Allowing Men to Care: Fatherhood Project in South Africa
In South Africa, men are increasingly rejecting wide-spread stereotypes of manhood by stepping forward to challenge gender roles that compromise their well-being and the health of their partners and their families. This case study documents the Sonke Gender Justice Network’s Fatherhood project, which was designed to reduce HIV transmission and address related problems, such as gender-based violence, women’s overwhelming burden of care, and the preponderance of children in need of care and support.
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Allowing Men to Care
By Saranga Jain, Margaret Greene, Zayid Douglas, Myra Betron, and Katherine Fritz
Fatherhood and Child Security Project: A Program to Engage Men on HIV, Violence, and Caregiving in South Africa
In South Africa, the end of apartheid in 1994 affected many things, including gender relations. Many men support government efforts to achieve the vision of a gender-equitable society as articulated in South Africa’s Constitution and Bill of Rights. However, men still face widespread pressures to express their manhood in more traditional ways, such as authority figures in relationships with their wives and children. While such traditional male norms give men greater decision-making power, they also limit who they are and what they can do. Many men fear being mocked—by men and women—if they enter the kitchen, care for their children, or make decisions jointly with their wives. Some fear being seen as weak if they go to a health clinic because they are sick. They may feel pressure to have many sexual partners. And a substantial number are encouraged—by the examples of men around them and by society’s failure to fully implement laws on domestic and sexual violence—to abuse women and children.
In South Africa, more and more men are rejecting the stereotypes of manhood that still exist and are stepping forward to challenge gender roles that compromise their own health and well-being and that of their partners and their families. Sonke Gender Justice Network, a nongovernmental organization that began in 2006, recognized that South African men are as trapped by gender norms as women, and that harmful male behavior is interlinked with HIV risk and sexual and gender-based violence (GBV). As part of its Training and Capacity Building Programme, Sonke Gender Justice Network created the Fatherhood and Child Security project (the Fatherhood project) to mobilize men to play an active role in changing traditional norms that are harmful to men, women, and children. The project works with local government and civil society groups to implement and evaluate programs that increase men’s involvement and capacity as fathers and caregivers, and to change negative attitudes and behaviors within these roles. This case study describes how the Fatherhood project works to develop healthy relationships between men and their families. AIDSTAR-One staff conducted interviews with the project coordinator, Patrick Godana, and Sonke Gender Justice Network’s co-director, Dean Peacock. They also reviewed project materials, including tools, evaluations, reports, and case studies that document program activities and how they address links between gender equality and HIV.
Disclaimer: The author's views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government.
Gender and HIV in South Africa
South Africa has the largest number of HIV-positive people in the world, with 5.6 million people living with HIV (Joint UN Programme on HIV/ AIDS [UNAIDS] 2010). HIV prevalence is regionally diverse among 15- to 49-year-olds; it ranges from 5.3 percent in Western Cape Province to 25.8 percent in KwaZulu-Natal Province (Shisana et al. 2009). Women disproportionately bear the burden of HIV, as they represent 57 percent of people living with HIV (UNAIDS 2008), and this disparity continues through nearly all age groups. Heterosexual sex is the primary mode of transmission, and cross-generational sex, transactional sex, early sexual debut, multiple concurrent partnerships, and substance abuse are among the many risk factors (South African National AIDS Council [SANAC] 2006), along with prevailing norms around masculinity and power that shape the context in which South Africa’s AIDS epidemic thrives.
The South African government has invested resources into the fight against AIDS, starting with the creation of the National AIDS Coordinating Committee of South Africa in 1992, followed by the formation of the SANAC in 2000, which is responsible for designing and implementing the HIV & AIDS and STI National Strategic Plan for South Africa (NSP).(1) However, while there is a lot of effort, albeit fragmented, in HIV prevention, care, and treatment programming, a national HIV monitoring system is not yet fully operationalized, further making it difficult for South Africa to track progress made toward implementing a “Three Ones” approach(2) (Republic of South Africa 2010).
While South Africa has progressively addressed human rights in areas such as education and employment rights, attempts to address gender inequality are fewer in number, and this may be attributed to institutional and legal barriers that continue to exist for some marginalized populations such as sex workers, but are slowly being removed through recent legislative action (Republic of South Africa 2010). The Criminal Law (Sexual Offences and Related Matters) Amendment Act, Number 32 of 2007, for example, fights GBV, directs attention to offenses concerning children and individuals with disabilities, and expands the definition of rape to include nonconsensual penetration.
