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Male Engagement and Couples’ Decision-Making

MCSP actively engaged men and promoted partnerships for healthy decision-making among couples in reproductive, maternal, newborn, child and adolescent health (RMNCAH) services. Men play a key part in their own and their family’s health, yet they are often neglected in outreach and service delivery. The involvement of fathers before, during and after the birth of a child has been shown to have positive effects on violence reduction, improved maternal health outcomes, breastfeeding, the use of contraceptives and health services, and fathers’ long-term support for their children.

In many countries, men make most decisions about sexual behavior, family size, whether to give birth in a facility or at home, care for children, the allocation of household assets, and the division of household labor and caregiving. Engaging men as clients, supportive partners, and champions of gender equality can contribute to improvements in gender equality, couples decision-making, and the utilization of maternal health services. This in turn leads to better health outcomes for men, women, and their families.

MCSP engaged men and couples by:

  • Building the capacity of providers to engage men in counseling and health services, and to work with their partners to decide family size and create birth plans;
  • Encouraging facility improvements such as privacy screens in labor and delivery wards, and sensitization of providers to allow women to bring their partners into the delivery room if they choose to do so; and
  • Facilitating couple and community dialogues to transform harmful gender norms that act as barriers to positive RMNCAH outcomes.

Key Results


  • MCSP co-chaired the Male Engagement Taskforce of the USAID Interagency Gender Working Group which grew to 177 members in one year. In this role, MCSP facilitated dialogue and exchange of lessons on male engagement in RMNCAH. In February 2018, MCSP hosted a workshop, “State of the Art and Advancements in Male Engagement Programming,” highlighting successful and promising approaches, as well as lessons in engaging men as clients, partners, and champions for change in programming for HIV, RMNCAH, violence prevention, child marriage, and economic empowerment.
  • In Mozambique by December 2017, MCSP reached 31,424 community members through community dialogues conducted by 758 community health committees in Sofala and Nampula Provinces. The dialogues encourage couples to practice positive gender norms such as sharing household labor and caregiving, ensuring pregnant women have rest, nutritious food and access to health services, and preventing GBV. MCSP trained 1,358 health providers and facility managers from 86 health facilities on gender-sensitive service delivery and male engagement. These providers helped 5,185 couples develop joint birth preparedness plans, deciding where to deliver, arranging transport and saving money. Between October 2016 and December 2017, over 190,000 men accompanied their partners to RMNCAH visits, leading to increased rates of facility delivery.
  • In Rwanda, MCSP built the capacity of 173 trainers and 1,500 health providers on gender, GBV and male engagement, improving gender-sensitive RMNCAH service delivery and GBV identification, care and referral. MCSP reached 4,267 individuals through community dialogues on transforming harmful gender norms, engaging men, and preventing GBV. MCSP also engaged individuals in Rwanda through community dialogues on transforming harmful gender norms, engaging men, and preventing GBV through an adaptation of the successful Bandebereho Curriculum developed by Promundo. In 2018, Promundo conducted a randomized controlled trial of the full intervention and found that participants had significant increases in contraceptive use, sharing of housework, involvement of women in household financial decision-making, and reductions in physical and sexual violence.
  • In Nigeria, MCSP promoted the engagement of men and couples in RMNCAH by ensuring that health providers and facilities are “male-friendly,” and educating clients. MCSP developed awareness-raising posters, a pamphlet and job aid to help providers counsel clients on how men can contribute to their family’s health. MCSP built the capacity of 41 pre-and in-service providers as training facilitators on male engagement in March 2018. The Program also provided privacy screens in key facilities to improve respectful care for pregnant women, and to ensure men could support their partners during labor and delivery. These interventions resulted in 6,529 males accompanying their partners at their request between October and December 2017, representing a four-fold increase compared to the previous quarter.
Maternal and Child Survival Program