Male involvement in sexual and reproductive health in the Mendi district, Southern Highlands province of Papua New Guinea: a descriptive study

Male support for cervical cancer screening in Debre Berhan City Ethiopia a community based cross sectional survey

Male partner involvement strongly influences a woman's decision to undergo cervical cancer screening. Women of low socioeconomic status are disproportionately affected by cervical cancer. Women living in low-and middle-income countries often encounter resistance from their partners regarding participation in cervical cancer screening. The lack of men's support for sexual and reproductive health programs, including cervical cancer screening, creates a barrier to women's utilization of health services. To assess Ethiopian men's awareness, knowledge, perceptions, and attitudes toward cervical cancer screening and their support to their female partners during screening. A community-based cross-sectional survey was conducted from June 20, 2023, to August 04, 2023. A multistage sampling procedure was used to recruit 614 male survey participants. Descriptive statistics were used to summarize sociodemographic data. Univariate and multivariate regression analyses were performed to measure the associations between the dependent and independent variables. A p-value of less than 0.05 was considered statistically significant. In this survey, 58.5% (359) of participants supported their partners for cervical cancer screening. More than half 55.9% (343) of the participants had an awareness of cervical cancer disease and 47.2% (290) participants knew the risk factors associated with the development of cervical cancer. In addition to that, 66.8% (410) of men have a positive attitude towards screening and encourage their wives to get screened if they notice symptoms of cervical cancer. Regarding the perceptions of cervical cancer, 37.0% (227) of male participants believed that their female partners were at risk of developing the disease, while 38.3% (235) of men believed that cervical cancer screening was only necessary if the woman showed symptoms. Completion of higher education (AOR = 3.75, 95% CI 1.60-8.79, p = 0.002), living with other people (AOR = 0.09, 95% CI 0.03-0.29, p < 0.0001), not being tested for HIV (AOR = 0.26, 95% CI 0.10-0.74, p = 0.011), and having information about cervical cancer (AOR = 3.33, 95% CI 1.36-8.15, p = 0.009) were statistically significantly associated with men's support for their partners in cervical cancer screening. Men's awareness, knowledge, and perceptions of cervical cancer screening were low. On the other hand, men have a positive attitude towards screening and encourage their wives to get screened if they notice symptoms of cervical cancer. This survey will serve as a basis for the development of further strategies and action plans to promote and support male participation in cervical cancer screening in Ethiopia. This can be achieved through the development of strategic plans, including public campaigns, raising awareness among social and community leaders, involving non-governmental organizations focusing on women's health, and community education.

Enablers and barriers of male involvement in the use of modern family planning methods in Eastern Uganda: a qualitative study

BACKGROUND

Male involvement plays a critical role in the utilization of various sexual and reproductive health services. We explored enablers and barriers of male involvement in the use of modern family planning methods in Eastern Uganda.

METHODS

This was a qualitative study in Mbale, Eastern Uganda done between November and December 2022. We conducted three group discussions comprising of four participants each, with male partners and eight key informant interviews with midwives. We followed a group discussion guide during the group discussions and an interview guide during the key informant interviews to explore enablers and barriers of male involvement in the use of modern family planning methods. All the interviews and group discussions were audio-recorded with permission from the participants, transcribed verbatim, and analyzed following thematic content analysis approach.

RESULTS

Two sub-themes emerged from the analysis; perceived enablers and barriers. The perceived enablers included positive attitude, subjective norms, need to support the woman, mutual consent, limited resources and expected benefits of reducing gender-based violence and sexually transmitted infections. Lack of male partner consent, busy work engagement, social stigma, religious prohibition, desire for many children and gender roles incompatibility hindered male partner involvement in family planning. Fear of side effects and misconceptions, unconducive hospital environment in form of mistreatment, family planning considered a female's issue, and lack of consideration of male partner needs in family planning clinic were additional barriers to male involvement.

CONCLUSION

Male involvement in family planning was related to positive attitude and subjective norms towards family planning, mutual consent, and recognition for limited resources to support a large family size. Lack of male partner approval, fear of side effects and misconceptions, unconducive hospital environment and social, cultural and religious prohibitions discouraged male partner involvement in family planning. Community based approaches to family planning sensitization, such as community education campaigns, may be an important step toward reducing barriers to male involvement in the use of modern family planning methods.

