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Mohammed S, Yakubu I, Fuseini AG, Abdulai AM, Yakubu YH. Systematic review and meta-analysis of the prevalence and determinants of exclusive breastfeeding in the first six months of life in Ghana. BMC Public Health 2023; 23:920. [PMID: 37208682 DOI: 10.1186/s12889-023-15758-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 04/26/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Exclusive breastfeeding is a public health priority in sub-Saharan Africa. However, systematic reviews on its determinants in Ghana remain scarce. Therefore, we systematically reviewed the prevalence and determinants of exclusive breastfeeding in children 0-6 months in Ghana. METHODS We conducted systematic searches in Embase, Medline, and Africa-Wide Information from the databases' inception until February 2021 for studies that assessed the prevalence and determinants of exclusive breastfeeding in children 0-6 months in Ghana. Random-effects meta-analysis was used to estimate the pooled prevalence of exclusive breastfeeding and narrative synthesis to summarise the determinants. We calculated the proportion of total variability that was due to between study heterogeneity using I² statistics, and Egger's test assessed publication bias. The review is registered with PROSPERO, CRD42021278019. RESULTS Out of the 258 articles identified, 24 met the inclusion criteria. Most of the included studies were cross-sectional and were published between 2005 and 2021. The pooled prevalence of exclusive breastfeeding (EBF) among children 0-6 months in Ghana was 50% (95%CI 41.0-60.0%). The prevalence was higher in rural areas (54%) than in urban areas (44%). Several factors were identified as facilitators of EBF, including older maternal age, self-employment, unemployment, living in a large house, being a house owner, giving birth in a health facility, non-caesarean delivery, adequate antenatal attendance, counselling services, participation in support groups, adequate knowledge about EBF, positive attitude towards EBF, and higher maternal education among rural dwellers. Additionally, having an average birthweight facilitated EBF. Barriers to EBF were also identified, including higher maternal education among urban dwellers, less than three months of maternity leave, maternal HIV-positive status, the experience of partner violence, lack of access to radio, inadequate breastmilk production, lack of family support, having a partner who wants more children, counselling on complementary feeding, healthcare worker recommendation of complementary feed, single marital status, and infant admission to neonatal intensive care units. CONCLUSION In Ghana, EBF rates are low, with only about half of all children aged 0-6 months breastfed exclusively. A multi-dimensional approach is required to tackle the diverse sociodemographic, obstetric, and infant-related issues that hinder EBF practice in Ghana.
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Affiliation(s)
- Shamsudeen Mohammed
- MedicineDepartment of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Ibrahim Yakubu
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand.
- Department of Nursing, Nursing and Midwifery Training College, Gushegu, Ghana.
| | | | - Abdul-Malik Abdulai
- Department of Nursing, Nurses' and Midwives' Training College, Tamale, Ghana
| | - Yakubu H Yakubu
- School of Clinical Sciences, Department of Nursing, Auckland University of Technology, Auckland, New Zealand
- Department of Intensive Care Unit, Tamale Teaching Hospital, Tamale, Ghana
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Abiiro GA, Gyan EK, Alatinga KA, Atinga RA. Full title: Trends and correlates of male participation in maternal healthcare in a rural district in Ghana. SCIENTIFIC AFRICAN 2022. [DOI: 10.1016/j.sciaf.2022.e01180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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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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Reis-Muleva B, Duarte LS, Silva CM, Gouveia LMR, Borges ALV. Antenatal care in Mozambique: Number of visits and gestational age at the beginning of antenatal care. Rev Lat Am Enfermagem 2021; 29:e3481. [PMID: 34730761 PMCID: PMC8570256 DOI: 10.1590/1518-8345.4964.3481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 04/17/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE 1)to assess the gestational age at the beginning of antenatal care and its covariates; 2)to assess the number of antenatal visits and its covariates; and 3)to identify the reasons for the late initiation of antenatal care and for attending less than four visits among postpartum women living in Nampula, Mozambique. METHOD cross-sectional study conducted with 393 mothers who answered a structured instrument in face-to-face interviews. Logistic regression was used to analyze the covariates of having initiated antenatal care up to the 16thgestational week, having attended four or more antenatal visits, and reporting both situations simultaneously. RESULTS all postpartum women underwent antenatal care, but only 39.9% started it until the 16thgestational week, 49.1% attended four or more visits, and 34.1% reported both events. Having concluded high school (ORadj=1.99; 95%CI=1.19-3.31) or college (ORadj=3.87; 95%CI=1.47-10.18) were aspects associated with reporting both situations. The reasons for the late initiation of antenatal care and attending less than four visits were as follows: not finding it important to attend several visits, not having easy access to the health facility, not being aware about pregnancy, and not having a companion for the visits. CONCLUSION the gestational age at the beginning of antenatal care and the number of antenatal visits are lower than the current recommendations in the country.
