Determinants of Men's Involvement in Maternity Care in Dodoma Region, Central Tanzania

Men's involvement in maternal health in sub-Saharan Africa: A scoping review of enablers and barriers

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.

Understanding male involvement in antenatal care in the Kilimanjaro region of Tanzania: Barriers, facilitators, and opportunities for engagement

BACKGROUND

Male engagement in antenatal care (ANC) has been recommended by the World Health Organization to improve maternal and newborn health outcomes, but implementation challenges remain. This study explored barriers, facilitators, and opportunities to improve male attendance and engagement in ANC.

METHODS

In-depth interviews were conducted individually with pregnant women and male partners attending a first ANC visit at two public health facilities in Moshi, Tanzania. Interviews examined factors influencing male ANC attendance and male experiences during the clinic visit. Interviews were recorded, transcribed verbatim, and translated from Swahili into English. Transcripts were coded thematically in NVivo.

MAIN FINDINGS

Constructions of masculinity both positively and negatively influenced male involvement in ANC. Individual-level barriers included a fear of HIV testing, perceptions of pregnancy as the woman's responsibility, and discomfort with ANC as a predominantly female space. Structural barriers included inability to take time off from work and long clinic wait times. The primary facilitator to male involvement was the preferential care given in the ANC clinic to women who present with a male partner. Additionally, some men desired to learn about their family's health status and felt that attending ANC was a sign of respect and love for their partner.

CONCLUSIONS

Opportunities exist to improve male involvement in ANC, namely training providers to engage men beyond HIV testing and counseling. Peer programs that promote men's engagement in pregnancy could prove useful to reduce apprehension around HIV testing and dispel conceptions of ANC as only a women's healthcare space.

Strategies for promoting male partner involvement in maternal, newborn and child health care in Kiambu County

Introduction

the 1994 International Conference on Population and Development (ICPD) recommended that men should share responsibility and be actively involved in sexual and reproductive health. The level of male partner involvement in Kenya remains low despite growing evidence showing its benefits in maternal and newborn health. This study sought to explore strategies for encouraging male partners to accompany their spouses to Maternal and Child Health (MCH) department.

Methods

a qualitative exploratory study was used to gather the views of nurse-midwives and invited men on mechanisms to encourage men to accompany their spouses to MCH clinic. Three and two focused group discussions (FGDs) composed of six to eight participants from nurse-midwives and men were conducted respectively. The FGDs were audio recorded and lasted 60-90 minutes. Content analysis was used to generate themes using MAXQDA 2022 software.

Results

seven categories emerged as strategies that can encourage male partner participation in the Maternal Neonatal and Child Health (MNCH) services: creating community awareness and sensitization, engaging men in the MCH department, reducing waiting time, provision of health services that address male health needs, inviting male partners to the MCH clinic, encouraging MCH staff to be receptive to couples and re-scheduling of MCH working days as well as extension of hours.

Conclusion

evidence-based strategies that adopts multi-level interventions with greater focus on community sensitization and re-organization of the MCH services are important in encouraging men accompany their spouses to clinic and actively participate in the MNCH.

Gender-based roles, psychosocial variation, and power relations during delivery and postnatal care: a qualitative case study in rural Ethiopia

Introduction

The World Health Organization (WHO) strongly encouraged men to support women in receiving maternal healthcare. However, especially in developing countries, maternal healthcare has traditionally been viewed as an issue in women, with men making little or no contribution, even though sexuality and children are shared products. The study aims to understand how gender-based roles, psychosocial variation, and power relations are related to child delivery and postnatal care (PNC) services.

Methods

The study was conducted in three rural districts of Oromia regional state, Jimma Zone, Ethiopia. An in-depth interview and focus group discussion were held with carefully chosen health professionals, health extension workers, community health development armies, and religious leaders. The data was collected, translated, and transcribed by experienced men and women qualitative researchers. For data analysis, ATLAS.ti version 9 was used. The data were coded and categorized concerning delivery and PNC service utilization. Independent and shared gender-based roles were identified as a means to improve maternal healthcare service delivery.

