Ugandan Love Letters Pull Men to Fetal Heartbeats

Published by Women's eNews, this article outlines a strategy being used by clinics in the Jinja district of Uganda to encourage men to be involved in the pre-natal care and reproductive health of their wives. When a woman visits a clinic alone, after her consultation she is given a brief letter for her husband, signed by the local district health director, which includes some basic information and a polite request to come to the clinic in person to discuss health matters, such as: HIV testing; what to expect during the delivery; and how to care for a pregnant woman. According to one man interviewed for the article, Moses Funga, this letter encouraged him to take the time to come to the clinic to find out what the couple could expect in the time leading up to the birth of their child.

David Kitimbo, local district health director, says the secret of the love letter's success is its direct and personal appeal. The letter is designed to encourage men to attend the clinic as an expression of love for their family. When a man arrives at the clinic for a first pre-natal visit, he is not treated passively; he is weighed and his temperature and blood pressure are taken alongside his partner's, in order to demonstrate to men that they are directly involved in the childbearing process.

According to Sarah Byakika, Jinja's deputy district director of health services, in addition to getting some men to come to the clinics, the love letter also gives women much-needed bargaining power, providing them with a way to confront their husbands about sensitive issues related to health care. Without male support, Byakika said, it is virtually impossible to get HIV-positive women to follow through on interventions to protect their babies and themselves. Health workers found that infected women who covertly tried to seek treatment at health centres faced suspicious questioning from their husbands and the threat of punishment or beating. Under those conditions, practicing safe sex was virtually impossible.

Before the love letter approach, according to this article, Jinja district health workers employed a variety of strategies to try to coax men to come to clinics with their pregnant wives. Since radio is the main means of mass communication in Uganda, they composed a catchy radio jingle. They tried appearing on radio and television talk shows to educate the public on the importance of male involvement in the childbearing process. These campaigns ran for over a year but, ultimately, registered almost no impact. The organisers state that through the love letter approach, they have boosted the number of men who accompany their wives or girlfriends to clinics from 2 percent to 7 percent.