One consequence of South Africa’s high HIV prevalence is the disproportionate burden placed on women to provide HIV-related care. A national time-use survey found that more than two-thirds of primary caregivers for people living with HIV are women, and that women carry out eight times more care work in general than men (Peacock and Weston 2008). Care for orphans and vulnerable children (OVC) also reflects a strongly gendered pattern, with widowed women caring for children in many more households than widowed men. The disproportionate burden on women is mostly the result of gender roles and expectations. Explaining masculine roles, Sonke Gender Justice Network reports, “Men don’t cook, clean, get involved in the upbringing of their children, or take care of the sick. They are seen as financial providers of their families and as the heads of households who lay the law” (Palitza 2008).
Yet male involvement in care and in raising children is becoming critical as women’s HIV-related mortality rates continue to increase. Further, women caregivers need the support of men, as HIV-related care places tremendous pressure on caregivers, taxing their physical and emotional health, weakening their ability to study or earn income, multiplying their workload, and isolating them socially.
Engagement of men is also critical, as women have limited power within relationships to avert either HIV infection or GBV without the support of partners. While South Africa’s NSP does mention the need to educate men about women’s rights and identifies patriarchal attitudes as a significant problem, not enough has been done to turn the commitments in the NSP into on-the-ground action. Further, intervention research has shown that working with men to change male attitudes and behavior around risky sex and gender equality can reduce men’s self-reported use of violence and lower women’s HIV vulnerability (Jewkes et al. 2008). Exploratory research conducted by Sonke Gender Justice Network has demonstrated that many fathers are absent from their homes as a result of migration or because they are not expected to help out in the home. When men feel disconnected from their families, they are more likely to be violent in the home and/or to engage in risky sexual behavior.
Sonke Gender Justice Network’s Approach
Sonke Gender Justice Network developed its Fatherhood project both to reduce HIV and address problems that are interlinked with the epidemic, such as GBV, women’s overwhelming burden of care, and the preponderance of children in need of care and support. Sonke Gender Justice Network identified the need to alter gender norms among men as a key component to affecting change in all of these realms. Through their own and existing research, they learned that many men care deeply about widespread levels of violence but do not know what to do about it. They also saw that many men are starting to question their own gender roles, manifested, for example, in their expressed interest in dividing work in their homes more equitably with their partners. Sonke Gender Justice Network’s strategy is to shift individual and community expectations of men’s behaviors, particularly around caregiving, as a sustainable way of addressing all of these areas of need.
Development and Implementation
To improve men’s family relationships, the Fatherhood project addresses norms that condone GBV which exacerbate the spread of HIV and leave the needs of OVC unmet. In particular, it works with men and communities to change traditional roles for men to include caring for the ill, parenting children, and supporting women in balancing workloads. The project is part of Sonke Gender Justice Network’s One Man Can (OMC) campaign, an initiative to engage men in ending violence against women and children and promoting healthy relationships.
The Fatherhood project began in November 2006 in two municipalities in rural KwaZulu-Natal and the Eastern Cape, in sites with relatively high levels of GBV. It trains and supports local government and civil society groups to address all forms of violence and to mobilize men’s greater involvement with their families. These groups are trained in:
- Developing men’s roles as fathers to help them meet children’s psychosocial and educational needs and help children get essential social services such as child grants and education
- Increasing men’s capacity to be advocates and activists in efforts to eliminate violence against women and children
- Working with men to prevent the spread of HIV and increase access to health care by OVC.
The Fatherhood project works to educate key municipality members and local government officials, as well as religious and traditional leaders, about the link between rigid concepts of masculinity and risky behavior so that these groups can better address violence, HIV, and the neglect of OVC. It trains staff and volunteers from partner organizations on how to engage men and how to monitor and evaluate the impact of projects seeking to change harmful male norms. It also establishes networks, linking government and civil society representatives, to coordinate and integrate activities around male involvement and changing social norms.
Additionally, the Fatherhood project trains local partner organizations to implement the OMC campaign in local communities, which teaches men about ending violence, preventing the spread of HIV, and advancing gender equality through community-based workshops and information, education, and communication materials, and advocacy and media. These men then roll-out the OMC campaign, often by forming either OMC Community Action Teams or OMC chapters, through which they encourage other men to prevent violence, reduce the impact of HIV, and provide support to OVC.
The Fatherhood project encourages organizations that facilitate support groups for women to create fathers-to-fathers support groups for men. Men in these support groups attend workshops where they discuss masculinities, gender stereotypes, the needs of wives and children, violence, HIV, and caregiving. These meetings use self-reflection to respond to men’s own concerns and to help them determine for themselves how they can be better husbands and fathers. These men gradually begin to change their roles within the home, taking on new responsibilities and defying social pressure to conform to traditional expectations. Some of them begin to care for the ill, helping them write wills, assisting them in accessing antiretroviral treatment, and referring them to social services. Others educate the broader community about HIV prevention, distribute condoms, and encourage community members to get tested.