Women and health providers' perspectives on male support for cervical cancer screening in Gwanda district, Zimbabwe

Several studies have shown that male involvement increases the uptake of sexual and reproductive health programmes for improved family health outcomes. The role of men in reducing the burden of cervical cancer has however not been researched in Zimbabwe. It is for this reason that this study explores male support for cervical cancer screening programmes from the perspective of women and health providers in the Gwanda district of Zimbabwe. A qualitative approach that engaged thirty-six women aged 25-50 years in focus group discussions, and twenty-five health providers with different roles in the cervical cancer screening programme in in-depth interviews was used to determine their perspectives on male support for cervical cancer screening. Data were analysed thematically using ATLAS.ti Computer Assisted Qualitative data analysis software. Key findings reflected that men lacked knowledge on cervical cancer and its risk factors and prevention. Subsequently, they engaged in sexual behaviours that increased their partners' risk of acquiring Human Papillomavirus infection, the virtually necessary cause of cervical cancer. Furthermore, men did not provide the necessary emotional and financial support for their women to access screening and treatment. Participants were optimistic that innovative awareness creation strategies and intense, sustained cervical cancer education efforts targeting men could increase male partner support. Involvement of community leaders was seen as crucial in the facilitation of male involvement for programme acceptance and improved uptake of cervical cancer screening. Male involvement is seen as an integral component of the cervical cancer prevention and control programme that has to be implemented in Gwanda district to minimise male partner-related barriers to cervical cancer screening. Further research focusing on men is required to identify specific knowledge gaps that would enable development of appropriate strategies that best involve men in cervical cancer prevention and control interventions.

Community perspectives and experiences of quality maternal and newborn care in East New Britain, Papua New Guinea

BACKGROUND

Quality maternal and newborn care is essential for improving the health of mothers and babies. Low- and middle-income countries, such as Papua New Guinea (PNG), face many barriers to achieving quality care for all. Efforts to improve the quality of maternal and newborn care must involve community in the design, implementation, and evaluation of initiatives to ensure that interventions are appropriate and relevant for the target community. We aimed to describe community members' perspectives and experiences of maternal and newborn care, and their ideas for improvement in one province, East New Britain, in PNG.

METHODS

We undertook a qualitative descriptive study in partnership with and alongside five local health facilities, health care workers and community members, using a Partnership Defined Quality Approach. We conducted ten focus group discussions with 68 community members (identified through church, market and other community-based groups) in East New Britain PNG to explore perspectives and experiences of maternal and newborn care, identify enablers and barriers to quality care and interventions to improve care. Discussions were transcribed verbatim. A mixed inductive and deductive analysis was conducted including application of the World Health Organisation (WHO) Quality Maternal and Newborn Care framework.

RESULTS

Using the WHO framework, we present the findings in accordance with the five experience of care domains. We found that the community reported multiple challenges in accessing care and facilities were described as under-staffed and under resourced. Community members emphasised the importance of good communication and competent, caring and respectful healthcare workers. Both women and men expressed a strong desire for companionship during labor and birth. Several changes were suggested by the community that could immediately improve the quality of care.

CONCLUSIONS

Community perspectives and experiences are critical for informing effective and sustainable interventions to improve the quality of maternal and newborn care and increasing facility-based births in PNG. A greater understanding of the care experience as a key component of quality care is needed and any quality improvement initiatives must include the user experience as a key outcome measure.

Investigating different dimensions of infertile women's quality of life: a descriptive cross-sectional study

BACKGROUND

Infertility is a major challenge in the life of women which affects their quality of life. Infertile women's quality of life is a relatively new field of research that has recently been considered by health researchers. However, there has been no standard tool for measuring different aspects of infertile women's quality of life with female factors, and general and specific tools of infertile couples have been used to assess their quality of life. This study, thus, aimed to analyze different aspects of the quality of life of infertile women.

METHODS

This descriptive cross-sectional study was conducted on 320 infertile women referred to a teaching hospital affiliated with Mazandaran University of Medical Sciences and private infertility treatment centers in Sari, Iran. Demographic and fertility characteristics and the quality of life questionnaire for infertile women questionnaire (a 25-item tool was designed which measured 7 factors of psychological effects, sexual life with infertility family and social effects, infertility-related concerns, physical effects, adaptive approaches and factors preventing infertility adaptation), were recruited for data gathering. Data were analyzed using SPSS version 22. Descriptive statistics (percentage, mean, standard deviation), correlation coefficient, independent sample t-test, and multiple linear regression were used. P-values less than 0.05 were considered statistically significant.

