Once community leaders are informed of the intentions of men getting involved during pregnancy, childbirth and postnatal care, it will be important for leaders to organize and disseminate information about men‟s involvement to community members. About two-thirds of the participants suggested reaching communities through organized village meetings and using mass media. While these suggestions are insightful, it is important that any health messages be designed to highlight the importance of men‟s involvement in reproductive health and should also be delivered in culturally acceptable languages. Recall that some communities in this study were much more sensitive to discussing issues about sexual intercourse, reproductive health, and men and women‟s physiology than others. In specific health issues, such as cholera, family planning, HIV/AIDS, the use of media, drama,
comedy, and storytelling has proven successful in Malawi in disseminating messages to the wider public. The quote below from a health worker suggests how community sensitization can be organized.
“They [barriers] can be overcome by going to the community, community dialogue or mobilising the community in drama etc. If we start with the
grassroots we will overcome them [the problems] rather than starting from up. We will not overcome them [starting from the top] because …, these men were born in the same community they have grown up there. They have grown with that culture in their mind; it‟s difficult to change them overnight. If we go to the community we start with District Excecutive Committee (DEC) meeting where these Chiefs attend then the Chiefs will go back to their people and tell them, then we will forge ahead.” A 59 year woman, Nsanje
One of the health workers talking from his professional experience suggested taking advantage of any social gathering, for example, “sending off parties, women‟s guild, funeral gathering, or other functions” (a 52 year old man, Mzuzu). While participants suggested these social gatherings, other gatherings may include political rallies and fairs. In addition, both electronic and print media may be used to
disseminate information. From my experience as a Malawian and as a civil servant working for Ministry of Health, these avenues have helped get information across to the population. For example festivals, fairs, television, radio, dramas and folklore have been used to disseminate information, health related or political. These modes of information are also in line with what (Food Agriculture Organisation of the United Nations, 1998) suggested.
While participants suggested dissemination of information about male involvement to community members, it may also be valuable to plan dissemination of information to other stakeholders in sexual and reproductive health. These may include non-governmental organisations, civil society groups and government ministries. Building partnerships with other organisations has the potential to complement government efforts in providing services to its population to achieve male involvement in pregnancy, childbirth and postnatal care. This will require commitment, support and inputs from partners. Furthermore collaborative efforts to promote male involvement may show the commitment of the government and stakeholder about how important the issues are and to prevent duplication of efforts. Participants acknowledged that health workers are aware that information cannot reach the community by health workers alone; there is need for concerted and collaborative efforts in order to achieve the required results as this health worker elaborates:
“Ok. I think there should be much of it dealing with the community as we know that if we have to prevent maternal death we cannot do it at the hospital level. We have to start at the communities. So these people we are dealing with they should be able to participate and if we do not go to them and tell them why it is important they will not know. So it is our duty to go to the community, sensitise them, tell them the advantages and then its only then they can come up.” A 38 year old woman, Dowa
Apart from using village meetings and taking advantage of any social gathering to disseminate information, participants suggested “civic education” specifically “to all men” about male involvement, a 43 year old woman, Nsanje. Media could be used as a powerful tool for behaviour change because some
participants spoke about it favourably and recalled ways that it had been combined with other promotional tools to add intensity. For example, this health worker from Blantyre said:
“Ok, I think there are already programmes that do address men I remember there is something that is done by Banja la Mtsogolo (BLM) [...] The other thing you may use [is] the mass media. The radios just tell people that it‟s ok for you to go to antenatal with your wives. I think if I remember safe
motherhood... [Used] T shirts that are showing the man carrying his wife to the hospital so you just need to intensify on things like those.” A 44 year old woman, Blantyre
Although the radio is used widely to reach people in the most remote areas, some participants suggested targeting men in venues where they congregate in large numbers or where they can easily be reached. These may include places like pubs and workplaces.
Even though the participants advocated community sensitisation and civic education, other participants cautioned that the media or meetings should not be used to coax people that are not ready to get involved. Rather, the media should allow them to digest the information so that they make informed decisions on what course of action to take. There are fears that the community may be rushed into participating in projects that they may not understand. Therefore, education should not be a
onetime activity, but continuous in order to achieve the expected results.
“[As] men we should also be careful because you can‟t push things on people who are not ready. I mean you can‟t push a PhD on a person who is not ready to take a PhD! So what we need to do is to be careful to start with intensive civic education and allowing those who are enthusiastic and leave the men who are not willing or who are sissies. Others may just have psychological
problems.” A 52 year old woman, Blantyre