The Fatherhood project encourages men in the program to attend community activities such as child care forums and marches to raise awareness about the importance of male participation and to share their experiences. These men encourage other men to participate in support groups, workshops, and program activities. Program participants become models in society on a different way to be a man, stimulating dialogue and normative change among the broader community.
A key mechanism for changing norms and behaviors is through digital storytelling, which uses the media to give adults, youth, and children an opportunity to share their experiences with violence and HIV. The stories are video recorded and shared with service providers, policymakers, and community members, giving storytellers a voice in society for the first time. The stories generate dialogue for social change on challenging issues such as masculinity and gender roles. Another initiative, PhotoVoice, allows vulnerable children to document their daily lives through photography and writing. Set in schools, the project uses these media to help children share their perspectives and issues with adults, especially men, to help adults meet the needs of children. For example, children discuss their challenges, gender inequality, experiences with their fathers, and perspectives on violence and HIV. Many children use photos and writing to express distanced relationships with fathers, the desire for their fathers to be more involved in the home, and examples of positive male models in the community. In a caption to one photo, one child wrote, “This is my father, he is 52, he is looking after the garden and we benefit from it. I love him.”
What Worked Well
Quantitative and qualitative findings, based on knowledge and opinion surveys and consultation seminars with local and government partners, show that the Fatherhood project has had a significant impact on men and their families, communities, civil society, and government.
Effects on men and families: OMC has seen increased participation from men in workshops over time. Program staff in partner organizations and some program participants also reported how attitudes and practices are shifting. In Qumbu, for example, men are becoming involved as HIV caregivers, where they were "initially ridiculed for doing work reserved for women… [but now] have quickly become role models and earned respect for their courage to do things differently and take responsibility for the goings-on in their villages" (Palitza 2008).
Men in project communities are beginning to accept new roles and behaviors that are traditionally viewed as unmanly. For example, they are spending more time parenting and meeting the needs of children and are less violent with women and children. As a man who attended Sonke Gender Justice Network workshops explained, "I learnt better ways of relating to [my girlfriend], to consult, communicate, and make decisions together… I don't solve conflict with anger and violence anymore, but show love to my girlfriend and daughter. I nurture them" (Palitza 2008). Men who received training on gender equality are taking on household responsibilities to help offset women's workloads. Men are caring for children after school, assisting them with homework, and preparing meals for them.
Similarly, children who participated in the PhotoVoice project have started talking about what gender inequality means in their own lives. The boys are also clear about wanting to be involved fathers, in contrast to their own experience.
Effects on communities: The Fatherhood project has begun to change the way communities address HIV and care for OVC, their expectations of women and men, and the extent to which institutions and policies are gender equitable. According to one partner organization located in the community of Qumbu, "Since men got involved in home-based care, we have seen many benefits and a great change of social dynamics in our community" (Palitza 2008). In Qumbu, the number of people seeking testing for HIV is increasing as a result of outreach from men (Palitza 2008). Staff in schools, health facilities, and social service programs are more willing to support fathers as caregivers of children. In Nkandla municipality, local government officials have recognized the need to involve men in addressing HIV and violence against women and children. They have expressed their commitment to establishing projects that support men's role in combating these problems.
The Fatherhood project has also helped local leaders revise traditional justice systems to adequately protect women and children. In addition to encouraging men to reflect on traditional gender roles and ways that they can supersede them, community leaders in some villages have encouraged accomplished local women to take on leadership roles. Commitment from local leaders has had a powerful impact, and many men in the community have heeded their chiefs' calls to take responsibility for their families.
Effects on civil society and government: As a result of conducting workshops, creating networks, and coordinating activities, the project has reached thousands of community members, as well as improved relationships among local government, law enforcement, and local communities. At two project sites, at least 1,200 men were trained on issues related to masculinities, fatherhood, OVC, and HIV. At the same sites, over 1,000 community members attended marches on raising awareness on these interlinked issues, and over 2,000 more attended PhotoVoice exhibitions. Furthermore, police are now attending child forum meetings, and government officials are working more cooperatively across departments and with other community leaders on issues such as engaging men, meeting the needs of OVC, and addressing GBV. Local organizations are now implementing projects that work to change harmful social norms, and these organizations are able to plan, implement, monitor, and evaluate their work as a result of the training they received. By building the capacity of government and civil society, Sonke Gender Justice Network has been able to extend its reach to more men, women, and children, in addition to helping local groups own and sustain this work.
