Never Too Old To Learn: Nigérien “Husband Schools” Promote Family Health and Well-Being

Photo By: HKI Niger

Women in Niger face many challenges in ensuring the health and well-being of their families. Food security threats are regular occurrences, and ensuring that children are healthy and benefit from proper nutrition is a day-to-day struggle. When women benefit from the support of their husbands to pursue modern family planning methods, get regular health check-ups for their children, and learn about proper hygiene and nutrition practices, their job is much easier. Helen Keller International’s adoption of the “Husband Schools” approach to create model husbands who are supportive of the needs of their wives and children, and who advocate among their peers to do the same, has proven very effective in reducing the unequal burden often borne by women.

In terms of economic development and most indicators of well-being, Niger is one of the poorest countries on earth, ranked 187 out of 188 countries for which data are available on the United Nations Human Development Index (2015). Niger ranks near the bottom of the United Nations Gender Equality Index and has the highest total fertility rate in the world, with 7.5 children born over the average woman’s reproductive lifetime, according to the United Nations Population Fund (UNFPA). Niger’s poverty rate, combined with the high fertility rate, and related inadequate birth spacing, hunger, lack of access to healthy foods, a lack of knowledge regarding essential nutrition and hygiene actions, as well as certain prevalent cultural practices such as child marriage, results in high maternal and child mortality. It is also worth noting that most women in Niger lack modern conveniences such as running water and household appliances, so they have a heavy labor burden, spending hours each day engaged in tasks such as fetching water and firewood.

Children under two years of age are particularly vulnerable. Many pregnant and lactating mothers and their children lack proper nutrition and do not engage in key nutrition practices such as exclusive breastfeeding up to six months of age, or hygiene practices such as handwashing with soap at key moments during the day. In a conservative Islamic country such as Niger, these challenges are amplified when husbands themselves lack knowledge and do not support their wives.

“Husband Schools” are an innovation that increases the chance of a household’s success in raising healthy, well-nourished children. Piloted in 2007 by the United Nations Population Fund (UNFPA) to focus on family planning as a strategic response to worrisome maternal and newborn health indicators, Husband Schools have been adapted by HKI Niger to promote a whole range of good health and nutrition behaviors, thanks to generous support from the United States Agency for International Development (USAID) and the Margaret A. Cargill Foundation. HKI trains its field agents and government health workers on essential nutrition and hygiene actions (ENA/EHA). They, in their turn train the members of the Husband Schools on the same key actions and follow up, providing regular support to help the Husband Schools succeed.

The approach relies on building a cohesive cadre of ten model husbands per village who educate themselves with regard to birth spacing, modern family planning methods, and essential nutrition and hygiene actions (ENA/EHA). The aim is to induce men to become advocates for actions promoting maternal and child health. These model husbands are chosen based on a number of qualities, including moral fiber, work ethic, and leadership ability. Given the importance of surmounting cultural and religious misgivings about practices such as family planning, some Husband Schools include local religious leaders. The men’s learning reinforces capacity building done with women in groups promoting exclusive breastfeeding for children up to six months of age and nutritious complementary feeding for children aged six months and above. In the cultural context of Niger, men may be more likely to support their wives if they think that something like family planning is their own idea. Husband Schools often become a nexus of social capital and collective action, doing good deeds around the community such as repairing health center walls, building shaded enclosures to protect sick people and those accompanying them, building latrines, safely disposing of medical waste, and the like. The ten men per village are expected to be role models for other men in the community, creating a snowball effect of learning and good practices.

Tanimoune’s Example

Mr. Amadou Tanimoune is an exemplar of the virtues of Husband Schools. Tanimoune, a 45-year-old farmer, lives in Badifa, a village of about 1550 inhabitants located over 120 miles east of Niamey, the nation’s capital. Most of Badifa’s heavily-Muslim population is from the Arawa Hausa ethnic group and they make their living farming and raising livestock. Tanimoune and his wife, Ahi, age 33, have had six children, of whom five are still living. Tanimoune is well-known in Badifa and surrounding communities for his great efforts to make Ahi’s life easier, to such an extent that others called him, somewhat derisively, “Bawan Mata” (“slave to women”). Even before joining the Husband School, Tanimoune swept his courtyard, fetched water, occasionally cooked, and undertook other tasks to support his wife. Participation in the Husband School has increased his knowledge about exclusive breastfeeding, basic hygiene, family planning and birth spacing, among other subjects, and he has worked to open other men’s eyes to such issues. He also encourages his peers to make family decisions jointly with their wives, as he and Ahi do.

In a deep, authoritative voice, Tanimoune told us that his ten-month-old daughter, Cherifa, his first child to be exclusively breastfed for six months, is cheerful, doesn’t cry, and is much healthier than his older children were at the same age – “my other kids never went more than 40 days without having to go to the clinic.” Thanks to Tanimoune’s example and advocacy, other men in the village are promoting exclusive breastfeeding, family planning, and other healthy practices.

With high rates of poverty and population growth, much remains to be done to improve the health and quality of life of women and children in Niger. In order to make sustainable improvements, the buy-in of men is essential. Husband Schools are proving to be an exciting innovation – they lighten the load of beleaguered women and give them the time they need to ensure their families’ health.

This blog post was co-authored by John Uniack Davis, Helen Keller International’s Regional Director for West Africa and Ali Idrissa, a field agent for HKI’s Margaret A. Cargill Foundation-funded AGRANDIS project in Niger. A shorter version of this was posted on HKI’s website on November 8, 2017.