Results

The result obtained three categories, namely, gender-based roles, psychosocial variation, and power relations. Men can persuade pregnant women to use delivery services and PNC. The place of delivery is determined by the levels of gender-based power relations at the household level, but women are usually the last decision-makers. The belief of the community that giving birth in a health facility makes women look clean and neat, as opposed to home delivery, increases their intention to use maternal healthcare services.

Discussion

The study contributes that the role of a man as a husband is crucial in mobilizing others to carry pregnant women to health facilities, contributing to early intervention during labor. The decision-making capacity of women has improved over time, with men accepting their right to make decisions about their health and fetuses. Home delivery and men not being present during delivery are perceived as signs of backwardness, whereas giving birth in health institutes is seen as a sign of modernization and the rights of women.

Barriers to the participation of men in reproductive health care: a systematic review and meta-synthesis

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.

Reassessing the level and implications of male involvement in family planning in Indonesia

BACKGROUND

Although there is global recognition of the importance of involving men in family planning and reproductive health matters, this issue has received insufficient attention in many countries. The present study sought to characterize married Indonesian males as to their level of involvement in family planning, identify the correlates thereof and assess the implications of male involvement for unmet need for family planning.

METHODS

A mixed methods research design was used. The main source of quantitative data was 2017 Indonesian Demographic Health Survey (IDHS) data from 8,380 married couples. The underlying "dimensions" of male involvement were identified via factor analysis. The correlates of male involvement were assessed via comparisons across the four dimensions of male involvement identified in the factor analysis. Outcomes were assessed by comparing women's and couple's unmet need for family planning for the four underlying dimensions of male involvement. Qualitative data were collected via focus group discussions with four groups of key informants.

RESULTS

Indonesian male involvement as family planning clients remains limited, with only 8% of men using a contraceptive method at the time of the 2017 IDHS. However, factor analyses revealed three other independent "dimensions" of male involvement, two of which (along with male contraceptive use) were associated with significantly lower odds of female unmet need for family planning. Male involvement as clients and passive male approval of family planning, which in Indonesia empowers females take action to avoid unwanted pregnancies, were associated with 23% and 35% reductions in female unmet need, respectively. The analyses suggest that age, education, geographic residence, knowledge of contraceptive methods, and media exposure distinguish men with higher levels of involvement. Socially mandated gender roles concerning family planning and perceived limited programmatic attention to males highlight the quantitative findings.

CONCLUSIONS

Indonesian males are involved in family planning in several ways, although women continue to bear most of the responsibility for realizing couple reproductive aspirations. Gender transformative programming that addresses broader gender issues and targets priority sub-groups of men as well as health service providers, community and religious leaders would seem to be the way forward.

Community Perspective of Male Involvement in Maternal Health Care in Uttarakhand, India: A Qualitative Study

Background

Due to the significant role of male in decision making in India, they may decide if, when and where a woman may access antenatal, delivery and postnatal care; and whether or not to provide financial resources to travel to these services. Men's involvement in maternity care is recognized as a key strategy in improving maternal health and accelerating the reduction of maternal mortality. This study explores key components and challenges to male involvement in maternal health care (MHC).

Methods

Focus group discussions (FGDs) were conducted with a purposive sample of the community key stakeholders from the field practice area of All India Institute of Medical Sciences, (AIIMS) Rishikesh from October 2020 to January 2021. Manual thematic analysis with a semantic approach was used for the data analysis. Themes were prioritized using Participatory rural appraisal (PRA) technique.

Results

Twenty-three participants represented the heterogeneous group of key stakeholders. Stakeholders identified the need for improved awareness regarding MHC services among men. Husband involvement is affected by availability (work stations at different places), literacy, gender-based work domain and social cultures, finances and health facility environment.Four major themes were identified: Male involvement in antenatal, intranatal; postnatal care; and barriers to male involvement in MHC. Sub-themes under male involvement in antenatal care; intranatal care; and postnatal care were further prioritized via PRA as 'very important'; 'important' and 'not so important' and scores were given as 3, 2 and 1 respectively.

Conclusions

Male involvement is a key strategy to improve pregnancy outcome; however, different challenges exist in their involvement in the maternal health care. Current study helped to contextualize the perception regarding importance of male involvement in MHC; and the situation of study area in order to understand social and cultural factors that shape the behavior and practices of men in relation to their involvement.

