N’DAKRO, Cote d’Ivoire — After Kouame Koffi’s daughter Grace was born in 2008, he swore he would not have any more children. Koffi’s wife, Odette, had given birth twice before, in their one-room home in N’Dakro, a remote village about three hours outside of Abidjan, the economic capital of Cote d’Ivoire. Those two babies were stillborn, and while Grace was born healthy, Odette started hemorrhaging and would have died if there hadn’t been a man with a truck delivering bread to the village. He drove Odette to the hospital in Bonikro, about four miles away, and she survived.
During her first pregnancies, Odette consulted the village’s midwives and planned to have her babies at home, as most women here do. When her second child died before he even took a breath, Odette decided that for her next pregnancy she would go to the doctor for prenatal checkups and give birth at the hospital. But she needed Koffi’s permission to do so.
“Men are in charge. They are the ones who have the money. They are the ones who decide whether or not the woman should go to the hospital,” Koffi explained. However, he says he “did not know about the good in hospitals.”
Men in the village often believe that birth-control pills and injectable contraceptives will make their wives ill or sterile or encourage them to cheat. They also don’t understand or know about the need for prenatal care and don’t want to spend the money for their wives to go to clinics when they believe traditional medicine works just as well.
Now, as part of a government and United Nations Population Fund (UNFPA)-sponsored “school for husbands” in N’Dakro, Koffi uses the story of his wife’s near death to teach other men in his village about the importance of prenatal care and encourages them to give their wives money so that the women can give birth at the hospital instead of at home in the village.
Cote d’Ivoire has one of the highest rates of maternal and neonatal mortality in the world. Every day, 16 women die in childbirth and almost 40 out of 1,000 children are stillborn. Cote d’Ivoire ranks 138th out of 148 countries on the Gender Inequality Index, which measures women’s reproductive health, empowerment and economic activity.
“Men play a key role in bringing about gender equality since, in most societies, men exercise preponderant power in nearly every sphere of life, ranging from personal decisions regarding the size of families to the policy and program decisions taken at all levels of government,” said Babatunde Osotimehin, executive director of UNFPA. In order to create lasting, positive change, it isn’t sufficient to educate women about reproductive and maternal health and gender equality; men have to be educated as well.