Lesson 7: Men’s Involvement in BF and Child Care

  • Male caregivers will support and encourage breastfeeding women in the following ways:
  • Support his wife as she exclusively breastfeeds for the first six months and continues to breastfeed for two or more years.
  • Encourage her to eat two additional snacks each day.
  • Help divide household responsibilities so the breastfeeding mother can take breaks to properly breastfeed her infant.
  • Save a small portion of rice from the rice harvest for the mother and family to eat.[1]
  • Male caregivers will contribute to their children’s mental, social, and physical development by:
  • Initiating physical contact (hugs, allowing children to sit on their lap, holding their hand or holding the child) so the child feels loved and secure.
  • Talking to the infant and looking in his eyes to stimulate brain development and intelligence.
  • Using family resources to ensure the infant is well fed, vaccinated, and receives medical attention when sick.
  • Allowing the infant’s mother to take the child to the health center and participate in activities (like Care Groups or vaccination campaigns) that improve her ability to care for the infant.
  • Male caregivers will protect their wife’s life by supporting her to delay pregnancy until their current child is two years old by:
  • Supporting the mother to exclusively breastfeed her child for the first six months of life.
  • Supporting the mother to select a family planning method in the first six weeks after delivery.
  • Considering the mother’s health and physical stamina to deliver another healthy child.

Additional Information for the Trainer and Promoter

  • This lesson is designed for women in the care group, however it is important that these messages are also shared with men in the community.
  • Share these teachings with community leaders. Encourage them to pass the same teachings to the men in the community through group meetings.

Materials:

  1. Attendance Registers
  2. Essential Nutrition, Hygiene and Care during Infancy Flipchart

Lesson 7 Summary:

  • Game: The Whisper
  • Attendance and Troubleshooting
  • Share the story and ask about current behaviors: Karorero’s husband Brings Mangos.
  • Show pictures and share key message on flipchart pages 54-59 about Supporting Women after Delivery, Supporting Infant Feeding and Supporting Child Development.
  • Activity: Agree or Disagree
  • Probe about possible barriers
  • Inform them of possible solutions to the barriers
  • Practice and Coaching in pairs
  • Request a commitment
  • Examine commitments and behaviors related to clinical services and growth monitoring and prevention.

/ 1. Game: The Whisper - minutes 10
  1. Participants sit in a circle.
  2. The facilitator thinks of a very long message such as, “I’m going to the market to buy some bananas and amaranth and then I am going to meet the promoter for lunch.”
  3. She whispers this message into the ear of the person sitting on her right. The woman receiving the message repeats the message to the next person in the circle.
  4. Continue passing the message from one person to another until it reaches the last person in the circle.
  5. Ask her to say the message aloud.
  6. Compare the final message to the original message. Usually the message changes as it is passed around the circle.
  7. Repeat the game with a new message.

?What can we learn from this game?

  • Sometimes messages change as it is passed from one person to another!
  • When we do not hear or do not understand, we must ask questions and ask for clarification.
  • Because the flipchart teaching is passed from one person to many others, we must be careful to hear the message clearly and repeat it just as we have heard it.

Now that we are energized, let’s begin our lesson.

/ 2. Attendance - 5 minutes
  1. The Promoter should fill out the attendance sheets for each Mother Leader following the role play model from Lesson Four of Module 1.
  2. Promoter asks if any of the Mother Leaders had problems during their meetings with their mothers. Promoter problem solves with the mothers, helping to solve troubles they are having, and asking other Mother Leaders for advice.
  3. Promoter asks about maternal deaths, child deaths or new pregnancies in the neighbor groups. Promoter records new events on the attendance sheet.
  4. Promoter thanks all of the mothers for their hard work and encourages them to continue.

Karorero’s Husband Brings Mangos (Picture 7.1) – 10 minutes

3. Story

  • Read the story on page 52 of the flipchart.

Karorero’s husband brings home mangos for his two older children. Karorero is busy working, so he cuts the mangos into small pieces for his youngest daughter. Barumwete’s husband walks by. He stops and thinks to himself, “What is Karorero’s husband doing? Feeding the children! Isn’t this woman’s work?”

4. Ask

  • Read the questions on page 52 of the flipchart.
  • Ask the first two questions to discover the women’s beliefs about men’s role in child care.
  • We hope the women respond in this way: Barumwete’s husband is surprised by what he sees. He is not used to seeing men feeding the children.
  • Allow the women to respond as what is “normal” for men in this community. Remind the women that what is “normal” does not mean that it is good practice or a practice that improves the child’s health.
  • Ask the last question to find out some of the things that husbands in this community do to help women with child care.
  • Encourage discussion. Don’t correct “wrong answers.” Let everyone give an opinion. This page is for discussion, not for teaching.
  • After the participants answer the last question, move to the next flipchart page by saying, “Let’s compare your ideas with the messages on the following pages.”