RESULTS

The total mean score of infertile women's quality of life was 65.68 ± 8.91%. Findings were indicative of infertile women's quality of life in the dimensions of adaptive approach (70.48 ± 15.02%), psychological (67.88 ± 12.06%), family and social (64.63 ± 10.76%), physical, 63.42 ± 11.36%), inhibitory factors/ factors preventing adaptation (60.98 ± 8.24%), related concerns (51.52 ± 10.21%) and sexual life (40.12 ± 14.28%). According to the final multiple linear regression model, women's education (B = 2.57, p < 0.001), spouse's education (B = 1.56, p = 0.046), economic status (B = 1.64, p < 0.001), age of women (B = -0.62, p < 0.001), age of spouse (B = -0.65, p < 0.001), duration of infertility (B = -0.36, p = 0.024) and duration of marriage (B = -0.39, p = 0.022) were the final predictors of the quality of life score in infertile women of the study.

CONCLUSION

Given that infertility causes extensive changes in individuals, families, and social dimensions of infertile women, it can affect their quality of life. We can take steps to improve the health of infertile women by promoting various dimensions of their quality of life.

"Men are the head of the family, the dominant head": A mixed method study of male involvement in maternal and child health in a patriarchal setting, Western Nigeria

INTRODUCTION

The importance of involving men in reproductive, maternal and child health (RMCH) programs is increasingly recognized globally. In Nigeria, most MCH services do not actively engage fathers.

AIM

To assess men's knowledge, involvement in MCH and the barriers in Southwest Nigeria. Predictors of good knowledge and involvement were also assessed.

METHODS

This was a community-based cross sectional study. Quantitative and qualitative methods were used in data collection which was done within a period of three months in 2018. Quantitative data were collected with interviewer administered questionnaires from 418 respondents who were selected by multistage sampling methodology. The topic was further explored using focus group discussion (FGD). Quantitative data were analysed using EPI-INFO version 7. Quantitative variables were summarized using means and standard deviations while multivariable analysis was carried out to determine predictors of good knowledge and involvement in MCH. A combination of deductive and inductive analysis was used for the qualitative data.

RESULTS

Overall, 65% of men had good knowledge of MCH while 60.8% had good involvement. Predictors of good knowledge were being a Christian (AOR 1.674, 95% CI 1.045-2.679), being of Yoruba tribe (AOR 1.753, 95% CI 1.100-2.796), having post-secondary education (AOR 1.984, 95% CI 1.002-3.928), having more under-fives in the household (AOR 2.162 95% CI 1.365-3.425) and spouse having post-secondary education (AOR 2.755, 95% CI 1.189-6.382). Predictors of good involvement in MCH include higher educational level of spouse: secondary (AOR 2.852, 95% CI 1.214-6.699), post-secondary (AOR 2.270, 95% CI 1.000-5.161) and having good knowledge of MCH (AOR 2.518, 95% CI 1.587-3.994). From the FGD, other factors which influence involvement were related to traditional/cultural orientation, time constraint and finance among others.

CONCLUSION

Men's knowledge and their involvement in maternal and child health were sub-optimal. For improvement, community-based intervention programmes should be designed for men and implemented, taking into consideration their traditional/cultural roles, religious orientation, busy schedules, and educational backgrounds. They should be re-oriented on their patriarchally informed belief about their perceived roles in RMCH.

Community Perspectives on Contraception in the Context of Zika Virus in American Samoa and the Commonwealth of the Northern Mariana Islands

