Like most men in Mozambique, Virgilio Ajuda didn’t think it was his place to escort his pregnant wife to the health clinic for her antenatal care visits. “I always thought [antenatal care] was only for women,” said the 41-year-old father. But when his wife, Sara, 36, was pregnant with their fourth child, he learned of the important role a partner can play in helping a woman prepare for a healthy birth.
Virgilio and Sara are among the nearly 500 couples who participated in a project to engage men in safe childbirth activities that was sponsored by Johnson & Johnson and the U.S. Agency for International Development’s Maternal and Child Survival Program with Jhpiego. The project, developed in cooperation with the Ministry of Health, encouraged couples to make shared decisions and be informed of danger signs signaling obstetric complications and emergencies.
When Sara went into labor in the middle of the night, Virgilio was prepared, and with help from his neighbors, he quickly organized transport to the village health center, about 40 minutes away. When they arrived, the nurses told him Sara had a complication. The baby and mother were in danger—the baby was lying in an abnormal position, posing a risk to a safe birth. Sara needed immediate surgery, a cesarean section, to deliver the baby.
Jhpiego worked with local communities to initiate the Birth Preparedness and Complication Readiness project in Boane District in southern Mozambique in 2013. By addressing critical delays in seeking care and promoting the importance of men’s roles in family health, the project inspired Virgilio and Sara and 489 other couples in Boane to make reproductive health decisions together, for example, arranging for transport to a health facility. Such mutual decision-making was unlikely just a few months earlier, given the traditional roles men followed in the community.
The project particularly focuses on male involvement by engaging partners like Virgilio who were initially reluctant. Through this project, now men are more responsible for and take pride in protecting their families. As a result, since the initiative began in 2013, men’s participation in antenatal care has increased more than three-fold: from 9 percent (179 of 1,997 women) in February 2014 to 29 percent (489 of 1,700) in February 2016, with an average of 20 percent male involvement.
“We live far from the health facility, and as I was advised, I saved money for transport. I talked with my neighbors, who have a car ready at any time to take my wife to the hospital,” said Virgilio.
Because the health center could not perform the cesarean section that night, Sara needed to be transferred to the nearby provincial hospital. But they encountered another problem. The health center’s ambulance was not available to transport her. However, Virgilio’s preparedness paid off.
“We went to the provincial hospital using the same car that brought us, [this time] accompanied by a health care provider,” said Virgilio. Today his wife, their now four-month-old son, Armando, and their three other children are growing healthy and strong.
“I love my family, but I should confess, [before this] I never had time to go with my wife to the hospital,” said Virgilio. “I am very grateful for the education and information I received during antenatal care sessions and from the home visits,” which were organized by the Birth Preparedness and Complication Readiness project.
Virgilio has a message for his fellow countrymen: “We must work to spread birth preparedness and complication readiness education and counseling in the community so that more men understand the importance of participating and being with their women during pregnancy [and birth].”
Denise Alves is a communications officer and Zaida Macie is a community development officer in Jhpiego’s Mozambique office. Colleagues Gilda Sitefane, Mercino Ombe and Charles Wanga also contributed to this article.