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Moyo E, Dzinamarira T, Moyo P, Murewanhema G, Ross A. Men's involvement in maternal health in sub-Saharan Africa: A scoping review of enablers and barriers. Midwifery 2024; 133:103993. [PMID: 38626505 DOI: 10.1016/j.midw.2024.103993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 03/17/2024] [Accepted: 04/05/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Globally, there are about 800 maternal deaths every day, with low-to-middle-income countries accounting for most of these deaths. A lack of access to maternal healthcare services is one of the main causes of these deaths. In sub-Saharan Africa (SSA), one of the barriers to accessing maternal healthcare services by women is a lack of their male partners' involvement. This scoping review aimed to assess the enablers and barriers to men's involvement in maternal healthcare services. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) checklist was used as a guide for this review. We searched for peer-reviewed articles published between 2013 and 2023 in the English language from SCOPUS, ScienceDirect, PubMed, Africa Journals Online (AJOL), and Google Scholar databases. Two reviewers independently conducted the data extraction and article selection. All of the authors discussed and decided on the codes and categories for enablers and barriers after using NVivo to generate them. RESULTS Twenty-seven articles were used in this review. Of these, seventeen were qualitative studies, six were quantitative studies, and four were mixed-methods studies. The enablers of men's involvement in maternal healthcare were grouped into sociodemographic factors, health system factors, and policy factors, while barriers were grouped into sociodemographic, cultural, economic, and health system barriers. The lack of maternal health knowledge, insufficient economic resources, and unfriendly staff at healthcare facilities all contributed to a lack of involvement by men. CONCLUSION To improve men's involvement in maternal healthcare in SSA, there should be economic empowerment of both men and women, health education, and the provision of adequate infrastructure in healthcare facilities to accommodate men.
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Affiliation(s)
- Enos Moyo
- University of Kwa-Zulu Natal, College of Health Sciences, School of Nursing & Public Health, Durban, South Africa.
| | - Tafadzwa Dzinamarira
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.
| | | | - Grant Murewanhema
- University of Zimbabwe, Faculty of Medicine and Health Sciences, Unit of Obstetrics and Gynaecology, Harare, Zimbabwe
| | - Andrew Ross
- University of Kwa-Zulu Natal, College of Health Sciences, School of Nursing & Public Health, Durban, South Africa
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Paul PL, Pandey S. An examination of the factors associated with male partner attendance in antenatal care in India. BMC Pregnancy Childbirth 2023; 23:532. [PMID: 37481558 PMCID: PMC10362642 DOI: 10.1186/s12884-023-05851-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 07/12/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND A growing body of literature indicates that including male partners in antenatal care can be instrumental to improving women's health service utilization and maternal and child health outcomes. Despite this, very few studies have documented overall trends in male partner attendance and what factors influence this involvement within the Indian context. In this study, we used nationally representative data to examine levels of male partner attendance in antenatal care and the factors associated with male partner attendance. METHODS Data were used from the National Family Health Survey (NFHS-4) conducted in 2015-16. Weighted (probability weights) descriptive statistics were conducted to summarize the level of male partner attendance in antenatal care in India, and multivariable logistic regression models were constructed to estimate the factors associated with male partner attendance in antenatal care. RESULTS In 2015, of the women who had attended at least one antenatal care contact during their pregnancy, about 85% reported that their male partners had accompanied them to antenatal care contacts, with variations across regions. Level of education, household wealth, knowledge of pregnancy-related issues, men's age at marriage, region, and women's level of autonomy emerged as significant predictors of male partner attendance in antenatal care. CONCLUSIONS The results of this study highlight the multiple influences that shape male partners' attendance in antenatal care. The findings underscore the need for a multi-faceted approach to programs and interventions aimed at encouraging male partner involvement; recognizing men both as individuals, as well as being situated within the family/household and community.
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Affiliation(s)
- Pooja L Paul
- Department of Social Work, Umeå University, Umeå, 901 87, Sweden.