The prevention of unintended pregnancy was identified as a primary prevention strategy to reduce Zika-related adverse birth outcomes during the 2016-2017 Zika virus outbreak. The Centers for Disease Control and Prevention in partnership with local health agencies conducted formative research to guide the development of culturally appropriate messages and materials to increase awareness of the prevention of unintended pregnancy as a strategy to decrease Zika-related adverse outcomes in American Samoa and the Commonwealth of the Northern Mariana Islands (CNMI). Nine focus groups (N=71) were conducted with women and men aged 18-44 years living in American Samoa and CNMI. Semi-structured interview guides were used to explore participants' knowledge and perceptions of Zika, family planning, and contraception; barriers and facilitators to access contraception and use; and information sources and contraception decision-making. Trained staff from local organizations co-moderated each focus group. Thematic analysis was conducted with NVivo 10. Participants had mixed knowledge about Zika virus and its relation to pregnancy and birth defects. Women and men had varied knowledge of the full range of contraceptive methods available in their jurisdiction and identified barriers to contraceptive access. Social factors including stigma, gender roles, and religion often deterred participants from accessing contraceptive services. Participants highlighted the need for culturally appropriate and clear messaging about contraceptive methods. Results demonstrate the feasibility of conducting formative research as an effective strategy for understanding community perspectives on unintended pregnancy prevention in the context of the Zika virus outbreak to develop health communication materials.

Contraceptive discontinuation among women of reproductive age in Papua New Guinea

Background

Papua New Guinea has one of the lowest contraceptive prevalence rates among women of reproductive age in the Western Pacific Region and this makes contraceptive discontinuation in this country a critical public health issue worth studying. This study sought to assess the factors associated with contraceptive discontinuation among women of reproductive age in Papua New Guinea.

Methods

The data used for the analysis were obtained from the Papua New Guinea Demographic and Health Survey which was conducted in 2016–2018. The outcome variable for this study was contraceptive discontinuation among women of reproductive age. Crude odds ratios and adjusted odds ratios with 95% confidence intervals were estimated using binary logistic regression.

Results

About 33.26% of the women discontinued injectables, 19.15% discontinued pills and 3.77% discontinued other contraception methods. Women aged 20–24 [aOR = 2.12, CI = [= [1.04,4.31] through to those aged 30–34 [aOR = 1.98, CI = 1.03,3.79] had higher odds to discontinue contraceptive usage compared to those aged 45–49. Women with no information on choice of contraception [aOR = 2.85, CI = 2.31,3.51], those with two or more births in the last five years [aOR = 2.35, CI = 1.65,3.35] and those living in the Highland region [aOR = 1.71, CI = 1.28,2.29] were more likely to discontinue contraceptive usage compared with those with information on contraceptive choices, those with no births and those living in the Island region respectively. However, women in the rural areas [aOR = 0.78, CI = 0.61,0.99], women using LARC [aOR = 0.10, CI = 0.06,0.15], injectables [aOR = 0.43, CI = 0.30,0.63] and other modern contraception methods including condom [aOR = 0.22, CI = 0.15,0.34] were less likely to discontinue contraceptive usage.

Conclusion

A nationwide mass education on the benefits of contraception is recommended for the Papua New Guinea National Department of Health to tackle the key findings of this study which were high contraceptive discontinuation prevalence with lack of information on choice, disproportionately high contraceptive discontinuation rate in the Highland Region and the desire to give birth to more than two children as some factors associated with contraceptive discontinuation in Papua New Guinea.

Maternal, Sexual and Reproductive Health in Marginalised Areas: Renewing Community Involvement Strategies beyond the Worst of the COVID-19 Pandemic

The COVID-19 pandemic and resultant lockdowns have brought unprecedented challenges for Maternal, Sexual and Reproductive Health (MSRH) services. Components of MSRH services adversely affected include antenatal, postnatal, and newborn care; provision of family planning and post-abortion care services; sexual and gender-based violence care and prevention; and care and treatment for sexually transmitted infections including HIV. Resuscitating, remodeling or inventing interventions to restore or maintain these essential services at the community level, as a gateway to higher care, is critical to mitigating short and long-term effects of the COVID-19 pandemic on essential MSRH. We propose a possible framework for community involvement and propose integrating key information, education, and communication of MSRH messages within COVID-19 messages.

Prevalence and determinants of the involvement of married men in family planning services in Ethiopia: A systematic review and meta-analysis

Background:

Male involvement in family planning includes not only using contraceptives but also encouraging and supporting their partners’ contraception needs and choices, encouraging peers to use family planning, and influencing policy to make male-related programs more conducive. In Ethiopia, the prevalence and associated factors of male involvement in family planning were highly inconsistent across studies. As a result, the goal of this study was to use a systematic review and meta-analysis to estimate the pooled prevalence of male involvement in family planning and its associated factors in Ethiopia.

