EL DIRECTOR GENERAL DE ADMINISTRACION DE RECURSOS DISPONE:

Societal expectations about the type of social interaction that men and women can have and gender roles within the household represent another barrier to men‟s involvement in pregnancy, childbirth, and the postnatal period. Through

socialization, the segregation of men and women from interaction with each other and in the household culminate over time, leading to men‟s lack of involvement. One participant, a health worker, commented on gender segregation and its occurrence early among young boys and girls.

“Right from the beginning when boys and girls are growing up we tend to separate them. You find that many grow up not knowing how to cook because they are not allowed to enter the kitchen and these conceptions continue [into] obstetric care services and so on. For example, when a woman delivers there is separation with a spouse and therefore the husband is not directly involved.” A 64 year old man, Lilongwe

In general in Malawi, interaction among men and women is considered acceptable, but it is unacceptable for a woman to be present with a group of men, and for a man to be present with a group of women. If for some reason a woman is in the presence of a group of the opposite sex, she is seen as being promiscuous. Women receive considerable scrutiny and such behaviour is considered uncultured while men are not scrutinised because of the belief that it is their right to behave so (Oladeji & Adegoke, 2008). Traditionally, men and women are not supposed to be together in terms of physical presence or interaction if they are not married, and a girl cannot claim to have a boy as a friend. Relationships are not seen as plutonic, rather sexual in nature.

“Traditionally men meet to discuss issues related to men. Women do not join men‟s groups. Likewise women meet as women to discuss issues of women; men do not join women‟s groups. In addition, if you take young people, boys and girls are not initiated together. They don‟t know what happens to initiation ceremony for girls or boys. Culturally this is how it has been.” A 62 year old man, Lilongwe

The socialisation process also contributes to men‟s lack of participation in household chores. Men socialise with each other, separately from women. Men drink beer to socialise with their friends or to deal with problems related to lack of

employment or financial problems. In some instances, beer drinking has been a source of violence in the home (Oladeji & Adegoke, 2008). Women who were interviewed explained that men go out to drink beer and eat very good meals like roasted meat which is called “kanyenya” while the family is left at home starving. For example, one woman expressed concern about men‟s behaviour and stated:

“As he comes home he is drunk, has eaten roasted meat (kanyenya) at the bar. He deliberately comes [home] late so that when a woman shouts he should go away looking for other women. It is worse during hunger periods then they just go to their parents homes looking for food.” A 67 year old woman, Nsanje

Men‟s behaviour of socialising while drinking beer is the cause of many problems in the home, especially wife beating. It is also a contributing factor for lack of involvement in pregnancy, childbirth, and the postnatal period.

Another aspect of gender segregation that relates to men‟s lack of involvement concerns information. A consequence of boys and girls, men and women being socialised to fill different roles in a rigid division of labour is that they

receive different types of information. While women may be taught about aspects of reproduction, men lack this information. Most men in this study observed that information about reproduction is hidden from them. They are excluded from the process in many ways, particularly when their wives are in labour. One male participant explained:

“When a woman is giving birth, like in my village, they hide things from men, they don‟t tell us quickly, no! They just come and collect your wife and maybe tell you to go away so that they do what they want to do until you hear about finished business, that she has a newborn baby. So as a man you cannot get involved in anything because they don‟t inform you, no! These are women‟s issues and men should not what, they should not know.” A 25 year old man, Mangochi

The little information men do receive comes from their parents and only concerns traditional medicine and traditional beliefs about illness.

“For the people to be taught to follow today‟s health at the hospital, the information does not reach us. So people still have that old life that when things happen, then they go and touch the traditional medicine...so information is what seems to be the problem. People are not taught for them to be aware.” A 42 year old man Mzimba

According to participants, even if the man wants to support his partner, he will not show up and attend the birth because it is not culturally acceptable to do so. In matrilineal societies like Dowa and Mangochi, family members may serve as gatekeepers in making decisions on when the woman can be taken to the hospital. Such behaviours risk women dying during labour if gatekeepers cannot make prompt decisions to take women to the hospital. One participant succinctly described gender segregation as an obstacle to male involvement.

