"The Role of the Man Is to Look for Food": Lessons from Men's Involvement in Maternal and Child Health Programmes in Rural Central Malawi

"Policies need to foster cooperation between men and women to maximise the potential of men and women in meeting food security and nutrition objectives."

Men have often regarded pregnancy, childbirth, and, by extension, childcare as women's domain. Yet the role of men in maternal and child nutrition was highlighted as critical in as early as 1992 during the First International Conference on Nutrition. In Malawi, men are increasingly taking on responsibility for care work in light of government and non-governmental organisation (NGO) initiatives to strengthen men's participation in gender equality and in maternal and child health. This study sought to investigate how men's involvement in maternal and child health interventions are changing the role of men in household food production, preparation, and purchasing, exploring the implications of changing gender dynamics for food security and nutrition policy design.

In order to understand how the role of men in gender equality is integrated into Malawi's health and nutrition policies, a review of international, African, regional, and national agreements, policies, strategies, and legislation was conducted. Some highlights: Malawi embraced the concept of gender as early as 1994, by signing the Cairo Declaration on Population Development. In 1995, Malawi signed the Beijing Declaration and Platform for Action, which committed all member states to integrate gender in all development actions including policies and programmes, and all levels. Malawi's Sexual and Reproductive Health and Rights Policy, adopted in 2009, included a specific goal to promote men's involvement in sexual and reproductive health and rights issues and services. The Malawi Growth and Development Strategy III (MGDS III) and the National Multi-Sector Nutrition Policy and Strategy both emphasised men's participation in housework and childcare to enable women to have more time to pursue economic and social activities.

This study was conducted in the Central Region of Malawi in Ntcheu district, where 84% of women were employed in agriculture compared to 15% of men in 2015, and where women report the highest incidence of joint decision-making over men's cash earnings compared to other districts in Malawi. The researchers interviewed 8 Health Surveillance Assistants (HSAs) and conducted 5 focus group discussions (FGDs) with men (n=14) and women (n=22). All of the participants were involved in subsistence farming and ganyu labour to sustain their livelihoods.

The results indicated that men's participation in maternal and child health was indeed shifting gender dynamics and that a new definition of gender is emerging in this community. Figure 2 in the article (and above) maps out the progression of themes indicating how conditions for gender role disruption result in more flexible gender roles. The undoing of traditional gender roles includes men taking up roles in food processing/production and food purchasing or sourcing. The transition from strictly adhering to traditional gender roles to more flexible gender roles has resulted in greater cooperation between men and women; consequently, a new definition of gender is emerging in this community. The themes are mapped out in this order to illustrate how they relate to one another and to indicate how the positive roles men are taking up are increasing cooperation and advancing gender equality.

The study found that while men did indeed take on responsibilities that have typically been associated with women, they only did so under certain conditions or circumstances - for example, when women are busy, sick, or pregnant. While advocacy, through avenues such as radio messages, encouraged men to support their partners during pregnancy, not all men were supportive. According to the researchers, while it is not in all instances that men are actively involved in child care, policymakers can leverage the positive roles men are playing to improve the gender equality at the household level.

"Nutrition policies often target women as the primary beneficiaries of policy interventions particularly in relation to nutrition education because studies have frequently reported that women are the primary producers, preparers and purchasers of food. The results presented in this paper suggest that policymakers need to re-think how policies are designed and consider the changing gender dynamics that ensue as an outcome of policy interventions from other sectors."

In fact, "[b]oth male and female participants emphasised working together and sharing housework for the benefit of the household....For the most part, policies have overlooked cooperation, yet the 1994 Cairo Declaration...emphasises cooperation between men and women. By emphasising women, policies are not taking advantage of the positive changes in men's role. Policymakers can leverage on the cooperation between men and women to improve food security as well as gender outcomes."