Male partner involvement in postnatal care service utilization and associated factors: A community-based cross-sectional study in Motta district, Northwest Ethiopia

BACKGROUND

Male partner involvement during the postpartum period is an effective strategy to improve maternal and newborn health outcomes. However, since reproductive health has been viewed as only a woman's issue, it remains a major challenge in developing countries, including Ethiopia. The current study aimed to assess male partner involvement in postnatal care service utilization and associated factors in the Motta district of North West Ethiopia in 2020.

METHODS

A community-based cross-sectional study was conducted from March 16 to 30, 2020, among male partners whose wives gave birth in the last twelve months in Motta district. A systematic random sampling technique was used to obtain 612 study participants. Data entry was carried out by using Epi Data version 3.1 and exported to Statistical Package of Social Science version 23 for analysis. A binary and multiple logistic regression method were employed to estimate the crude and adjusted odds ratios with a confidence interval of 95% and a P value of less than 0.05 were considered statistically significant.

RESULTS

The findings from this study highlight that the overall male partner involvement in postnatal care service utilization was 20.8% at 95%CI (17.6%, 24.1%). The regression results indicated that male partners residing in urban areas, attending primary and secondary education, having good knowledge of postnatal care services, having good knowledge of danger signs and complications during the postnatal period, having a favorable attitude toward male partner involvement in postnatal care, and a short distance to health care facilities were shown to be significantly and positively associated with male partner involvement in postnatal care services.

CONCLUSION

The magnitude of male partner involvement in postnatal care service utilization was low as compared to other studies. Community-based awareness creation through health education and expanding educational and health care service institutions are essential to increase the involvement of male partners in postnatal care services.

Birth preparedness and complication readiness among husbands and its association with skilled birth attendance in southern Ethiopia

Introduction

Birth preparedness and Complication Readiness (BPCR) promotes prompt use of skilled delivery and readiness for any complications to reduce delays in the provision of emergency care. Husband’s involvement in preparation for childbirth is one way to mitigate life-threatening delays in providing care during childbirth. The current study assessed the association of the husband’s involvement in birth preparedness and complication readiness with the use of skilled birth attendants.

Method

A community-based cross-sectional study was conducted among 1,432 husbands. Study participants were selected from Arbaminch university health and demographic surveillance sites. Data were collected electronically using the Open Data Kit. The data were exported to STATA version 16 for analysis. Descriptive statistics were computed to describe the sociodemographic and reproductive variables of the study. The associations between birth preparedness and complication readiness practice and birth in the presence of a skilled birth attendant were assessed using multiple logistic regressions after adjusting for known confounders. Explanatory variables on bivariate logistic regression analysis were entered into multivariable logistic regression analysis, and a p-value of less than 0.05 was used to ascertain statistical significance.

Results

Mean age of respondents was 33.7 (SD ± 6.2) years. Of all the respondents, 140 (10.3%) had made at least three preparations according to birth preparedness and complication readiness. After controlling for confounders through multivariable logistic regression, giving birth in the presence of a skilled birth attendant consistently increased with husbands involved in birth preparedness and complication readiness (AOR = 4.1, 95% CI: 2.5–6.9). Husbands whose wives had complications during previous pregnancy were 33% less likely to have skilled birth attendants (AOR = 0.67, 95% CI: 0.49–0.917). Moreover, husbands whose houses were near the health facilities were more likely to have skilled birth attendants for their wives (AOR = 3.93, 95% CI: 2.57–6.02).

Conclusion

Husband’s involvement in birth preparedness and complication readiness is strongly associated with using skilled birth attendants in Ethiopia. It is imperative that when designing husband’s involvement programs targeting birth preparedness and complication readiness, programs and strategies should focus on enhancing activities that are inclusive of husbands in birth preparedness and complication education.

Male partners involvement in human immune deficiency virus testing and counseling during prenatal care visits in Bichena town Westcentral Ethiopia: a cross-sectional study

Objective

Transmission of the Human immune deficiency virus (HIV) from mother to child remains a significant problem in developing countries. Male partners’ involvement in HIV testing and counseling is a major entry point for the prevention of mother-to-child transmission (PMTCT) of HIV. This study aimed to assess male partners’ involvement in HIV testing and counseling during prenatal care visits in Bichena town, Westcentral Ethiopia.

