Assessing the Importance of Gender Roles in Couples’ Home-Based VCT and Family Planning Counseling in Malawi

Jessica D. Gipson, University of California, Los Angeles
Carie J. Muntifering, Johns Hopkins Bloomberg School of Public Health
Felluna Chauwa, University of Malawi
Frank Taulo, University of Malawi

Although couple interventions have been shown to positively influence health outcomes, it is important to consider existing gender relations in ensuring equal benefit and protection to both partners. This qualitative study assessed the importance of gender roles on couples’ home-based family planning (FP) counseling and HIV voluntary counseling testing (VCT) near Blantyre, Malawi. Focus group discussions and in-depth, couple interviews revealed that clearly-defined gender roles influence couple communication, as well as knowledge and uptake of reproductive health services. Male and female participants indicated that wives are expected to defer to their husbands in all matters. Wives, however, also discussed ways in which confrontation or potential conflict are avoided through covert contraceptive use and non-disclosure of HIV test results. Findings suggest that couples’ home-based FP/VCT interventions can provide benefits to both partners, but need to be carefully implemented given the differential impacts for women versus men.