| | - Shanta Pandey
- School of Social Work, Boston College, Chestnut Hill, MA, USA
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Shorey S, Downe S, Chua JYX, Byrne SO, Fobelets M, Lalor JG. Effectiveness of Psychological Interventions to Improve the Mental Well-Being of Parents Who Have Experienced Traumatic Childbirth: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:1238-1253. [PMID: 34894877 DOI: 10.1177/15248380211060808] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Considering the adverse impact that traumatic childbirth experiences can have on parental mental well-being, studies that have investigated the potential of providing postnatal psychological support for this group of parents require evaluation. This systematic review aimed to examine the effectiveness of psychological interventions at improving the mental well-being of parents who have experienced traumatic childbirth in terms of anxiety, depression, fear of childbirth, and post-traumatic stress disorder (PTSD) symptoms. Seven electronic databases were searched from their respective inception dates up to January 2021. Only quantitative studies that reported the effects of psychological interventions on anxiety, depression, fear of childbirth, and/or PTSD symptoms in selective (at risk of traumatic childbirth experience) or indicated (self-defined childbirth experience as traumatic for any reason) populations of parents (mothers and/or fathers) were included. Eight studies were included and meta-analyses were conducted using a random-effect model. All studies were conducted on mothers only, and one study had minimal father involvement. Results showed that psychological interventions were more effective in reducing fear of childbirth and improving PTSD symptoms compared to anxiety and depression. Greater improvement in depression was reported at 3-8 weeks' follow-up than at immediate post-intervention. Subgroup analyses showed that technology-based interventions were feasible, and indicated interventions were more effective than selective interventions. Conducting future interventions in more geographical regions, engaging and including fathers more actively, incorporating both personalized professional therapy and informal peer support, striving for flexibility and convenience, as well as addressing topics on self-doubt and coping skills can improve current interventions.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Singapore
| | - Soo Downe
- School of Community Health and Midwifery, University of Central Lancashire, Preston, UK
| | - Joelle Yan Xin Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Singapore
| | | | - Maaike Fobelets
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Brussels, Belgium
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Roudsari RL, Sharifi F, Goudarzi F. Barriers to the participation of men in reproductive health care: a systematic review and meta-synthesis. BMC Public Health 2023; 23:818. [PMID: 37143008 PMCID: PMC10158256 DOI: 10.1186/s12889-023-15692-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 04/17/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Despite emphasizing the importance and benefits of men's active engagement in reproductive health programs, their engagement in reproductive health care is low. Researchers have identified different barriers to men's avoidance of participation in various aspects of reproductive health in different parts of the world. This study provided an in-depth review of the hindrances to men's non-participation in reproductive health. METHODS This meta-synthesis was conducted using keyword searches in databases including PubMed, Scopus, Web of Science, Cochrane, and ProQuest until January 2023. Qualitative English-language studies that investigated barriers to men's participation in reproductive health were included in the study. The critical appraisal skills program (CASP) checklist was used to assess the articles' quality. Data synthesis and thematic analysis were done using the standard method. RESULT This synthesis led to the emergence of four main themes such as failure to access all inclusive and integrated quality services, economic issues, couples' personal preferences and attitudes, and sociocultural considerations to seek reproductive healthcare services. CONCLUSION Healthcare system programs and policies, economic and sociocultural issues, and men's attitudes, knowledge, and preferences, influence men's participation in reproductive healthcare. Reproductive health initiatives should focus on eliminating challenges to men's supportive activities to increase practical men's involvement in reproductive healthcare.
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Affiliation(s)
- Robab Latifnejad Roudsari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farangis Sharifi
- Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Fatemeh Goudarzi
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
- Department of Midwifery, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran.
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Shorey S, Wong PZE. Traumatic Childbirth Experiences of New Parents: A Meta-Synthesis. TRAUMA, VIOLENCE & ABUSE 2022; 23:748-763. [PMID: 33256544 DOI: 10.1177/1524838020977161] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Childbirth is usually a joyous occasion. However, a significant proportion of parents experienced traumatic childbirths and suffered post-traumatic consequences, which needs urgent attention. Therefore, this review aimed to explore and understand the traumatic childbirth experiences of parents. A systematic review of qualitative studies was done. The consolidated evidence was meta-summarized and meta-synthesized based on Sandelowski and Barroso's approach for synthesizing qualitative research. Seven electronic databases, including PubMed, CINAHL, Embase, PsycINFO, Cochrane, Scopus, and Web of Science, were searched from each database's inception to April 2020. Retrieved studies were screened using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and 19 studies were included in this review. All included studies were meta-summarized and meta-synthesized. An overarching theme, "traumatic birth: an evolving voyage," with three main themes, (1) "proceedings to traumatic birth," (2) "internal and external battles," and (3) "muddling through to beating the odds," and 10 subthemes were identified. Overall, parents felt fluctuations of emotions that seemed to be never-ending journeys. They expressed that various factors led to their traumatic birth experiences, especially health care providers' dismissive attitudes. Parents commonly reported feelings of powerlessness and fear for the safety of mothers and infants. Their constant battles to overcome traumatic experiences affected some of their relationships. To deal with the trauma, some mothers displayed avoidance behaviors while others relied on social support. As health care providers play important roles in influencing outcomes of childbirth, they should be mindful of the care provided during labors and childbirths.