Male partner involvement in women's sexual and reproductive health as well as maternal and child health care has recently attracted considerable attention. The International Conference on Population and Development (ICPD) in Cairo, 1994  and the 4th World Conference on Women in Beijing  drew attention to women’s health and the need to have men more involved in the promotion of sexual and reproductive health. Although the notion of ‘men as partners’ was contested in Cairo by some of the women’s movements , both conferences emphasized men’s shared responsibility and active partnership in sexual and reproductive health and promotion of gender equality [1, 2].
Changing and improving the way men are involved in reproductive health problems can also have positive impact on women’s, men’s and children’s health [4, 5]. Evidence also shows that men can prevent unintended pregnancies, reduce unmet need for family planning (FP), foster safe motherhood and practice responsible fatherhood . In the USA, partner involvement in pregnancy has increased antenatal care 1.5 times . Even in India, a maternity care model that encouraged husband’s participation in their wives’ antenatal and postnatal care found positive changes in knowledge, gender roles and decision-making . In addition, demographic and health surveys in five Latin American countries (Bolivia, Peru, Colombia, Haiti and Nicaragua) indicated that positive couple interaction is associated with improved health outcome for children .
Previous studies suggest various ways in which men mediate and restrict women’s access to health care services including men’s decision-making authority [10–16], their influence over material resources including financial resources [10, 14], low level of basic knowledge in any of maternal and child health care issues [11, 12], and cultural barriers that pose restrictions on women’s movement and exclude men from taking part in women’s health . In many cultures, men, older women and families make decisions to take contraceptives, when and where to seek treatment and the type of services to use, whether to pay for skilled assistance or transportation to a hospital, that affect women’s sexual and reproductive health and contribute to high incidences of reproductive disease, disability and death [9, 11, 15].
In Bangladesh, predominantly a patriarchal society, women’s access to social, economic, politico-legal and health care institutions is largely mediated by men. Within the household and in the public sphere, men control women’s sexuality, their choice of marriage partner, their access to labour and other markets and their income and assets [18, 19]. This affects women’s health and health-seeking behaviour in several ways, firstly, by controlling behaviours and decision-making authority of husbands and elderly members [20–22], secondly, through neglect and low prioritization of women’s health issues [23, 24] and finally, because of cultural beliefs that consider morbidity during pregnancy a normal consequence of pregnancy . Other prominent barriers to male involvement in maternal health are social stigma derived from notions of bad fate (awful happening linked with women’s luck) associated with an abnormal pregnancy or delivery; shyness and embarrassment at having to deal with ‘women’s matters’ publicly; and job responsibilities [26–28].
With the Millennium Development Goals (MDG) of reducing maternal, neonatal and child mortality in Bangladesh in mind, BRAC has initiated a large community-based programme to reduce maternal, neonatal and child mortality in 2005 in Nilphamari and has taken a decision to scale up in three new districts (Rangpur, Gaibandha and Mymensingh) in 2008. There is limited literature to inform our understanding of what happens at a micro level in terms of men’s knowledge and practice in relation to antenatal, delivery and neonatal care. To address this shortcoming, this study explores the knowledge of men on maternal and child health issues, their awareness of their wives’ practices and the preferred means of decision-making.
The objective of the study is to compare men’s knowledge and awareness of their wives’ practices, and the preferred means of decision-making on maternal, neonatal and child health issues between intervention and control districts.