Sonke Gender Justice Network learned that men’s HIV prevention and care attitudes and behaviors are strongly associated with norms around masculinity and that fatherhood is an important entry point for working with men. It also learned that many men are aware of their risk behaviors but are unable to adopt new practices because of strong social pressure to conform to male norms. Men who may want to support their wives may worry about being ridiculed by their partners or others in the community. Thus, Sonke Gender Justice Network realized that organizations, institutions, and communities must recognize that men are as limited by norms of masculinity as women are by gender norms that restrict them.
Men quickly recognized the links between their behavior and its consequences for themselves and their families once they had an opportunity to learn and discuss these issues. For example, Sonke Gender Justice Network shared with men the descriptions children in the community gave of their fathers: fathers were absent from their lives; they did not accompany children to school; they did not help with homework. Men were distressed to learn this and affirmed that they wanted to be part of their children’s lives. Thus, some men are responsive to adopting new roles when they are helped to make links between masculinity and undesirable behavior.
Acting in a way that is different from others requires courage and support. Sonke Gender Justice Network’s fathers-to-fathers support groups and workshops provided safe spaces for men to discuss sensitive issues and to receive peer support as they implemented new behaviors in their lives. As men became more confident in their new roles and better able to handle disparaging comments, they were able to serve as models and support for other men. Thus, peer influence can be a barrier but also an asset to changing gender norms.
Sustainability is key to ensuring changes in gender norms have positive impact in the long run on the health and lives of community members. Sonke Gender Justice Network has been training local partners in planning and implementing male engagement projects, report writing, monitoring and evaluation, and more. It also has worked to revise policies at the local and national levels so that gender equality is codified for protecting men and women in the future. As a result, local partners have adapted and replicated the materials for use in their communities and institutions. For example, community action teams were formed in each municipality, each carrying out a range of community education, mobilization and advocacy to reach and engage men for gender norms transformation. In KwaZulu-Natal and the Eastern Cape, the materials are also used by teachers to carry out HIV/AIDS and GBV prevention activities with students. Likewise, in Limpopo, the campaign and materials have been adapted for use with commercial farm workers (Colvin 2009).
In working to change entrenched gender norms, Sonke Gender Justice Network learned the value of engaging multiple actors—individuals, communities, institutions, and government agencies. Many social structures enforce concepts of masculinity and femininity, and these will serve as barriers to change unless included in program efforts. The spectrum of change approach involves various actors in incremental steps so that small changes occur gradually, giving communities the opportunity to adjust and accept new norms even as these are building to broader social change.
Though the Fatherhood project has contributed to changing the attitudes and behaviors of many men in the community around concepts of manhood, risky behavior, and positive roles for men, the shifts are gradual and some changes happen behind closed doors due to a fear of censure or disapproval from others in the community. Men are increasingly doing what was traditionally “women’s work” at home. The challenge now is to change public perceptions so that such shifts in gender roles become accepted and expected, rather than shameful. Several men were closely involved in cooking during the project, for example, but when the project was being documented, they refused to be photographed. Modeling the changed behavior is a key first step toward effecting broader social acceptance and change.
Another challenge was that for many individuals in the program, communities, civil society organizations, and government, “gender issues” often simply means women’s rights. Men in the program expressed concern that concepts such as “gender equality” were foreign ideas in South Africa. Sonke Gender Justice Network has addressed this issue by making connections between gender inequality and South Africa’s history with racism and broader concepts of social justice. It also has reminded program participants that issues such as protecting children and preventing illness are not foreign ideas. However, working with men to bring about positive changes in society is a strategy that is still new and not fully understood by many.
Sonke Gender Justice Network’s Fatherhood project has generated what appears to be an effective, replicable model for working with men to increase their involvement as husbands, partners, fathers, caregivers, and members of society. Future prospects for the Fatherhood project are promising, and Sonke Gender Justice Network’s primary objective is to sustain and scale up promising aspects of the project so that small-scale changes become part of a broader change across the country. With funding for its next phase from the Open Society Institute, Sonke Gender Justice Network intends to continue to mainstream men into the care economy. Sonke Gender Justice Network also plans to reach out to new places where men are present, including churches, sports clubs, private sector associations such as a taxi drivers’ association, schools, governing bodies, and more.
