(Mis)measuring Men’s Involvement in Global Health: The Case of Expectant Fathers in Dakar, Senegal

Background: In 2018, USAID published a report based on Demographic and Health Surveys data on the relationship between men’s involvement and women and children’s health outcomes. Based on the data collected, USAID’s analysis implies that Senegalese men are not involved in women and children’s health. Methods Twenty-two months of ethnographic research from 2012 to 2018. Research participants included 32 pregnant women and 27 expectant partners recruited from three maternity wards by convenience sampling, plus chief physicians, nurses, midwives, employees of the Ministry of Health and Social Action, and employees of nongovernmental organizations in the health sector. Research methods included participant observation, semi-structured interviews, free-list and pile sort exercises, and various visual ethnographic methods. Data were evaluated using rhetorical, textual, and cultural domain analysis. Results This research demonstrates that expectant fathers are involved in prenatal care in ways that USAID does not track through DHS. Conclusion Context independent reporting on men’s involvement is potentially harmful and obstructive to improving maternal and child health when the problem that is targeted is not a problem at all. State and non-state organizations investing in men’s involvement campaigns would save money and resources by amplifying men’s strengths (an asset-based model) rather than seek to educate them toward Eurocentric conceptions of fatherhood and masculine care (a deficit-based model).