Results

A community-based cross-sectional study design was conducted from October 1/2018 to June 15/2019 among 406 male partners. Less than half (41.38%) [95% CI: 36.20–46.10%] of the male partners were involved in HIV testing and counseling. In multivariable analysis male partners who are found in the age group of 20–29 years, secondary, and diploma and above educational level, good knowledge of the services provided in the prenatal care visits, male partners whose wife had ≥ 4 prenatal care visits, good knowledge of mother to child transmission (MTCT) and PMTCT of HIV, entering the prenatal care room together with his wife, discussing maternal health issue with health care providers, and travel < 15 min to reach a nearby health facility were associated with male partners involvement in HIV testing and counseling.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-022-06215-9.

Individual and intimate-partner factors associated with cervical cancer screening in Central Uganda

Intimate-partner factors have a significant effect on the uptake of services that affect maternal reproductive health outcomes. There is limited research on intimate-partner factors associated with cervical cancer screening. Therefore, this article examines the intimate-partner correlates of cervical cancer screening among married women in Central Uganda. We conducted a cross-sectional survey in Wakiso and Nakasongola districts in Central Uganda. A total of 656 married women aged 25–49 participated in the study. Frequency distributions for descriptive statistics and Pearson chi-squared tests were done to identify the association of selected individual explanatory variables and intimate-partner factors with cervical cancer screening. Finally, multivariable complementary log-log regressions were used to estimate intimate-partner factors associated with women’s cervical cancer screening uptake in Central Uganda. About 2 in 10 (20%) of the participants had been screened for cervical cancer. The following characteristics when examined separately in relation to the uptake of cervical cancer screening service and were significant: woman’s age, education attainment, occupation, wealth index, parity, male partner’s age, and male partner’s emotional support. After adjusting for independent factors, cervical cancer screening was significantly associated with women who had; attained secondary (AOR = 2.19; CI 1.18–4.06) compared to none/ primary education, and received partner’s emotional support (AOR = 30.06; CI 13.44–67.20) compared to those who did not receive partner’s emotional support. In Central Uganda, cervical cancer screening among married women was significantly associated with women’s education, and partner’s emotional support. These factors point to the importance of intimate-partner factors. Therefore, more effort should be directed at encouraging men’s participation. This should be supplemented with empowering women through education to increase uptake of screening services.

Associated Factors of Male Participation in Antenatal Care in Muaro Jambi District, Indonesia

Objective. This study aims to evaluate the level of male participation and factors associated with male participation in antenatal care. Methods. A cross-sectional study was performed, involving a survey of 381 men, selected through multistage random sampling. The outcome variable male participation in antenatal care was constructed from eight dichotomized indicators, and measurement results were low (scored 1 and 2) and high (scored 3 and 4). Multiple logistic regression analysis was performed using SPSS 24.0 at a significance level of 0.05. Results. The percentage of male participation in antenatal care was low (41.2%). Associated factors included age ( $\text{OR}=1.858$ , $95\%\text{CI}=1.066–3.240$ ), number of children ( $\text{OR}=2.909$ , $95\%\text{CI}=1.532–5.522$ ), income ( $\text{OR}=1.715$ , $95\%\text{CI}=1.060–2.775$ ), and knowledge ( $\text{OR}=3.706$ , $95\%\text{CI}=2.320–5.919$ ). Knowledge was found to be the main factor for male participation in antenatal care in Muaro Jambi Regency. Conclusion. Male participation in antenatal care in Muaro Jambi District was low and was influenced by age, number of children, income, and knowledge. Health promotion programs are needed to empower men to participate in antenatal care by providing communication, education, and information.

Factors affecting men's involvement in maternity waiting home utilization in North Achefer district, Northwest Ethiopia: A cross-sectional study

Background

Maternity waiting home (MWH) is a direct strategy to improve newborn and maternal survival. The utilization of MWH, however, remains very low in Ethiopia. Men involvement in maternal health programs is a key strategy to increase utilization of maternal health services, including MWH. This study defines men involvement in-terms of men’s participation in deciding to admit their spouse to an MWH, accompanying their spouse to an MWH, providing financial support, availing food at an MWH, and taking care of the home or children. Thus, the current study aims to identify factors affecting men’s involvement in MWH utilization.

