Presentation at the Global Maternal Newborn Health Conference, October 20, 2015
Background: Gender norms and inequalities shape maternal and child health. Early marriage and childbirth contribute to maternal mortality and poor birth outcomes, and women’s limited control over family resources may impede uptake of ANC services. Norms that leave household chores and health issues as women’s responsibility reduce time available for breastfeeding and may reduce men’s support for use of health services.
Methodology: We reviewed the evidenced base for gender-integrated social behavior change communication (SBCC) interventions that promote behaviors relevant to maternal and child health and describe interventions that build on the evidence base. Interventions were identified from systematic searches of the published and grey literatures. Studies were eligible if an SBCC intervention addressed gender (e.g., search terms included gender dynamics, spouse, interpersonal relations), measured relevant behavioral outcomes (e.g., antenatal care, nutrition), used at least a moderate evaluation design, and were implemented in low- or middle-income countries.
Results: Most (N=22) of the 23 interventions identified addressed reproductive and maternal-child health behaviors (e.g., birth spacing, antenatal care, breastfeeding). Eight interventions acknowledged, but did not seek to change gender norms and inequalities, and 15 sought to change gender norms or inequalities. Evidence suggested that engaging men in health education and counseling was beneficial. Evidence was most compelling for SBCC approaches that empowered women. For example, participatory approaches that gathered women together and empowered them to address health issues in their community were shown to reduce maternal and child mortality.
Conclusions: Our review suggests that addressing gender in maternal health interventions is beneficial. Building on this evidence base, the MCSP program is carrying out formative work in Tanzania, Rwanda and Nigeria to better address gender in clinical services and SBCC programming. SBCC activities, for example, will constructively challenge norms around GBV and constructively engage men in health promotion around antenatal care.