Husbands’ Schools Initiative

In 2007, the United Nations Population Fund commissioned a study on obstacles to promoting reproductive health in the Zinder Region of Niger. Conducted by the Laboratoire d’Études et de Recherche sur les Dynamiques Sociales et le Développement Local (LASDEL – Laboratory for Study and Research into Social Dynamics and Local Development), the study identified a number of barriers to the use of reproductive health services, the most important being the power and behaviour of the men who determine whether or not women can have access to medical care. To address this, eleven pilot Husbands' Schools were set up in two health districts in Zinder, located in particularly vulnerable areas with low reproductive health indicators. In 2010, the initiative has expanded to 137 schools in this district.

The concept, approach, and functioning of the EdMs were defined in detail at an initial workshop, based on a participatory approach, bringing together national non-governmental organisations (NGOs), health workers, volunteer husbands, support organisations, and other stakeholders. Criteria for selecting model husbands to participate in the schools were established, including that the participants must be married; a husband whose wife/wives use(s) reproductive health services; aged 25 or over; willing to volunteer; and a husband who allows his wife to participate in community life.

The Husbands' Schools or EdMs are based on voluntary membership and community involvement, the goal being to encourage men to take responsibility for their own development. There is no leader: all members are equal and work in a non-hierarchical framework, with each member assuming his share of responsibilities on a rotational basis. According to the organisers, the EdMs are a forum for discussion, decision-making, and action. The members meet around twice a month to analyse and discuss specific cases within the community in the field of reproductive health. This interaction is important since it gives the members insight into how they each perceive maternal health issues and problems. The group dynamic is also a tool for behavioural change.

The husbands look for appropriate solutions based on reliable knowledge available within the group or obtained from a specialist resource person. For example, based on information provided by health personnel in the area, the husbands identify critical health indicators, such as low rates of prenatal consultation. Having identified the problem, the husbands can devise strategies and actions to get more pregnant and breastfeeding women attending Integrated Health Centres (Centres de Santé Intégrés, CSI), thereby improving health in the community. This has included such actions as building latrines in the CSIs to enhance women’s comfort and privacy; a midwife's residence, an observation room for women in labour, and a prenatal consultation room. Awareness sessions held during religious ceremonies are also one of the strategies they use.

According to the organisers, the Husbands’ School primarily influences behaviour within individual couples - wives say that there is now dialogue with their husbands and that men understand the importance of the health of their wives and children. They say that for the first time, husbands have even been attending the births of their children at the CSI. Member husbands are acting as guides and role models for their own families as well as for other families that would otherwise have difficulties using the services of a CSI. The organisers say there has also been a noticeable change in behaviour among villagers, authorities, and health workers and as the Representative of UNFPA Niger, Mr. Yacine Diallo, says "the initiative is having such an impact that is has caught the attention of other development partners". The decisive factor is the new relationship that has been built up between the EdMs and health workers, making the husbands direct actors of development, which is having a qualitative impact on health indicators. The objective is to involve the husbands in sensitisation around other areas such as gender-based violence, forced marriage, malnutrition amongst others to increase the positive impact on development.

Maternal Health, Reproductive Health

In Niger, where the maternal mortality ratio is 648 deaths per 100,000 live births, a woman dies every two hours. This is one of the highest ratios in the world, and it does not include the unacceptable number of women left disabled after childbirth. According to the United Nations Population Fund, working to ensure that women survive childbirth is a human rights imperative and an absolute priority for international development. The organisers report that in the project area, the reproductive health indicators are improving, with particularly significant rises in deliveries assisted by skilled personnel, prenatal and postnatal consultations, and family planning.