/ ?Why is Barumwete’s husband surprised by what he sees?
?Is it normal for men to feed and help care for children?
?What special things does your husband do to help you and the children?

Supporting Women after Delivery (Picture 7.2) – 5 minutes

5. Show:

  • Ask the caregivers to describe what they see in the pictures on page 55.

/ ?What do you think these pictures mean?

6. Explain:

  • Share the key messages using flipcharts pages 54 and 55.
  • Use the captions on the flipchart to remind you which images represent each point.

  • Divide the work so that women can rest after delivery.
  • Karorero’s husband assigns the housework to the children.
  • He knows Karorero must rest.
  • His daughter sweeps the floor.
  • His niece gathers water so Karorero can rest.
  • Encourage exclusive breastfeeding for six months.
  • Karorero’s husband doesn’t let others give foods or liquids to Biguvu.
  • He protectshis son from harmful foods.
  • He agrees with Karorero that breast milk is best.
  • Encourage women to breastfeed even if they are sick.
  • Breast milk is the best food and liquids for infants.
  • Encourage breastfeeding women to eat two additional snacks each day.
  • Karorero’s husband is helping her to eat a mango.
  • He knows breastfeeding women she should eat two additional snacks each day.
  • He knows that if Karorero is healthy, her infant will be healthy too.
  • Save rice from the harvest for breastfeeding women to eat.
  • Breastfeeding women who eat rice have healthier infants.
  • Karorero’s husband does not sell all of the harvest.
  • He saves rice for his wife and family.
  • Rice helps Karorero and her breastfeeding infant stay healthy.
?Do you think husbands are willing to help in this way?
?How can women encourage their husbands to help?

Supporting Infant Feeding (Picture 7.3) – 5 minutes

7. Show:

  • Ask the caregivers to describe what they see in the pictures on page 57.

/ ?What do you think these pictures mean?

8. Explain:

  • Share the key messages using flipcharts pages 56 and 57.
  • Use the captions on the flipchart to remind you which images represent each point.

  • Save money for emergency care for mother or child.
  • Karorero’s husband saves money in an envelope.
  • If one of the children is ill, Karorero can use this money.
  • If Karorero is ill, she can use this money for treatment or transport.
  • Encourage women to participate in health meetings.
  • He knows that vaccinations are important for his children.
  • He encourages his wife to go to special health campaigns.
  • He wants his children to be healthy.
  • Protect the women’s health. Delay pregnancy for two years after each birth.
  • Delayed pregnancy helps women to regain health after birth.
  • Delayed pregnancy helps children to grow well.
  • The husband and wife learn about methods to delay pregnancy.
  • Together they choose the method that will be the easiest for them.

Supporting Child Development (Picture 7.4) – 5 minutes

______

9. Show:

  • Ask the caregivers to describe what they see in the pictures on page 59.

/ ?What do you think these pictures mean?

10. Explain:

  • Share the key messages using flipcharts pages 58 and 59.
  • Use the captions on the flipchart to remind you which images represent each point.

  • Hug children and play with them often.
  • Holding hands and hugging children helps them to feel loved.
  • Physical touch comforts children.
  • Children who feel loved and valued grow well.
  • Teach children new things to help their mind grow.
  • Karorero’s husband is explaining how to fix radios.
  • He takes time to teach his children new things.
  • Teaching them new things helps them to do well in school
  • Spends time talking and discussing things with the children.
  • Interacting with the family helps children to learn.
  • Interacting with the family helps children to feel safe.
  • Interacting with the family helps children to grow.

/ 11. Activity: Agree or Disagree – 15 minutes
  1. Tell the women to stand in a row, standing shoulder to shoulder.
  1. Explain that this exercise will help us to understand some of our ideas, values and attitudes about gender.
  2. Read the following phrases. Ask the women to take one step back if they disagree with the statement and one step forward if they agree with the statement.
  3. After each statement ask two or three women to explain why they moved forward or backwards.
  1. The health of the child is a woman’s business.
  2. Making sure the family eats well is the woman’s responsibility.
  3. Women should always ask their husbands before they go to the health clinic.
  4. A man should not be seen taking his child to the Centre de Santé.
  5. Women should not talk with their husband about new pregnancies.
  6. A woman does not need to know about how much money her husband makes.
  7. It is okay for a husband to hit his wife if she deserved it.
  8. Men in the family should eat until their hunger is satisfied. The women and children should eat what is left.
  1. Allow each woman to sit down.

?How does each of these attitudes or beliefs affect our children? Do some of these beliefs have a negative impact on our children?

A few examples are listed below.