Methods:

Electronic literature search using PubMed, Google Scholar, EMBASE, HINAR, Scopus, and Web of Sciences were performed without time restriction to identify the primary studies. Data were extracted using a pretested standardized data extraction format and analyzed using STATA 14 statistical software. A random-effect model was used to estimate the pooled prevalence of male involvement.

Results:

A total of 17 studies were included to give the pooled prevalence of male involvement in family planning in Ethiopia, which was 39.66% (95% confidence interval = 29.86, 49.45). Educational status (adjusted odds ratio = 1.99, 95% confidence interval = 1.26, 3.14), discussion of family planning with wife (adjusted odds ratio = 4.15, 95% confidence interval = 2.21, 7.80), knowledge (adjusted odds ratio = 1.83, 95% confidence interval = 1.26, 2.64), positive attitude about family planning (adjusted odds ratio = 2.57, 95% confidence interval = 1.70, 3.90), and approval of contraceptive use (adjusted odds ratio = 2.57, 95% confidence interval = 1.70, 3.90) were found to be significantly associated with involvement of men in family planning service.

Conclusion:

The overall prevalence of male involvement in family planning in Ethiopia was significantly low. Male involvement in family planning should be made available, accessible, and advocated for by government and non-governmental organizations, service providers, program planners, and stakeholders. In addition, to increase the role of men in the use of family planning services, a conducive environment for education, behavioral change, and open discussion about reproductive health issues is required.

Family planning in Pacific Island Countries and Territories (PICTs): A scoping review

The use of contraceptives for family planning improves women's lives and may prevent maternal deaths. However, many women in low and middle-income countries, including the Pacific region, still die from pregnancy-related complications. While most health centres offer family planning services with some basic contraceptive methods, many people do not access these services. More than 60% of women who would like to avoid or delay their pregnancies are unable to do so. This scoping review identifies and analyses evidence about family planning service provision in Pacific Island Countries and Territories (PICTs), with the aim of better informing family planning services for improved maternal health outcomes in the Pacific. We used Arksey and O'Malley's scoping review guidelines, supported by Levac, Colquhoun and O'Brien to identify gaps in family planning service provision. Selected studies included peer-reviewed publications and grey literature that provided information about family planning services from 1994 to 2019. Publication data was charted in MS Excel. Data were thematically analysed and key issues and themes identified. A total of 45 papers (15 peer-reviewed and 30 grey literature publications) were critically reviewed. Five themes were identified: i) family planning services in the Pacific; ii) education, knowledge and attitudes; iii) geographical isolation and access; iv) socio-cultural beliefs, practices and influences; and v) potential enabling factors for improved family planning, such as appropriate family planning awareness by health care providers and services tailored to meet individual needs. While culture and religion were considered as the main barriers to accessing family planning services, evidence showed health services were also responsible for limiting access. Family planning services do not reach everyone. Making relevant and sustainable improvements in service delivery requires generation of local evidence. Further research is needed to understand availability, accessibility and acceptability of current family planning services for different age groups, genders, social and marital status to better inform family planning services in the Pacific.

Men's perceptions of sexual and reproductive health education within the context of pregnancy and HIV in Zambia: a descriptive qualitative analysis

BACKGROUND

Although health care providers are beginning to focus on men's roles as fathers and husbands, there is limited understanding of how men view their ability to promote sexual and reproductive health in families affected by HIV and their experiences with receiving education through antenatal care. This paper aims to explore men's perceptions of the education they need regarding sexual and reproductive health within the family in the context of HIV.

METHODS

We interviewed a convenience sample of 18 male partners of pregnant women living with HIV in Lusaka, Zambia. Atlas.ti was used to facilitate data management and content analysis.

RESULTS

Men reported being the primary decision-makers regarding sexual and reproductive issues in the family; however, they admitted far-reaching unmet needs in terms of information on sexual and reproductive health in the context of HIV. Most men felt that antenatal care was not a conducive setting to fully educate men on sexual and reproductive health because it is a woman's space where their health concerns were generally neglected. There was a strong desire for more education that was specific to men's sexual and reproductive health, especially because all the couples were affected by HIV. Men especially requested education on sexual preparedness, safe sex, the use of condoms in sero-concordant and sero-discordant relationships and general health information. Although men stated they were the main decision-makers regarding sexual and reproductive issues such as pregnancy, most men were not confident in their ability to promote sexual and reproductive health in the family because of limited knowledge in this area.