Methods

A community-based cross-sectional study was conducted from October 1st to December 30th, 2018. Four hundred three men were involved in the study. Data were analyzed by the statistical package for social science (SPSS) version 23. Independent predictors were identified by a multivariable logistic regression model. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported.

Results

Men’s involvement in MWH was 55.6% (50.71, 60.45). Age (AOR = 0.86, 95% CI = 0.82–0.94), knowledge about MWH (AOR = 4.74, 95% CI = 2.65–8.49), decision-making power (AOR = 4.00, 95% CI = 1.38–11.57), and receiving counseling about MWH during spousal antenatal care visits (AOR = 9.15, 95% CI = 3.34–25.03) had statistically significant associations with men’s involvement in MWH utilization.

Conclusions

Nearly, half of the male partners were involved in MWH utilization. Men’s age, MWH knowledge, decision-making power, and receiving counseling were factors affecting their involvement in MWH utilization. Interventions targeting to improve male involvement in MWH utilization should focus on building men’s knowledge about MWH, increasing male involvement in ANC with an appropriate level of counseling about MWH, and changing patriarchal thinking in society with appropriate behavioral interventions such as community-based health education.

Male partners' participation in birth preparedness and complication readiness in low- and middle-income countries: a systematic review and meta-analysis

BACKGROUND

Maternal and neonatal health outcomes remain a challenge in low- and middle-income countries (LMICs) despite priority given to involving male partners in birth preparedness and complication readiness (BPCR). Men in LMICs often determine women's access to and affordability of health services. This systematic review and meta-analysis determined the pooled magnitude of male partner's participation in birth preparedness and complication readiness in LMICs.

METHODS

Literature published in English language from 2004 to 2019 was retrieved from Google Scholar, PubMed, CINAHL, Scopus, and EMBASE databases. The Joanna Briggs Institute's critical appraisal tool for prevalence and incidence studies were used. A pooled statistical meta-analysis was conducted using STATA Version 14.0. The heterogeneity and publication bias were assessed using the I2 statistics and Egger's test. Duval and Tweedie's nonparametric trim and fill analysis using the random-effect analysis was carried out to validate publication bias and heterogeneity. The random effect model was used to estimate the summary prevalence and the corresponding 95% confidence interval (CI) of birth preparedness and complication readiness. The review protocol has been registered in PROSPERO number CRD42019140752. The PRISMA flow chart was used to show the number of articles identified, included, and excluded with justifications described.

RESULTS

Thirty-seven studies with a total of 17, 148 participants were included. The pooled results showed that 42.4% of male partners participated in BPCR. Among the study participants, 54% reported having saved money for delivery, whereas 44% identified skilled birth attendants. 45.8% of male partners arranged transportation and 57.2% of study participants identified health facility as a place of birth. Only 16.1% of the male partners identified potential blood donors.

CONCLUSIONS

A low proportion of male partners were identified to have participated in BPCR in LMICs. This calls countries in low- and middle-income setting for action to review their health care policies, to remove the barriers and promote facilitators to male partner's involvement in BPCR. Health systems in LMICs must design and innovate scalable strategies to improve male partner's arrangements for a potential blood donor and transportation for complications that could arise during delivery or postpartum haemorrhage.

Women's Perception of Male Involvement in Antenatal, Childbirth and Postnatal Care in Urban Slum Areas in Bangladesh: A Community-Based Cross-Sectional Study