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Phyllis Zhi En Wong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Gyan EK, Dugle G, Abiiro GA. Promoting male participation in maternal healthcare in the Jaman North District in Ghana: Strategies and implementation challenges. Int J Health Plann Manage 2022; 37:1754-1768. [PMID: 35178753 DOI: 10.1002/hpm.3441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/03/2022] [Accepted: 02/08/2022] [Indexed: 11/07/2022] Open
Abstract
Promoting male participation in maternal healthcare is essential for improved maternal health outcomes. This study explored existing strategies to promote male participation in maternal healthcare and assessed their implementation challenges within healthcare facilities in the Jaman North District in Ghana. A qualitative approach was implemented in April 2020. Interviews were administered to a stratified purposive sample of 18 respondents comprising six midwives and 12 male partners of postnatal mothers. All interviews were audio-recorded, transcribed, and manually analysed using thematic analysis. The findings revealed early service, male partner invitation, male partner incentivisation, public sensitization, and male informed education, as strategies to promote male participation in the district. The implementation of these strategies has been constrained by socio-cultural and health system factors, namely, perception of pregnancy as non-illness, perceived experiences gained by women during previous births, cultural stereotypes, unconducive environment of healthcare facilities, inappropriate timing of facility attendance and unexpected costs associated with male participation. Promoting male participation, therefore, requires dedicated policy attention to the existing socio-cultural and health system constraints. The Ghana Health Service and other stakeholders should consider both community-level and targeted sensitization on the benefits of male participation in maternal healthcare and a general improvement in maternal healthcare infrastructure.
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Affiliation(s)
- Emmanuel Kofi Gyan
- Graduate School (MPhil Candidate), University for Development Studies, Tamale, Ghana
| | - Gordon Dugle
- Department of Management Studies, School of Business, SD-Dombo University of Business and Integrated Development Studies, Wa, Ghana
| | - Gilbert Abotisem Abiiro
- Department of Health Services, Policy, Planning, Management and Economics, School of Public Health, University for Development Studies, Tamale, Ghana.,Department of Population and Reproductive Health, School of Public Health, University for Development Studies, Tamale, Ghana
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Lanjewar S, Nimkar S, Jungari S. Depressed Motherhood: Prevalence and Covariates of Maternal Postpartum Depression among Urban Mothers in India. Asian J Psychiatr 2021; 57:102567. [PMID: 33581370 DOI: 10.1016/j.ajp.2021.102567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 12/08/2020] [Accepted: 01/18/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND The prevalence of Postpartum Depression (PPD) in the world is estimated to range from 10 to 30%. In India, about 22% of mothers suffer from postpartum depression. PURPOSE Study objective is to examine the prevalence and covariates of postpartum depression among new mothers; and find the association between the indices of social support, partner support and attention shifting with experience of postpartum depression. METHODS A cross-sectional hospital-based study design was used. The sample for this study included 240 postnatal mothers from Pune urban areas selected randomly from three hospitals who attended postnatal check-ups or immunizations in the city. Postpartum depression was assessed using Marathi validated Edinburgh Postpartum Depression Scale (EPDS). Support from the respondents mother, mother-in law, husband, relatives was assessed for estimating Social Support Index. The husband's support was assessed for Partner Support Index; and shift of attention from mother to baby was for Attention Shift Index. Mothers who scored ≥13 on the EPDS scale were categorised as depressed. Reliability and validity of the scales and indices was checked using Chronbach's alpha. Univariate, bivariate, and logistic regression were used to determine the association of various indices with PPD. RESULTS Of the 240 mothers surveyed, 63 (26.3%) mothers scored ≥13 on EPDS and thus, were categorised as depressed. A strong statistical association was found between social support with postpartum depression (AOR:3.037; 95% CI:1.486-6.208) and unadjusted models (UOR: 2.269; 95% CI:1.056-4.87), partner support (AOR:4.979;95%CI:1.348-18.388) and attention shift from mother to baby with PPD (Both adjusted to AOR:2.618; 95%CI:1.441-4.858; and unadjusted UOR: 2.373; 95%CI:1.072-5.254). However, no significant association was found between socio-demographic variables and postpartum depression. CONCLUSION Higher levels of postpartum depression in urban mothers affect the women and their children's health. Screening of expecting mothers for possible symptoms of depression during antenatal care could reduce the chances of depression during postpartum period. Considering its prevalence, depression should be addressed in national mental health programmes. More robust research is required for better understanding of the factors responsible for postpartum depression in urban India.
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Affiliation(s)
| | - Shilpa Nimkar
- Saral Designs Solutions Private Limited, Mumbai, India.
| | - Suresh Jungari
- Department of Public Health & Mortality Studies, International Institute for Population Sciences, Mumbai, India; Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India.
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