CONCLUSION

There is need to change the environment and messaging of antenatal care, as well as offer relevant education opportunities outside health facility settings to empower men with essential information for meaningful involvement in sexual and reproductive health in the context of HIV.

"You Cannot Catch Fish Near the Shore nor Can You Sell Fish Where There Are No Customers": Rethinking Approaches for Reaching Men With HIV Testing Services in Blantyre Malawi

HIV testing is the entry point to the cascade of services within HIV care. Although Malawi has made positive strides in HIV testing, men are lagging at 65.5% while women are at 81.6%. This study explored the preferences of men on the avenues for HIV testing in Blantyre, Malawi. This was a descriptive qualitative study in the phenomenological tradition in seven public health facilities in Blantyre, Malawi, among men and health-care workers (HCWs). We conducted 20 in-depth interviews and held 14 focus group discussions among 113 men of varying HIV statuses. All our participants were purposively selected, and data were digitally recorded coded and managed through NVivo. Thematic analysis was guided by the differentiated service delivery model. Men reported a preference for formal and informal workplaces such as markets and other casual employment sites; social places like football pitches, bars, churches, and "bawo" spaces; and outreach services in the form of weekend door-to-door, mobile clinics, men-to-men group. The health facility was the least preferred avenue. The key to testing men for HIV is finding them where they are. Areas that can be leveraged in reaching men are outside the routine health system. Scaling up HIV testing among men will require targeting avenues and operations outside of the routine health system and leverage them to reach more men with services. This suggests that HIV testing and counseling (HTC) uptake among men may be increased if the services were provided at informal places.

Risk factors and knowledge associated with high unintended pregnancy rates and low family planning use among pregnant women in Papua New Guinea

Unintended pregnancy is a major driver of poor maternal and child health in resource-limited settings. Data on pregnancy intention and use of family planning (FP) is scarce in Papua New Guinea (PNG), but are needed to inform public health strategies to improve FP accessibility and uptake. Data from a facility-based cross-sectional sample of 699 pregnant women assessed prevalence and predictors of unintended pregnancy and modern FP use among pregnant women in East New Britain Province, PNG. More than half (55%) the women reported their pregnancy as unintended. Few (18%) reported ever having used a modern FP method, and knowledge of different methods was low. Being single, separated or divorced (AOR 9.66; 95% CI 3.27–28.54), educated to a tertiary or vocational level (AOR 1.78 CI 1.15–2.73), and gravidity > 1 (AOR 1.43 for each additional pregnancy CI 1.29–1.59) were associated with unintended pregnancy; being accompanied by a male partner to ANC was associated with a reduced unintended pregnancy (0.46 CI 0.30–0.73). Factors associated with modern FP use included male partner involvement (AOR 2.26 CI 1.39–3.67) and gravidity > 1 (AOR 1.54 for each additional pregnancy CI 1.36–1.74). FP use also varied by the facility women attended. Findings highlight an urgent need for targeted interventions to improve FP knowledge, uptake and access, and male partner involvement, to reduce unintended pregnancies and their complications.

Quality of life among infertile women living in a paradox of concerns and dealing strategies: A qualitative study

Aim

The current work investigated the issues that cause apprehension in infertile women, the effects of this disquiet on their quality of life and the strategies that they adopt in dealing with their concerns.

Design

The qualitative research.

Method

This qualitative research sampled participants from a training centre in Mazandaran University of Medical Sciences and a privately owned infertility centre in Mazandaran Province, north of Iran. Purposive sampling continued until data saturation was reached. We conducted a conventional content analysis of the responses of 30 individuals (15 women with female infertility and 15 key informants) to in-depth and semi-structured in-person interviews on May to November 2019 .

Results

The results uncovered two themes subsuming four categories of issues: The first theme revolves around "infertility concerns," under which "concerns" and "the difficulty and vagueness of treatment" belonged. The second theme was "dealing with infertility," which covered "adaptive strategies" and "inhibitors of reconciliation with perceived infertility."

Community attitudes and gendered influences on decision making around contraceptive implant use in rural Papua New Guinea

Background

Despite targeted interventions to improve contraceptive implant acceptability and uptake in rural Papua New Guinea (PNG), ongoing use of this method remains limited. Previous literature has suggested community attitudes and intrinsic factors within the decision-making process may be negatively impacting on implant uptake, however these elements have not previously been studied in detail in this context. We set out to explore community attitudes towards the contraceptive implant and the pathways to decision making around implant use in a rural community on Karkar Island, PNG.

