Parental responsibility is supposed to be shared. That's what awareness campaigns, official speeches, and radio messages keep repeating. But between the slogan and the reality on the ground, the gap remains vast. Young men aged 15 to 35, of an age to be or become fathers, are largely absent from family planning services, prenatal consultations, and, more broadly, from the spaces where the health of their partner and unborn child is at stake.
This report goes in search of those who embody both sides of this reality: fathers who have stayed on the sidelines, out of ignorance or social habit, and those who have chosen to get involved, profoundly changing the dynamic within their household. It also questions health professionals, policymakers, and communities about the reasons behind this absence, and the possible paths to closing the gap.
An Absent Presence in the Waiting Rooms
The observation is neither new nor confined to a single locality: in most health centers, male attendance at reproductive health services remains marginal. Prenatal consultations, family planning sessions, educational talks on contraception _ these appointments are, in practice, designed for patients, rarely for couples.
Health professionals unanimously confirm it: men who accompany their partners are the exception rather than the rule. This absence has multiple roots consultation hours scheduled around women's availability, social discomfort at occupying a space perceived as feminine and sheer unfamiliarity with what actually happens there.
"The proportion of men who get involved in their wives' prenatal consultations during pregnancy is very small. In our community, it's very rare. We can estimate it at around 5%. When they do come, it's a joy for us, and it's reassuring. Staffs are trained to address both the woman and her husband on shared topics. When a subject concerns only the woman and her husband accompanies her, we ask her permission for him to be present." Aissata Coulibaly, midwife, Sokoura Urban Health Center
This absence is not without consequence. It deprives men of essential information about their partner's health, contraceptive decisions, and the warning signs of a high-risk pregnancy. It also reinforces, implicitly, the idea that reproductive health is an exclusively female domain — an idea that several health professionals interviewed consider outdated today, yet still firmly entrenched in practice.
The Cost of Staying Away: One Father's Testimony
To understand what this absence produces, one must listen to those who lived it from the inside. A young father in his thirties looks back on the first months of his partner's pregnancy: he did not accompany her to a single prenatal consultation, learning about the ultrasounds and medical recommendations secondhand, once he got home from work. Today he acknowledges having underestimated his role, believing that "these matters concerned women."
"When my girlfriend got pregnant, I was working, bringing home the money — I thought that was enough. I didn't go with her to a single prenatal consultation. The ultrasound results, I found out about them afterward without really understanding them. Looking back, I regret not asking the medical staff more questions. She used to reproach me for never being available to go with her. Today I understand it wasn't only her business." Jaurès Sanogo, a young father, 29, who stayed on the sidelines during his partner's pregnancy
This testimony illustrates a pattern health professional’s encounter frequently: men who discover their role as fathers only at the moment of birth, without having gone through the months of preparation, decisions, and adjustments that precede a child's arrival a starting point that makes the entry into active parenting all the more difficult.
When Fathers Get Involved, Everything Changes
In contrast, other young men have made a different choice. Accompanying their partner to every consultation, asking the medical staff questions, taking part in family planning decisions, getting involved in caring for the newborn: these seemingly simple gestures are redefining the role of the father.
According to several health professionals, the benefits of this involvement go well beyond the medical realm. A couple in which the man is involved from the start of the pregnancy communicates more about contraceptive choices, plans better for expenses linked to the child's health, and navigates the early months of parenthood more calmly.
"It was seeing my partner anxious before her first ultrasound that made me decide to go with her. I learned to ask the midwife questions, to understand what she needed. Our relationship communicates so much more now, we decide together, and I've felt like a real father since the pregnancy. At first some friends made fun of seeing me in the waiting room, but today several of them come to me for advice." Landry Loukou, 32
Services Still Poorly Designed to Welcome Men
If young fathers are rarely present in health centers, the responsibility doesn't lie with them alone. The services themselves are, for the most part, organized without any real strategy for including men: hours built around women's availability, no communication targeting men, and staff sometimes poorly trained to welcome them when they do show up. Some centers, however, are beginning to experiment with new approaches: extended hours, awareness sessions open to couples, and signage and radio messages addressed directly to men.
"As part of the C'est la Vie II project, we've favored a community-based approach involving people who have a direct influence on decisions within families: religious leaders, parents, and community leaders. We trained eighteen community facilitators to run educational talks and film-debates on early pregnancy, consent, and STIs/HIV-AIDS. The film-debates in particular have opened up dialogue on subjects that had long been taboo, such as fathers' involvement in their wives' prenatal consultations, and we're now seeing a real improvement in dialogue within communities." Doumbia Kassoum, Adolescent/Youth Program Officer at the NGO Sauvons 2 Vies, C'est la Vie II project manager
Real progress, then, but the program officer is careful not to present it as sufficient.
"The main difficulty remains financial and logistical: the lack of resources limits the number of activities we can organize, and the shortage of projection equipment or the absence of electricity in certain localities holds back our work. On top of that, there are deeply rooted sociocultural resistances, particularly around questions of sexuality, contraception, and consent." He said
The Weight of Social Norms
Beyond how services are organized, it is also society's gaze that holds back young fathers' involvement. In many communities, pregnancy and childcare are still seen as "women's business" a man who is too present in these spaces risks being mocked by those around him.
This social weight is often passed down from one generation to the next, with fathers themselves reproducing the distant parenting models they inherited from their own childhood. Shifting these perceptions takes time, but also credible relays within the communities themselves: religious leaders, traditional chiefs, youth associations.
"We've always been taught that dealing with a pregnancy or a baby is women's work. Men saw their fathers do the same, and they carried on that way without questioning it. But today things are changing. More and more young men want to be present for their wife and child. The problem is that when a man accompanies his wife to the hospital, some people still make fun of him. That's why respected figures in the community : community leaders, religious leaders, and so on need to set the example and say clearly that an involved man deserves respect, not mockery." Dr. Rodolphe Sambou, sociologist
Toward Responsible, Shared Parenting
Faced with this reality, several paths are emerging to keep young fathers' involvement from remaining the exception. On the health services side, better-adapted hours and communication explicitly aimed at men are regularly cited as levers that are achievable in the short term. On the community side, involving respected figures to carry the message of active fatherhood could help shift deeply entrenched norms.
But ultimately, it may be in the testimonies of fathers already engaged that the most convincing argument lies: beyond the statistics and institutional recommendations, it is stories of stronger couples, better-monitored children, and more confident fathers that concretely sketch out what a truly shared reproductive health system could look like.
In the courtyard of the community health center, the morning scene has repeated itself dozens of times since this investigation began: women waiting, a man standing apart. But it is no longer the only story being told. A few meters away, a young father holds his partner's hand before she goes in for her consultation, asks the midwife a question, and notes the date of the next appointment on his phone. This gesture, still a minority one, sketches out what a truly shared reproductive health system could look like.
Parental responsibility is not decreed in official speeches: it is built, day after day, in waiting rooms, in homes, and in the habits each generation passes on to the next. Adapting services, dismantling perceptions, valuing fathers who are already engaged, these are the concrete actions, more than awareness campaigns that will tip the balance. As long as male involvement remains the exception, reproductive health will continue to be shared more in words than in deeds. The change has already begun; it only needs to become the rule rather than the exception.
François M'BRA II
