This article has been written to call for further attention to the importance of involving males in efforts to reduce maternal mortality. Since the 1995 International Conference on Population and Development [ICPD], institutional and community arrangements have been implemented in developing countries to engage males in maternal and child health promotions. The government of Uganda - in partnership with other health promotion institutions such as the United Nations agencies - has in the past decade formulated and implemented national and local strategies for male involvement in Sexual and Reproductive Health and Rights (SRHR). Nevertheless, strategies are such as Male Action Groups (MAGs) have been short-lived because the strategies within cannot by themselves work without 'genuine' acceptance at community levels where implementation takes place. Even acceptance alone is also not enough. Majority of males have more interest in economic than social endeavors. They have less interest to engage in maternal health promotion initiatives. Cultural based perceptions and behaviors associated with patriarchal tendencies remain the greatest challenge. Therefore, relevancy, functionality, adaptability, and sustainability in relation to the effectiveness of male involvement initiatives must be assessed before these interventions are initiated in such culturally diverse communities with different informal institutional arrangements. The individual, interpersonal and institutional contexts in which interventions operate matters. The article identifies relevant stakeholders and suggests, though not discussed in detail, strategies for improving stakeholders' interests to respond to male involvement as a core issue in maternal health.
Network governance is commended as one of the appropriate approaches to manage infectious disease crises, but knowledge of its implementation is still limited especially in nondemocratic contexts. This study adopted a qualitative case study design using secondary evidence to review how Uganda used network governance to manage COVID‐19 crisis. Uganda used the Whole of Government and Whole of Society approaches to form core‐periphery networks of government and nongovernment actors. It institutionalized task forces and subcommittees at national, district, and community levels to coordinate the COVID‐19 response. Networks of actors contributed to the response through case surveillance and management, enforcement of measures, information sharing, social protection and community engagement, resource mobilization, supply chain management, and vaccination. However, the experiences varied across the country with challenges including consensus problems, mistrust, corruption, poor accountability, abuse of rights, and limited capacities especially in local governments. The study revealed that the effectiveness in handling infectious disease crisis might not greatly depend on the country's democracy but rather the government's ability to recognize the threats and adopt collaborative mechanisms to manage the crisis. Contextual understanding of such experiences may provide lessons that future governments may consider when, not if, crises of such magnitude confront them.
It is evident that maternal and under-five child deaths have gradually reduced in Sub-Saharan Africa (SSA) in the last three decades. In a bid to improve access and utilization of maternal and child health care services in the region, actors in public, private and civil society arenas at all levels have engaged in familiar circles towards service provisioning. Nevertheless, evidence from several SSA countries shows less utilization of some maternal and child health care services. The demand remains low for some services such as attendance of four antenatal visits as recommended by World Health Organization, delivery skilled birth attendants, postnatal care especially for newborns, child immunization, and use of modern contraceptives. The concern remains whether the less demand is influenced by supply-side or demand-side factors. The personal, socio-cultural, economic, health systems related factors may condition a person’s demand choices regardless of the need for a particular health service. Improved access may not necessarily translate into utilization because of these interrelated determinants of demand. Therefore, policy-makers might need to turn to Sen’s capability approach viewpoint to gaze at how expanding people’s choices-especially poor women might help to improve the demand for maternal and child health services in SSA. Policy interventions may include pro-poor healthcare service provisioning through public financing, improving women’s education, improving women’s access to information, etc. However, a multi-sectoral approach is necessary for addressing all demand determinants at all levels and the interventions should be context-specific.
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