to enable mothers to adopt changed practices that were favorable to their newborns. But we realized that changes to these deeply entrenched practices entailed a perceived risk, and therefore, we would have to gain the trust of the family and the community—both men and women. Men, having greater exposure to the outside world and appearing to occupy a more central position in social networks, presented an opportunity to act as change catalysts and resource mobilizers.
An interesting aspect of the Shivgarh experiment was the involvement of male community health workers (CHWs). Male CHWs set a living example and were instrumental in breaking role barriers, and demonstrating that men could and should care for newborns as well.
So began a conversation with the community, bringing men and women together around a shared responsibility and desire to ensure that pregnancy, childbirth, and postpartum periods were safe for mother and child. The initial reactions of “this is a woman’s job,” “not our concern,” etc., were soon replaced by fascination and an appreciation of what it entailed to bring a newborn into the world, and the skill and coordination needed to care for newborns and protect them from illness.
We had the men on board. Barriers were broken and a team was formed around the newborn that transcended divisions of gender, age, and caste. Men partnered equally with women in their shared mission to save newborns. Community leaders became strong advocates, poets composed songs about the intervention, grandfathers reinforced intervention practices, and fathers gave skin-to-skin care to their babies.
This strategy indeed paid off—in sixteen months, practices changed and neonatal mortality in the intervention villages was cut in half. There were some important collateral gains as well. The health care spending on newborn girls rose three times to equal that of boys. Maternal health care resources improved significantly, which could not have happened without the support of men.
The Shivgarh experiment has important insights for family health programming. We discovered that men can act as force-multipliers in initiating, spreading, and supporting behavior change. Participation by men in family health matters makes them receptive, responsible, and appreciative of the role of women.
Ultimately, it is not a zero-sum game: men and women complement each other and can unlock a greater power together, to create better health for their family and community. Men empowering women empowers whole communities.