Maternal health remains a heavy burden in Kenya, with an estimated 379 deaths per 100,000 live births and 22 women losing their lives each day due to pregnancy and childbirth complications.

This is despite years of investments in maternal and child health care services. While we strive to improve the clinical care women receive, we must also recognise the social and household factors that impact access to care. One of these factors is men.

Maternal health care refers to services provided during pregnancy, labour, and the postnatal period. While these services are woman-centred, many decisions about accessing care are made within the home. Households often look to men for decision-making on finances, transport, and when care should be sought. Men have the power to enable or hinder care being accessed in time.

Evidence on male involvement

There is consistent evidence supporting an association between male involvement and improved maternal and child health outcomes. Benefits associated with male involvement include higher usage of antenatal/postnatal care, preparedness for childbirth, and reduced depression in mothers. Improved maternal outcomes were also tied to decreased risk of complications due to early planning and increased speed during decision-making if complications occur.

Male involvement takes different forms. During antenatal care, male involvement may be supportive, and range from budgeting for birth, arranging transport fares to helping out at home. Furthermore, it can be through mobilising their partners to attend clinic appointments and support adherence to medications taken during pregnancy.

In labour and delivery, male involvement is largely based around decision-making and the preparatory stages. Partners make decisions together regarding the place of delivery and other costs associated with it. Where men are not present during delivery, preparedness minimises delay in seeking care.

During postnatal care men are involved in facilitating women to access services for their recovery as well as care for the newborn baby. This support ranges from supporting women to eat well and follow up for immunisation. Male involvement during this stage is still low when it comes to directly interacting with health providers.

Barriers to participation

Despite its benefits, male involvement remains low. This is due to a mix of structural, cultural, and informational barriers. Several factors contribute to this, including structural barriers, sociocultural norms, and lack of information. Maternal health continues to be seen by cultural norms as the exclusive domain of women. Many men also lack even rudimentary information about maternal warning signs and symptoms during pregnancy and childbirth.

These lead to delays in identifying problems and in accessing care. Facilities are not often equipped with the space or protocols to include men. Health provider bias can also deter male engagement. Waiting times at facilities and strict institutional policies can discourage male involvement as well. Efforts to increase male involvement are often framed around men as decision-makers who influence access to services. While this reflects reality in many households, it can reinforce unequal power dynamics.

Instead, increasing male involvement should focus on framing men as having shared responsibility. Men should be invited to participate as partners in reproductive health—not to control care. Men can share responsibility for family planning, childbearing, and caregiving. Leaders should shift their messaging from influence to participation.

Male engagement also allows us to tackle larger social norms that harm maternal health. Early marriage and early childbearing, gender-based violence, and restrictions on women’s mobility are all harmful practices that keep women from receiving the care they need. To dismantle these social norms, we need men on board.

What works in practice

Interventions that involve men have shown measurable results. These include; increased communication between partners, greater preparedness for childbirth and support for their partners during pregnancy complications, and equitable decision-making power in the household. However, these must be designed carefully as interventions can also reinforce controlling behaviour or cause conflict in relationships if not well thought out. Programmes should be rooted in context and shaped by principles of gender equality.

Male involvement remains an underused part of maternal health efforts. Men’s involvement can influence care-seeking behaviours, pregnancy preparedness, and birth outcomes. Optimising male engagement will require shifting perspectives on gender norms and the methods of engaging men.

Increasing male involvement requires action at multiple levels. National policies should promote the development of specific strategies for male involvement in maternal health. Community-level initiatives can help bridge gaps in knowledge and support positive deviance from negative social norms. Within facilities, providers can develop approaches to both accommodate male partners and prevent them from interfering with care.

At the same time, male involvement should not limit women’s autonomy. Maternal health remains closely tied to women’s rights and decision-making over their own bodies. Any effort to engage men must protect this. Engaging men in a way that supports shared responsibility and respects women’s autonomy is a necessary part of that effort.

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Dr Bosire is a medical doctor and lawyer. stebosi51@gmail.com