Um Helal is in her 30s and is the mother of six children. Her oldest child is 15 and her youngest five. Following her last pregnancy, Um Helal’s health began to take a turn for the worse. She felt dizzy and weak all the time. It was only then that she says she was able to convince her husband that they should not have any more children and explore birth control options.
“My husband wanted me to give birth to 12 children,” she said. “I was [initially] unable to change his mind that I cannot have any more children.”
Some specialists in Yemen say that men dictate reproductive health—including family planning and birth control options—for women like Um Helal. They say it often comes at the cost of the well-being of women that men tend not to be targeted when it comes to reproductive health awareness.
“All the services and education campaigns for [reproductive health] centers concentrate on women,” said Abdulla Al-Kamil, the coordinator of the reproduction health programs in the United Nations Population Fund (UNFPA).
He says the number of women coming into reproductive health centers across Yemen is increasing, but they are doing so without their husbands, which is problem because men then miss out on educational material about family planning.
Education is crucial to getting men on board with reproductive health options says the Ministry of Public Health and Population.
“We try to target men and provide them with [our] services, but this happens only if the man accompanies his wife on the visit,” said Mohammed Al-Mashraei, the manager of the Supply Department in the General Administration of Reproduction Health at the Ministry of Health and Population. “There are no group or individual educational sessions devoted to men only.”
Al-Mashraei says only rarely do they distribute condoms to men. A few husbands will get an occasional brochure talking about how much time couples should wait between pregnancies and signs that women should not have any more children.
At another reproductive center in Sana’a, an employee, Ibtihal Mohammed says he has never seen a man enter the clinic alone.
“The man only comes to accompany his wife,” he said.
“Women in Yemen bear the responsibility of persuading [their] husband [to learn] about the advantages of reproductive health,” said Al-Kamil. “The woman finds herself under the pressure of the decision-maker, the husband,” she said, referring to Yemen’s marriage structure that typically reflects patriarchal customs.
Ibrahim Al-Harazi, the manager of the Youth Department in Marie Stopes Organization in Yemen, an international NGO dedicated to reproductive health, says that entrenched beliefs of who should make decisions are hard to overcome.
“The majority of people think that the reproduction health affairs only concern women,” he said, but they aren't the ones really making the decisions.
The way hospitals and health centers are set up encourages this dichotomy instead of promoting joint decision making.
“When the man comes along with his wife [to the clinic], it is rare that they sit together in front of the doctor. The man remains in the waiting room,” said Afrah Al-Qadi, the manager of the Reproduction Health Program at the Family Care Organization, a Yemeni civil society organization that dedicated to female empowerment.
Yemen has one of the highest infant mortality rates in the world, according to UNFPA. According to a 2003 survey, out of every 100,000 births, there are 365 fatalities. Although there are many factors contributing to this statistic, experts believe an increased awareness of reproductive health could at least curb this number.
The World Health Organization conducted a study in 2001 in several countries including Zimbabwe and Kenya. Although Yemen was not included in the study, Al-Kamil said the information learned is also applicable to Yemen’s situation. In the study they found that when men are incorporated into family planning services like having a couple meet with a man together, sustainability of preventing things like unwanted pregnancies are improved.
Local doctors also want men and women to be making joint decisions.
“The reproduction health of women is not only the responsibility of the man, but also the responsibility of the whole society,” said Shawqi Al-Hamshri, a gynecologist.
Yemen’s ministry of health is trying to focus their efforts on rural areas, where men are likely to accompany their wives in a clinic but also where awareness of reproductive health tends to be the lowest.
They have a program where midwives are being trained to educate patients on family planning.
“Men can [and should] have access to education about reproductive health,” said Dr. Kareeman Rajeh, the coordinator of the reproductive health affairs department at the Ministry of Health.
Source: The Yemen Times