By Dr. Babatunde Osotimehin, United Nations Under-Secretary-General and the Executive Director of UNFPA, the United Nations Population Fund
In Niger, stubbornly high rates of maternal death spurred creative action from our team at the United Nations Population Fund. Action came in the form of Husbands’ Schools, an innovative strategy for engaging men in the conversation about maternal health and healthy child-spacing.
Despite the funny name, the goal of Husbands’ Schools is serious: to involve men in health promotion and foster a change in behavior in their communities. The need was twofold: the vast gender inequality and staggering number of maternal deaths in the country.
Niger ranks near the bottom of the gender equality list in the Human Development Index. Prevailing social norms see men as the decision-makers in their households, even over issues of women’s reproductive health. In Niger, where the maternal death ratio is 553 deaths per 100,000 live births in 2015, according to Trends in Maternal Mortality 1990-2015 projections, more than one woman dies every two hours. This is one of the highest maternal death ratios in the world, and it does not include the unacceptable number of women left disabled after childbirth.
Our team at UNFPA knew that involving men would be a game-changer. The Husbands’ Schools serve as a forum for discussion, decision-making and action, bringing together married men with national non-governmental organizations, health workers, members of the community, and cultural and religious leaders.
UNFPA set up 11 pilot Husbands’ Schools in two health districts in Zinder, an area of Niger bordering Nigeria with especially low reproductive health indicators. The members met around twice a month to analyze and discuss specific cases within the community in the field of reproductive health. This interaction was important since it gave the members insight into how they each perceive maternal health issues and problems.
In 2012, after seeing the success of the pilot program, Niger’s traditional chiefs, the country’s most influential leaders, signed an agreement with UNFPA to improve women’s health. The number of childbirths attended by skilled personnel has doubled in communities where the schools operate, and family planning services have tripled.
In addition, Husbands’ Schools have led to positive spin-off effects and new village initiatives. Their emphasis on the close link between sanitation and health, for example, has resulted in improved hygiene in villages. Latrines have been built in some of the communities with Husbands’ Schools to enhance women’s comfort and privacy. Residences for midwives and observation rooms for women in labor have also been built, as have prenatal consultation rooms.
Today, the impact of Husbands’ Schools goes far beyond Niger, where there are now schools in all eight regions of the country! There are 1,226 Husbands’ Schools across Niger, the Ivory Coast, Mauritania, Senegal and Sierra Leone. Leaders in Cameroon, Mauritius and Djibouti have also expressed interest in bringing the schools to their communities following the serious success of this creative experiment with a funny name.
Dr. Babatunde Osotimehin is United Nations Under-Secretary-General and the Executive Director of UNFPA, a position he has held since January 2011. A renowned physician and public health expert, he was previously Nigerian Minister of Health and Director-General of the country’s agency on AIDS. At UNFPA, Dr. Osotimehin leads efforts to promote sexual and reproductive health and the rights and ability of young people to build a better world.