Triulzi Isotta, Orlando Stefano, Palla Ilaria, Mthiko Bryan, Nyondo-Mipando Alinane Linda, Mamary Sangaré Hawa, Playster Tambwali Bruce, Ciccacci Fausto, Marazzi Cristina Maria, Turchetti Giuseppe
Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà, 56 Scuola Superiore Sant'Anna, Pisa, Italy.
Department of Biomedicine, University of Tor Vergata, Rome, Italy.
BMC Public Health. 2024 Dec 24;24(1):3582. doi: 10.1186/s12889-024-21170-9.
Malawi ranks 142 out of 170 countries on the UN's Gender Inequality Index (GII). Women and men in Malawi have unequal access to and control over resources. Previous research has primarily examined gender roles and norms from a women's perspective, but few studies have investigated men's attitudes and behaviors regarding gender equality. This study fills this gap by investigating the social factors that influence attitudes towards gender-equality and exploring the association between behaviors and attitudes in south-eastern Malawi.
A cross-sectional survey was administered to adult males during a health education program (male-friendly clinics) in four healthcare facilities from August 2022 to November 2022. The validated Gender-Equitable Men (GEM) scale, was employed to quantify men's attitudes towards gender norms. Univariate and multivariable analyses were used to identify the social determinants of and the behaviors associated with gender-equitable attitudes.
A total of 422 men, with a median age of 46 years (IQR = 34, 55), were included in this study. The participants reported a median score of 0.53 for gender attitudes, where 0 represents the minimum score and 1 the maximum. A higher GEM score was associated with a higher educational grade and living in an urban area. In terms of decision-making, 64% and 56% of men reported that they had the final say in matters concerning women's and children's health, respectively. Higher GEM scores were associated with joint decision-making in relation to women's (0.55 vs. 0.49; p = 0.008) and children's health (0.54 vs. 0.48; p = 0.012), and spending on food and clothing (0.56 vs. 0.49; p < 0.001). On the other hand, certain activities, such as cleaning the house (64% of men reported unequal participation), and cooking (70%) were not shared among partners. An equal or greater participation from men (70%) compared to women was reported for activities related to childcare. Men who participated in the previously mentioned tasks had higher GEM scores than those who did not.
The findings of this study shed light on the significant role of educational grade and living in an urban area as determinants of gender-equitable attitudes among men in south-eastern Malawi. More equitable perspectives towards gender norms were associated with being more involved in tasks typically assigned to women and in joint decision-making. Incorporating gender in research can contribute to the advancement of a more inclusive healthcare system.
在联合国的性别不平等指数（GII）中，马拉维在170个国家中排名第142位。马拉维的男性和女性在获取和控制资源方面存在不平等。以往的研究主要从女性的角度审视性别角色和规范，但很少有研究调查男性对性别平等的态度和行为。本研究通过调查影响性别平等态度的社会因素，并探索马拉维东南部行为与态度之间的关联，填补了这一空白。
2022年8月至2022年11月期间，在四个医疗机构的健康教育项目（男性友好诊所）中，对成年男性进行了横断面调查。采用经过验证的性别平等男性（GEM）量表来量化男性对性别规范的态度。单变量和多变量分析用于确定性别平等态度的社会决定因素以及与之相关的行为。
本研究共纳入422名男性，中位年龄为46岁（四分位间距 = 34, 55）。参与者报告的性别态度中位得分为0.53，其中0分代表最低分，1分代表最高分。较高的GEM得分与较高的教育水平和居住在城市地区相关。在决策方面，分别有64%和56%的男性报告称，他们在涉及妇女和儿童健康的问题上拥有最终决定权。较高的GEM得分与在妇女健康（0.55对0.49；p = 0.008）、儿童健康（0.54对0.48；p = 0.012）以及食品和衣物支出方面的共同决策相关。另一方面，某些活动，如打扫房屋（64%的男性报告参与不平等）和做饭（70%），伴侣之间并未共同承担。在与儿童保育相关的活动中，报告显示男性（70%）的参与程度与女性相当或更高。参与上述任务的男性的GEM得分高于未参与的男性。
本研究结果揭示了教育水平和居住在城市地区作为马拉维东南部男性性别平等态度决定因素的重要作用。对性别规范更公平的看法与更多地参与通常分配给女性的任务以及共同决策相关。将性别因素纳入研究有助于推动建立更具包容性的医疗保健系统。
