revisiting trails of improved practices methodology 5.10.11 mc_ewan
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Gender responsive programming
Changing men’s support to
women during pregnancy,
delivery, and post-partum.
Use of a modified
TIPS methodology
Elena McEwan, MD
Senior Technical Adviser
Catholic Relief Services
Core Spring meeting, May 2011
What is a key problem in
seeking care?
0
10
20
30
40
50
men together women
Who makes the decision
Pregnancy
Birth
For newborn
Step 1: Gather information on:
• existing knowledge and decision-making,
• Motivation and perceived benefits of recommended practices
• Possible barriers to recommended practices
Step 1
Focus Group
Discussion
14 FGD:
• 80 men with
pregnant wives
• 16 men with
postpartum wives.
• 16 postpartum
women
• 36 men with children
age 40 days to 2 yr
Home visits with
individual interviews,
husband and wife
32 interviews in 16
homes with children
age 0 to 40 days
Step 2:
a) Debrief and analyze
information
b) Develop community
“counseling” strategies
Step 2
We can take care of our
newborn during the day and the
night
Motivation for
recommended practices
Child will grow up to
have more love for the
father than is typical.
Newborn will be
healthy and the family
will save money not
treating sickness.
Infant will grow easily
and be happy.
After work, I find time to share
quality time with my family
Potential barriers to male
supportive care practices
Potential barriers:
1. Don’t know how to do it
2. Lack of communication with
wife regarding pregnancy
3. Lack of motivation due to
feeling left out by the health
staff during care
4. They feel embarrassed to be
seen by other women when
taking care of the newborns
Developing community counseling strategies
During pregnancy:
1. Collect firewood and water.
2. Support wife with household work
3. Go with wife during at least 3 ANC
visits and
4. Ask questions during care.
During childbirth and delivery:
1. Find someone to take care of the
house while he goes with wife to HU
for delivery.
2. Assist wife to go to maternity house 2
weeks before delivery.
3. Go with wife to HU and stay in room
during labor and delivery.
4. Agree with wife to stay at the maternity
waiting home seven days post partum.During post-partum period:
1. Alternating take care of newborn during the day and the night.
2. After work, feed other children (one snack and dinner).
Step 3:
Negotiate
“trial” practices
(3 men per each practice)
Note: Negotiation done at
group level
Step 3
Step 4:
Follow up home visits
to gather information
on experience with trial
practice: results,
response, reactions
Step 4: Results, response,
reactions
Step 4: Gather results
During pregnancy:
1. Collect firewood and water.
• 76% (practiced at least 4 times)
2. Support wife with household work.
• 100% (practiced at least 4 times)
3. Go with wife during ANC visits and ask questions.
• 66% (practiced at least during 3 ANC visits)
Step 4: Gather results (continued)
During childbirth and delivery:
1. Find someone to take care of the house while he goes with wife
to HU for delivery.
• 80% practiced
2. Assist wife to go to maternity house 2 weeks before delivery.
• 50% practiced
3. Go with wife to HU and stay in room during labor and delivery.
• 40% practiced
4. Agree with wife to stay at the maternity waiting home seven
days post partum.
• 75% practiced
During post-partum period:
1. Alternating with wife taking care of the
newborn during the day and the night.
• 71% practiced at least 4 times
2. After work, feed other children (one snack
and dinner).
• 98% practiced at least 4 times
Step 4: Gather results (continued)
Step 5: Recommendations for the program
1. Changes in recommended practices are feasible.
2. It will be possible to overcome resistance encountered.
3. It is critical to involve the Ministry of Health personnel in
support of recommended practices that involve Health
Units / Hospitals.
Step 5
Thank you!
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