Methods

We conducted 10 focus-group (FGD) and 23 in-depth interviews (IDI) using semi-structured topic guides. Key sampling characteristics included age, exposure or non-exposure to implants, marital status, education and willingness to participate in discussion. Four FGDs were held with women, four with men and two with mixed gender. IDIs were carried out with five women (current implant users, former implant users, implant never users), five men, five religious leaders (Catholic and non-Catholic), four village leaders and four health workers. Two in-depth interviews (four participants) were analysed as dyads and the remaining participant responses were analysed individually.

Results

Men were supportive of their wives using family planning but there was a community-wide lack of familiarity about the contraceptive implant which influenced its low uptake. Men perceived family planning to be ‘women’s business’ but remained strongly influential in the decision making processes around method use. Young men were more receptive to biomedical information than older men and had a greater tendency towards wanting to use implants. Older men preferred to be guided by prominent community members for decisions concerning implants whilst young men were more likely to engage with health services directly.

Conclusions

In communities where a couple’s decision to use the contraceptive implant is strongly coloured by gendered roles and social perceptions, having a detailed understanding of the relational dynamics affecting the decision-making unit is useful in targeting future healthcare interventions. Engaging groups who are reluctant to connect with health information, as well as those who are most influential in the decision making process, will have the greatest impact on increasing implant acceptability and uptake.

Male partners' involvement in pregnancy related care among married men in Ibadan, Nigeria

BACKGROUND

Maternal death remains a public health burden in the developing countries including Nigeria and the major causes are pregnancy related. Lack of male involvement in pregnancy related care is one of the contributing factors. Previous studies on male involvement focused on family planning services and were majorly targeted at women. This study, therefore, was carried out to assess the knowledge, perception and involvement of male partners in pregnancy related care among married men in Ibadan, Nigeria.

METHODS

A cross sectional study was conducted using a four-stage sampling technique to select 367 married men in an urban community in Ibadan. A semi-structured, interviewer-administered questionnaire was used to obtain information on the knowledge, perception and involvement of respondents regarding pregnancy related care. Responses to questions on knowledge of pregnancy related care were converted to a 33-point scale. Scores greater than or equal to the mean knowledge score (26.2) were categorized as good knowledge of pregnancy related care. Similarly, responses to involvement in pregnancy related care questions were converted to a 24-point scale with scores greater than or equal to the mean (15.1) classified as good involvement in pregnancy related care. Data were analyzed using descriptive statistics and association between qualitative variables was established using Chi-square test at p < 0.05.

RESULTS

Sixty-three percent had good knowledge of pregnancy related care. Majority believed that they had roles to play in their partners' care during pregnancy (89.9%), labor and delivery (92.9%), and in newborn care (97.5%). Overall, 56.9% had good involvement in pregnancy related care. About 20% followed their partners to antenatal care (19.6%) and postnatal (19.9%) clinics. A significantly higher proportion of respondents with good knowledge accompanied their partners for antenatal care (p = 0.008) and postnatal care clinic (p = 0.014); participated in birth preparedness (p < 0.001) and assisted with newborn care (p < 0.001). Job demands, social stigma and long waiting time at the health facilities were reasons highlighted for non-involvement in pregnancy related care.

CONCLUSIONS

The study revealed gaps in knowledge and involvement in pregnancy related care. There is a need for reproductive health policy review to strongly emphasize the need for involvement of male partners in reproductive health issues including pregnancy related care.

Supported motherhood? An examination of the cultural context of male participation in maternal health care among tribal communities in India

In many cultural settings worldwide, within families, men tend to be responsible for important choices relating to the allocation of household resources and care-seeking behaviour that directly impact on the health of women and newborns. This study examines the extent of male participation in antenatal care (ANC), delivery, postnatal care (PNC), household chores and providing food to wives among tribal communities in India. In addition, health care providers’ views on male participation in maternal health were examined. Primary data were collected from 385 men aged 15–49 from rural Gadchiroli District in Maharashtra, India. Interviews of 385 men whose wives had delivered a child within the previous 2 years were conducted between November 2014 and March 2015. Bivariate and multivariate analyses were done. The results showed that the tribal men’s participation in maternal health care was minimal. Around 22% of the men reported accompanying their wives to ANC, 25% were present at the time of delivery of their children and 25% accompanied their wives to PNC. Participation in household work, and support for wives in other ways, were slightly better. The main reason given by men for not participating in maternal health care was that they didn’t think it was necessary, believing that all maternal health issues were women’s concern. Health care providers among these tribal communities in India should encourage men to participate in issues related to maternal health care.