Male participation in reproductive health issues has been considered to be an effective and promising strategy to address the women’s reproductive health problems since the 1990s. Under this background, we aim to explore the women’s perception of men’s involvement in antenatal care (ANC), delivery and postnatal care (PNC) in the slum community of Bangladesh where various sexual and reproductive health problems exist. A community-based cross-sectional study was conducted among women and their husbands living in 12 slums of Chattogram city. Cross-tabulation with chi-square tests and multivariate logistic regression analyses were performed to examine the predictors of husbands’ support in wives’ antenatal, delivery and postnatal care. The study demonstrates that the education and economic level of most women and their husbands were very low although husbands seemed to have a better status than wives in these aspects. Almost all men (~90%) had never accessed services related to reproductive and maternal health. Only 10% of respondents gave birth to their last baby in government hospitals or private clinics. In addition, 60% of the husbands took care of their wives during pregnancy with 44% during childbirth and about 30% providing help in receiving postpartum care. Moreover, husbands’ discussions with a health worker regarding maternal and reproductive health were the most important predictors for support of their wives during pregnancy, childbirth and postpartum care (p < 0.05). Study participants’ perception of a satisfying spousal relationship also appeared to be a significant factor for husbands’ responsible role regarding wives’ antenatal care, delivery and postnatal care (p < 0.05). This study found that pregnant women living in slums received poorer health-related services when there was a low involvement of men; specifically, the husbands of pregnant women. In addition, men’s involvement was influenced by many aspects, particularly awareness-related factors (e.g., knowledge, communication and access to reproductive health services). Therefore, awareness creation is important for active involvement in antenatal, delivery and postnatal care. Strategies should be designed to provide men living in the slums with adequate information, education and communication to gain their interest and support about reproductive and maternal health.

Community perspectives: An exploration of potential barriers to men's involvement in maternity care in a central Tanzanian community

Background

Male involvement in maternal health has been linked to positive health outcomes for women and children, as they control household resources and make significant decisions, which influence maternal health. Despite of the important role they have in maternal health care, their actual involvement remains low. The objective of this study was to explore community perspectives on potential barriers to men’s involvement in maternity care in central Tanzania.

Methods

Qualitative research methods were used in data collection. We conducted 32 focus group discussions (16 FGDs with men and 16 FGDs with women) and 34 in-depth interviews with community leaders, village health workers and health care providers. Interview guides were used to guide the focus group discussions and in-depth interviews. The interviews and discussions were audio recorded, transcribed and translated into English and imported into QSR NVivo 9 software for thematic analysis. Three themes emerged from the data; men’s maternity care involvement indicators, benefits of men’s involvement in maternity health care services and barriers to men’s involvement in maternity health care services.

Results

Both men and women participants acknowledged the importance of men’s involvement in maternity health care services, even though few men actually got involved. Identified benefits of men’s involvement in maternity health care services include: Learning any risk factors directly from the health care providers and getting prepared in addressing them; and reinforcing adherence to instruction received from the health care provider as family protectors and guardians. Barriers to men’s involvement in maternity health care services are systemic; starting from the family, health care and culture-specific gender norms for maternity related behaviour as well as healthcare facilities structural constrains inhibiting implementation of couple-friendly maternity health care services.

Conclusions

Men’s involvement in maternity care is influenced by culture-specific maternity-related gender norms. This situation is compounded by the conditions of deprivation that deny women access to resources with which they could find alternative support during pregnancy. Moreover, structures meant for maternal health care services lack privacy, thus inhibiting male partners’ presence in the delivery room. Intervention to increase men’s involvement in maternity care should address individual and systemic barriers to men’s involvement.

Antenatal depression: an examination of prevalence and its associated factors among pregnant women attending Harare polyclinics

Background

Antenatal depression is the most prevalent common mental health disorder affecting pregnant women. Here, we report the prevalence of and associated factors for antenatal depression among pregnant women attending antenatal care services in Harare, Zimbabwe.

Methods

From January–April 2018, 375 pregnant women, aged 16–46 years, residing mostly in Harare’s high-density suburbs were recruited from two randomly-selected polyclinics. Antenatal depression was measured using the Structured Clinical Interview for DSM-IV. Sociodemographic data including; maternal age, education, marital status, economic status, obstetric history and experiences with violence were also collected. Chi-square tests and multivariate logistic regression analysis were used to determine the association between antenatal depression and participants’ characteristics.

Results

The prevalence of antenatal depression was 23.47% (95% CI: 19.27–28.09). Multivariate logistic regression analysis revealed intimate partner violence (IPV) [OR 2.45 (95% CI: 1.47–4.19)] and experiencing negative life events [OR 2.02 (95% CI: 1.19–3.42)] as risk factors for antenatal depression, with being married/cohabiting [OR 0.45 (95% CI: 0.25–0.80)] being a protective factor.

Conclusion

The prevalence of antenatal depression is high with associated factors being interpersonal. Context-specific interventions are therefore needed to address the complexity of the factors associated with antenatal depression.