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Affiliation(s)
- Belarmina Reis-Muleva
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brazil
- Bolsista da Universidade Lúrio, Nampula, Moçambique
| | - Luciane Simões Duarte
- Secretaria de Estado da Saúde de São Paulo, Coordenadoria de Controle de Doenças, Divisão de Doenças Crônicas Não Transmissíveis, São Paulo, SP, Brazil
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Suryawanshi DS, Rajaseharan D, Venugopal R. Involvement of husband in maternal and child health care in rural field practice area of a tertiary medical college in South India-A mixed method study. J Family Med Prim Care 2021; 10:2829-2833. [PMID: 34660413 PMCID: PMC8483132 DOI: 10.4103/jfmpc.jfmpc_2342_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 02/17/2021] [Accepted: 03/17/2021] [Indexed: 11/26/2022] Open
Abstract
Background: To commemorate the 25th anniversary of International Conference on Population and Development (ICPD) in the pursuit of Sexual and Reproductive Health Rights views of duty bearers (men) who are mostly not involved in antenatal care in a patriarchal society like India needs to be explored. Design: It is a mixed method study (Triangulation). Setting and Population: It was conducted in a rural field practice area of a private medical college in South India covering a population of 19,200. Objectives: 1) To determine the involvement of husband in maternal and child care. 2) To find out the perceptions of the husbands of antenatal pregnant women in maternal and child health (MCH) care. Methods: (Quan) A semi-structured questionnaire to find out the areas where husband is involved maximum during antenatal care (Qual). In-depth interviews was conducted to find out the factors associated with their involvement. Results: About 72.5% came for antenatal visits while it decreased to 27.5% during labor and further decreased to 20.3% during immunization. The reasons for decreased participation were (1) Professional Commitments, (2) Views of a Patriarchal society like India, (3) Financial Difficulties, and (4) Health Facility Related Challenges. Conclusion: There is a need to educate the husband regarding the importance of husband's involvement during delivery and immunization. Programs should also include men as the stakeholders for accountability and better MCH care for women.
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Affiliation(s)
- D S Suryawanshi
- Department of Community Medicine, Trichy SRM Medical College, Tiruchirappalli, Tamil Nadu, India
| | - D Rajaseharan
- Department of Community Medicine, Trichy SRM Medical College, Tiruchirappalli, Tamil Nadu, India
| | - R Venugopal
- Department of Community Medicine, Trichy SRM Medical College, Tiruchirappalli, Tamil Nadu, India
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Boltena MT, Kebede AS, El-Khatib Z, Asamoah BO, Boltena AT, Tyae H, Teferi MY, Shargie MB. Male partners' participation in birth preparedness and complication readiness in low- and middle-income countries: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2021; 21:556. [PMID: 34391387 PMCID: PMC8364032 DOI: 10.1186/s12884-021-03994-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 07/09/2021] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
| | | | - Ziad El-Khatib
- World Health Programme, Université du Québec en Abitibi-Témiscamingue (UQAT), Montreal, Québec Canada
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Andualem Tadesse Boltena
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Hawult Tyae
- Armauer Hansen Research Institute, Ministry of Health, Addis Ababa, Ethiopia
| | | | - Mulatu Biru Shargie
- Armauer Hansen Research Institute, Ministry of Health, Addis Ababa, Ethiopia
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Singh R, Kumar A, Kansal S. Involvement of male spouse in care during pregnancy in rural areas of district Varanasi. J Family Med Prim Care 2021; 10:2177-2183. [PMID: 34322410 PMCID: PMC8284230 DOI: 10.4103/jfmpc.jfmpc_1425_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 09/17/2020] [Accepted: 10/14/2020] [Indexed: 11/04/2022] Open
Abstract
Background Lack of male spouse involvement can affect the delays in the decision to take health care facilities, these are the main contributing factor for increasing maternal mortality and child death ratio. Men involvement in reproductive and sexual health including child health is important in reducing teenage pregnancy, maternal mortality, infant mortality, risky abortions, and total fertility rate. This study aimed to assess the awareness and practices of male spouse in maternal care services in rural areas. Methods This is a community-based and cross-sectional study which was undertaken in randomly selected four villages of Kashi Vidyapeeth block, Varanasi. Total enumeration of women from the selected villages delivered within last 3 years was done and their husbands were interviewed by using a pre-designed, pretested interview schedule. Data on socioeconomic and demographic characteristics, awareness of various aspects and antenatal and postnatal care were collected and analyzed with SPSS 20 trial version. Results Out of the total 130 interviewed male spouse (respondents), only 9.8% knows about minimum four antenatal visits. 26.9% were aware about the health related problems during pregnancy and only 7.7% were aware about the danger signs. Janani Suraksha Yojna was known to 11.5% only. 22.4% respondents accompanied their wife for antenatal registration and36.2% for T. T vaccination but 70.2% were present in the hospital during delivery. Logistic regression analysis shows that education of respondents is a key determinant of their involvement during pregnancy. Conclusions This study identified overall low awareness of male spouse about antenatal visits and involvement during antenatal care. Therefore, there is a strong need to re-strategize the involvement of male spouse in reproductive health including antenatal period.
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Affiliation(s)
- Reema Singh
- Post-Doctoral Fellow (ICSSR), Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar-Pradesh, India
| | - Alok Kumar
- Associate Professor, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar-Pradesh, India
| | - Sangeeta Kansal
- Professor, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar-Pradesh, India
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