  1. If the child’s health is only the woman’s business…
  2. The woman may not enough money to take a sick child to the clinic and the child may die.
  3. The man may not provide enough money for food so the children stay healthy.
  4. If women must ask their husbands before they go to the health clinic…
  5. If the child is very sick and the father is away the child’s sickness may worsen or he may die.
  6. If a man should not be seen taking his child to the Centre de Santé…
  7. When the mother is sick, the child may not get treatment nor needed vaccinations because of the mother’s illness.
  8. If women should not talk with their husband about new pregnancies…
  9. The woman may not be given enough money to purchase two additional snacks each day. Both she and her child will suffer.
  10. The woman may not be able to discuss options for family planning and her life may be in danger because of pregnancies that come too soon.

?Which of these statements would you like to change? Why?

?How can these attitudes and behaviors be changed?

Add any of the following responses not mentioned by the participants.

  • We can raise awareness in the community about the negative effectsthese behaviors have on the children.
  • We can speak to influential leaders that we know about the negative impacts these behaviors have on children.
  • We can make changes in our own families to protect our children.
  1. Summarize the discussion: Everyone has their own attitudes about women and men’s roles. Often, our attitudes differ from our neighbors, and even differ from the teachings on the flipcharts. It is important to respect our neighbor’s attitudes, but also to challenge attitudes and values that cause harm to families – whether it is our own family – or the family of our neighbor.

/ 12. Probe – 10 minutes

?What do you think about these ideas? Is there anything that might prevent you from trying these new health practices?

Ask mothers to talk to a woman sitting next to them. They will share barriers and concerns they have about the new teaching. Together they will try to find solutions to these barriers. After five minutes, ask the women to share what they have discussed with the large group.

/ 13. Inform – 5 minutes

Help find solutions to their concerns. If a woman offers a good solution to another woman’s concern, praise her and encourage others to consider this solution.

14. Practice and Coaching - 20 minutes
  1. Ask Mother Leaders to share the teachings they have learned today using the first two flipchart pages. They should share with another woman in the care group using the ASPIRE method.
  1. Tell the Mother Leaders listening to the message that they should give one objection to the lesson; one reason that they think this message would be difficult for them.
  2. The Mother Leaders sharing the message should try to help the women overcome this obstacle.
  3. After ten minutes, ask the women to switch roles. The other Leader Mother will share the teachings from the next two flipchart pages.
  4. The Promoter should watch, correct, and help the Mother Leaders who are having trouble.
  5. When everyone is finished, answer any questions that the mothers have about the materials, or today’s lesson.

/ 15. Request - 2 minutes

?Are you willing to make a commitment to the teachings you have heard today? What is your commitment?

Ask each mother to say out loud a new commitment that she will make today. Each mother can choose the commitment that is most important to her.

For example:

  • I commit to talking with my partner about the messages I’ve heard.
  • I commit to asking my partner to save some of the rice harvest for our family to eat.
  • I commit to encouraging my partner to spend time playing and talking with the children.

/ 16. Examine ─ 15 minutes

Ask each Mother one-on-one about her commitments.

? What was your commitment at the last lesson?

? Have you kept that commitment? How – what did you do?

Finally ask each mother one on one about her practices in the last two weeks:

  • When was the last time you took your children (under age two) to a growth monitoring station?
  • How is your child growing? What does his growth chart look like?
  • When will you return to the Centre de Santé for your child’s next vaccination?

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Lesson 8: Child Spacing

  • Caregivers will be able to list the benefits of waiting for two years before becoming pregnant:
  • Mothers who get pregnant too early are more likely to die from blood loss and prolonged delivery during birth than mothers who wait two or more years before becoming pregnant again.
  • Infants born to mothers who get pregnant too early are more likely to have weak blood and be born too early, too small or dead.
  • Leaving two or more years between each pregnancy lowers the chances of infants becoming malnourished before age two: each infant is breastfed for a shorter period of time when the mother becomes pregnant too soon.
  • Caregivers will prevent new pregnancy by exclusively breastfeeding their child for the first six months of life. Exclusive breastfeeding for six months prevents pregnancy as long as the infant was given the breast within one hour after birth, is breastfed on demand, and the mother’s monthly bleeding has not returned.[2]
  • Caregivers will talk with their spouse about fertility and follow the two day method to delay new pregnancy.
  • Women will check for vaginal secretions twice each day in the afternoon. Vaginal secretions are a sign that new pregnancy is possible.
  • To delay new pregnancy, women will abstain from sex if they see secretions yesterday or today. They will only have sex after two days without secretions.
  • Caregivers will believe that having children too close together puts the mother at great risk of death during pregnancy and childbirth (increased perceived severity).[3]

Additional Information for the Trainer and Promoter