The Fatherhood project model has been endorsed by local governments, and Sonke Gender Justice Network intends to continue its work in current communities and replicate it in four new municipalities, in partnership with provincial and national governments. This will be done in part by embedding the project in local integrated development planning processes, the South African system in which municipalities prepare five-year strategic plans on social, economic, and ecological objectives along with communities and stakeholders. It will also involve providing support to staff in civil society organizations and local government in supporting the replication of the model elsewhere.
Alongside its community-based work in KwaZulu- Natal and the Eastern Cape, Sonke Gender Justice Network is involved in advocacy efforts on male engagement at the national and regional level, working closely with the National Department of Health and the National Department of Social Development as well as with UN agencies nationally and regionally. Sonke Gender Justice Network uses publications, campaigns, mass media, and community events to share men’s experiences as engaged parents, husbands, caregivers, and community members. Through mutually reinforcing projects such as the OMC campaign, Sonke Gender Justice Network plans to engage men in their programs beyond individual change to become advocates and activists in their communities, districts, and provinces. It hopes to mobilize these men, local organizations, and communities in creating a nationwide campaign for change to end GBV and promote healthy relationships.
Colvin, C. 2009. Report on the Impact of Sonke Gender Justice Network's "One Man Can" Campaign in the Limpopo, Eastern Cape and Kwa-Zulu Natal Provinces, South Africa. Johannesburg, South Africa: Sonke Gender Justice Network.
Jewkes, R., M. Nduna, J. Levin, et al. 2008. Impact of Stepping Stones on Incidence of HIV and HSV-2 and Sexual Behaviour in Rural South Africa: Cluster Randomized Controlled Trial. British Medical Journal 337:1–11.
Joint UN Programme on HIV/AIDS. 2008. Sub-Saharan Africa AIDS Epidemic Update Regional Summary. Geneva, Switzerland: Joint UN Programme on HIV/AIDS. (PDF, 481 KB) (accessed December 2011)
Joint UN Programme on HIV/AIDS. 2010. Report on the Global AIDS Epidemic. Geneva, Switzerland: Joint U.N. Programme on HIV/AIDS (PDF, 3.7 MB). (accessed December 2011)
Palitza, K. 2008. I Have Two Healthy Hands: A Group of Men in the Eastern Cape Overcame Gender Stereotypes and Cares for the Sick and Disadvantaged. Case Study. Johannesburg, South Africa: Sonke Gender Justice Network.
Peacock, D., and M. Weston. 2008. Men and Care in the Context of HIV and AIDS: Structure, Political Will and Greater Male Involvement. Geneva: UN Division for the Advancement of Women.
Republic of South Africa. 2010. Country Progress Report on the Declaration of Commitment on HIV/ AIDS. 2010 Report. (Reporting Period January 2008–December 2009). Pretoria, South Africa: Republic of South Africa.
Shisana, O., T. Rehle, L. C. Simbyai, et al. 2009. South African National HIV Prevalence, Incidence, Behaviour and Communication Survey 2008: A Turning Tide Among Teenagers? Cape Town, South Africa: HSRC Press.
South African National AIDS Council. 2006. HIV & AIDS and STI Strategic Plan for South Africa 2007– 2011. Pretoria, South Africa: South African National AIDS Council.
Sonke Gender Justice Network
Sable Centre, 41 De Korte Street, 16th Floor,
P.O. Box 31166, Braamfontein 2017, South Africa
Tel: + 27 11 339 3589 / Fax: + 27 11 339 6503
Cape Town office:
Westminster House, 4th Floor, 122 Longmarket Street,
Cape Town 8001, South Africa
Tel: + 27 21 423 7088 / Fax: + 27 21 424 5645
Patrick Godana, Project Coordinator
Email Patrick Godana
Dean Peacock, Executive Director
Email Dean Peacock
The authors would like to thank Patrick Godana, coordinator of the Fatherhood and Child Security project at Sonke Gender Justice Network, and Dean Peacock, Sonke Gender Justice Network's executive director, for their time and enthusiasm for this work. Thanks to the President's Emergency Plan for AIDS Relief Gender Technical Working Group for their support and careful review of this case study. The authors would also like to thank the AIDSTAR-One project, including staff from Encompass, LLC; John Snow, Inc.; and the International Center for Research on Women for their support of the development and publication of these case studies that grew out of the Gender Compendium of Programs in Africa.
Jain, Saranga, Margaret Greene, Zayid Douglas, Myra Betron, and Katherine Fritz. 2011. Allowing Men to Care—Fatherhood and Child Security Project: A Program to Engage Men on HIV, Violence, and Caregiving in South Africa. Case Study Series. Arlington, VA: USAID's AIDS Support and Technical Assistance Resources, AIDSTAROne, Task Order 1.