“An example would be in certain cultures, an uncle would be a

gatekeeper...deciding whether the woman is taken to a hospital or not. So in those grouping within Malawi that insist on this, then I certainly think I will take that as an illustration of culture being a barrier to male involvement in reproductive health matters. When we look at childbirth at the moment...the setting that we have in Malawi where women deliver, are settings where culturally...they form a barrier in the sense that it‟s not acceptable that where a group of women are gathered, that a man should show their face in such a place. Well, people would say that this man is uncultured if he finds himself among a group of women.” A 45 year old man, Blantyre

of masculinity (Courtenay, 2000). Some men may assist their wives in private, but when they are in public they want to show that they fit with normative definitions of what it means to be a man. This 55 year old man from Lilongwe explained:

“I do believe this that in general masculinity is many times associated with strength with being hard, being strong, being aggressive not so much being loving and caring and tender and maybe soft. But I do also see many soft fathers towards their children and then it‟s more like a public picture that you do not want to appear as being soft. But maybe when the door is closed you are cuddling your baby and you are happy with the baby, maybe you just have to learn to say it‟s alright to cuddle your baby in public! There is nothing wrong with that!”

6.2.1 Lack of Respect

Participants explained that the cultural practices that segregate men and women from each other for most of their lives, while also relegating the household work to women lead some women to lack respect for their husbands. This is particularly the case for women who do not subscribe to dominant gender roles. Ironically, it is the cultural devaluation of women in relation to men that leads women to perform undervalued, unappreciated work and, in turn, lack respect for their partners. Thus, women‟s reactions to their subordinate status, according to participants, were a major reason for men‟s lack of involvement in pregnancy, childbirth, and the postnatal period.

One societal expectation for families in Malawi is that women respect men while men “are given free reign” (Oladeji & Adegoke, 2008, p. 58) because of their role as economical providers. Men are therefore considered superior to the women. A woman is not supposed to question her husband if she senses, for example, that he has had an affair (Oladeji & Adegoke, 2008). In fact questioning him may be interpreted as blaming him for having an affair. During marriage counseling, brides are told not to be jealous, not to question their husbands‟ integrity, and not to walkout on their husbands. It is argued that women should persevere to make their families strong. In addition, women are instructed to serve their husbands‟ social and sexual needs. Promotions of such messages contribute to systematically

disadvantaging women by continuing to keep them in a subordinate position (Courtenay, 2000).

Participants provided examples of ways in which women may be seen as disrespectful for not following society expectations about their subordinate status. For example, women who do not provide food for their husbands do not welcome them home, or who tell their husbands that the pregnancy is not theirs are seen as disrespectful to their partners. Further, if the husband perceives his wife is being disobedient and disrespectful to him, he may react violently (Oladeji & Adegoke, 2008).

This lack of respect was reported by participants in all four districts. One possible explanation for this kind of behaviour may be that women feel neglected and unsupported during pregnancy. Women may feel that their husbands no longer love them, and they may be experiencing emotional, physiological and psychological pressures that pregnancy brings. If husbands do not understand what is going on in their wives‟ bodies, they are bound to misinterpret the situation as women being intentionally disrespectful. In addition, the pressures women face when they are expected to work in the farm and bear responsibility for the household labour put a tremendous strain on women. Women may not feel appreciated for their long hours of household work when their work goes unnoticed. As one participant explained, this burden is magnified when there are multiple children to care for.

“There are other families who when they have two children, they start

quarrelling in the family. She says there is no child of yours here because the one who knows childbirth is the woman. So the next pregnancy that comes, you become powerless. If she is saying this without any remorse, that I don‟t have my children here, so why should I bother getting involved on this baby? So some men become weakened and they say the one who has born these children should what? Should help her.” A 25 year old man, Mangochi

Women‟s inability to communicate with their partners about the stress and burden associated with being pregnant and taking care of the household may escalate tensions between men and women thereby contributing to men‟s lack of

involvement. However, it is the cultural expectation that women do most, if not all, of the work in service to their husbands that devalues women and contributes to these tensions in the first place.

Thus far, the cultural and societal beliefs and practices of men and women in rural areas of Malawi have been discussed as preventing men from being involved in pregnancy, childbirth, and the postnatal period. Beyond what happens within the

household between men and their partners, the infrastructure and policies of the health care system and its workers in Malawi also prevent male involvement. These factors are discussed below.