Engaging fathers for healthier families: Equity means sharing responsibility of raising children
Evidence from randomised controlled trial in urban Nepal indicates that including husbands in antenatal health education sessions significantly improved maternal outcomes – increased birth preparedness, antenatal care attendance, institutional delivery, and health care seeking
Published: 10:45 am Mar 03, 2026
In Nepal, the journey of motherhood, from pregnancy to childbirth and childcare, is seen as solely a woman's responsibility. Fathers are often regarded as the provider of the family. It is disheartening that in most maternal out-patient departments (OPDs), expecting mothers are often accompanied by their mothers or mothers-in-law rather than the husbands. Yet, evidence shows that encouraging men's participation in reproductive health has been identified as an effective strategy for improving maternal and child health. It is considered as the cornerstone of safe motherhood. Husbands act as gatekeepers to their wives and family's health-seeking behaviours, decisions, and utilisation of health services. While fathers are considered only as the breadwinners, they can provide emotional support to their wives during pregnancy and postpartum, which can help reduce the woman's anxiety and stress. The role of husbands in pregnancy and childbirth is often overlooked and neglected. Equity means not only providing women with opportunities but also sharing the responsibility of raising children. With one of the highest maternal mortality rates in the world, it's high time Nepal strategise the importance of father's engagement in motherhood and newborn care. Many of these deaths are preventable through early care seeking, adequate nutrition, and institutional delivery – all of which can be improved when fathers are actively involved. Male involvement needs to be recognised and addressed due to the potential benefits it may bring to the maternal and child outcomes. Gone are the days when the father's role was merely waiting outside the antenatal care (ANC) or delivery room. Studies demonstrate that when fathers are involved, three delays are reduced, namely, decision delay, access delay, and delay in receiving care. The involvement of fathers can play a crucial role, especially in the first and second phases of development in developing countries, which positively impacts birth outcomes. This can prevent birth complications resulting in a healthy mother and baby. Research indicates that supportive partners can lead to better prenatal care attendance, healthier maternal behaviours like improved maternal nutrition, encourage exclusive breastfeeding, and low rates of postpartum depression. Hence, services should aim at raising their awareness about emergency strategies for involving men in maternal health. Evidence from randomised controlled trial in urban Nepal indicates that including husbands in antenatal health education sessions significantly improved maternal outcomes – increased birth preparedness, antenatal care attendance, institutional delivery, and health care seeking. If we compare and analyse the evidence from different countries, in Pakistan, promoting vaccine uptake was observed after involving fathers, where the immunisation rate was decreasing. In Ethiopia, programmes that encouraged men to participate in antenatal care, delivery, and planning led to better maternal service use, more exclusive breastfeeding, and healthier birth weights. Today, Nepal is definitely witnessing these positive shifts. The deeply-rooted concept that motherhood and childcare is solely women's responsibility is gradually changing. Families and communities are beginning to recognise that fathers play an equally vital role in ensuring the health and well-being of mother and child. In rural areas, Female Community Health Volunteers (FCHVs) are encouraging fathers to attend the antenatal check-ups and group discussions regarding nutrition, importance of ANC check-ups, danger signs of mother and baby, and birth preparedness. Many local governments are now actively involving males in safe motherhood campaigns, encouraging men's participation in maternal health activities. Nepal officially grants 15 days of paternity leave after childbirth, which shows the initiation and promotion of father's care for both mother and baby. The communities and the government should be responsible for the inclusion of the male in the journey of childbirth. Engaging fathers in the antenatal discussions, birth preparedness and planning, and even to discuss the delivery and postnatal visits is essential. Fathers should be encouraged by the FCHVs to attend their counseling and discussion sessions on issues regarding the danger signs of mother and baby, nutrition, and immunisation. Kangaroo Mother Care (KMC), that is, skin to skin contact could be done by the father in hospitals and home, which will not only help babies thrive but also connect a beautiful bond between the father and the baby. Father friendly places should also be designated in the hospitals . Paid paternity leave should be extended for at least three months where fathers can help the new mother in taking care of the newborn and be emotionally attached. Digitalised reminders like SMS alerts should be sent to both the parents regarding the nutrition, immunisation, and follow ups. Nepal is already heading towards these powerful shifts, and we can see males attending ANC visits and inside the delivery rooms of hospitals. However, to maintain the sustainability, we must normalise a father's involvement and encourage him to also involve in care. We must encourage shared parenting, and health facilities and delivery rooms should welcome men. Their sole presence can definitely transform the health of the future generation. Dr Koirala is a medical consultant at Noora Health