Increasing Men's Involvement in Maternal and Child Health in Rural Ghana

A UNICEF/GHS Pilot Project Is Using Talking Books to Engage Fathers in Maternal and Child Health

In 2019, Amplio partnered with UNICEF Ghana and Ghana Health Service to launch a Talking Book pilot project at 15 Community-Based Health Planning and Services (CHPS) compounds in Jirapa District, Upper West Region. The goal is to engage and inform rural communities about quality health information and services, by providing access to local language health messages during antenatal care visits and child welfare clinics.

For the CHPS pilot, Talking Books include messages about maternal, newborn, and child health, as well as birth registration, kindergarten enrollment, social protection, hygiene and sanitation, and other topics to promote good health and well-being (SDG 3).

One of the results the team has seen is an increase in men's participation. More men are attending in maternal and child health visits and listening to Talking Books.

Why Men's Involvement Matters

While Ghana has made progress in reducing maternal and child mortality, there’s still more work to do. According to UNICEF, about 70 babies lose their lives every day. This is mainly due to premature birth, infections, and complications during and after delivery. In Northern Ghana's underserved rural communities, many women and children lack access to quality health information and services. Moreover, men often control the household finances and decision-making, which can dictate whether mothers and children can participate in antenatal care visits and child welfare clinics.

Without the involvement of the father, mothers may not be able to make it to care appointments or act on the information they’ve received. This can present an obstacle to government and development agencies working to provide mothers with access to the information and services to help them have a safe pregnancy and delivery.

UNICEF considers male involvement in pregnancy and child care a key practice for

raising happy and healthy families. This includes ensuring that fathers are involved in the process of offering care to women during pregnancy, childbirth, and after birth. Men's involvement can help improve child survival, growth. and development.

A community health nurse uses a Talking Book to share local language health messages. For larger groups, the device can be attached to an external speaker.

How the CHPS Talking Book Pilot is Improving Health Education and Communication

The CHPS Talking Book pilot program, which launched in February 2019, has been implemented in five zones: Sigri, Gbari, Die, Ul-kpon,  and Doggo/Konzokala. Each zone has three outreach centers, covering a total of 15 communities.

Community health nurses, midwives, and volunteers play Talking Book messages in group listening sessions followed by discussion. With the Talking Book's built-in speaker, families and groups of about 20 can listen and learn together. For larger audiences, an external speaker can be attached. Community members can also listen to Talking Books while they're waiting to be seen. In addition, nurses play messages when they're consulting with patients. Because many nurses do not speak the local language of the district where they're working, the Talking Book helps support communication.

The project actively tries to engage men, not only to educate fathers on the importance of maternal and child health but also to encourage dialogue between couples when it comes to making important health decisions. And it seems to be working. The project saw a significant increase in men's attendance in ANC visits and child welfare clinics from July to September 2019 compared to the same period in 2018.

From July through September 2019, there was an increase in male participation in antenatal care visits and child welfare services across all five CHPS zones.

Involving Fathers Yields Positive Results 

Participation in Talking Book listening sessions has made men more aware of the importance of being involved in the health of their wives and children. Toffic Dapilaah, Monitoring and Evaluation Officer, Amplio Ghana, said that the team hopes to use this trend to spur greater engagement from men. To do so, they’re sharing success stories at Talking Book listening and discussion sessions. “We try to take advantage of every community meeting to highlight how some men are taking the lead in the regard, to encourage other fathers to do the same,” he said.

So far, the UNICEF/CHPS pilot project has received positive feedback from both male and female community members. Both men and women say that Talking Books provide useful information and entertainment while they're waiting to be seen.

Doonyuo Doosaah encourages other men to take their families for health visits.

"The Taking Book taught us that we should always accompany our wives for antenatal and child welfare services. Doing that helps me know about maternal and child health. As the family head, I am doing my best to ensure that my family is healthy. Whenever I meet my friends, I encourage them to do the same.”— Mr. Doonyuo Doosaah, a father of five

Winifred and her husband listen to Talking Book health messages.

“I was introduced to a Talking Book listening club for pregnant women when I went to the health center for my first ANC visit. I've learned a lot about good nutrition and folic acid, and why it's important for pregnant women to sleep under a mosquito net. My husband picks me up on his motorbike to go to my health visits. While we're there, he can listen to the Talking Book message. It's become easier to get him to help with some of the things the nurses recommend because he has heard the advice for himself.” — Winifred Domonaangmen

With the involvement of men in the CHPS Talking Book pilot program, families are more firmly committed to health and safety. Many participants have become agents of change in their communities by sharing the knowledge they have learned.