Health care providers' perspectives on delivering gender equity focused family planning program for young married couples in a cluster randomized controlled trial in rural Maharashtra, India

Background: There is increasing programming and research on male engagement and gender-equity (GE) counselling in family planning (FP) services. However, there is a lack of data on healthcare provider’s perspectives on delivering these interventions. The objective of the paper is to present providers’ perspectives on delivering a GE-focused FP intervention, CHARM, to married couples in rural India.

Methods:  In-depth interviews were carried out with 22 male village health care providers who were delivering a GE-focused FP intervention, CHARM, to 428 husbands (247 couples) rural Maharashtra, India. Providers were interviewed on their experiences and perspectives during delivery of CHARM. Major domains were identified during a thematic analysis.

Results: Local male health providers are interested and can be engaged in delivering a GE-focused FP intervention. Providers believed that the CHARM intervention improves couples’ communication, contraceptive use and strengthened their own capacity to provide FP services in accordance with national FP programmatic efforts. Providers found the low-tech flipchart including pictures and information helpful in supporting their service provision. Providers reported some challenges including lack of privacy and space for counselling, limited access to contraceptive options beyond pill and condom, numerous myths and misconceptions about contraceptives. Providers also reported persistent social norms related to expectancy of pregnancy early in marriage, and son preference.

Conclusions: Providers in rural areas with high fertility and related maternal health complications are interested in and can successfully implement a GE-focused FP intervention. Future efforts using this approach may benefit from greater focus to support broader array of spacing contraceptives particularly among first time parents, none or one child parents. There is a need to better support engagement of wives possibly through female provider led sessions parallel to male programs, i.e. gender synchronized rather than couples’ sessions.

Trialregistration: ClinicalTrials.gov  NCT01593943, May 8, 2012.

Assessment of mobile health technology for maternal and child health services in rural Upper West Region of Ghana

OBJECTIVES

This study assessed the perspectives of women and health workers on the feasibility of using mobile health technology (mHealth) for the provision of maternal and child health services in rural settings of the Upper West Region of Ghana.

STUDY DESIGN

The study used a mixed-design approach of quantitative and qualitative methods.

METHODS

Interviewer-administered questionnaires, focus group discussions (FGDs), and key informant interviews (KIIs) were employed. Participants included pregnant women, lactating mothers, and health workers from three rural districts.

RESULTS

A total of 489 interviews were conducted, consisting of 290 pregnant women and 199 lactating mothers, with an average age of 26.9 years. Some level of formal education had been received by 67.1% of participants. The mHealth intervention was implemented in the study districts via mobile phones in the form of SMS voice messages, text messages, and phone call reminders. Our results show that participants who received follow-up call reminders and messages (10.2%) from health providers about their health expressed general satisfaction and high optimism toward receiving future follow-ups via their mobile phones. The high acceptability level was also demonstrated in the FGDs and KIIs. Overall, our findings showed that this mHealth intervention was an acceptable and feasible solution to the challenges of access to healthcare services seen in rural areas. Despite the high acceptability level, participants also highlighted barriers, such as limited or erratic power supply and poor mobile network connectivity, which need to be addressed.

CONCLUSIONS

mHealth interventions targeting health providers and rural women have the potential to reduce barriers to equitable access to maternal and child healthcare services in these settings. These findings are of clear public health importance and are relevant to policy-makers in this area of service delivery and use; however, policy-makers and program implementers should be cautious of the challenges involved in the scale-up of such an intervention.

Factors influencing male participation in reproductive health: a qualitative study

INTRODUCTION

Male involvement in reproductive health is an essential component in promoting maternal and family health. In Nepal, men are not actively engaged in most maternal and child health (MCH) services nor in other reproductive health programs. There is a need to know about the understanding of key professionals in such practices. This study explores gendered perspectives among teachers and health professionals to understand the factors contributing to male involvement in reproductive health.

METHODS

The data were collected through two focus group discussions (FGDs) and seven key informant interviews (KIIs). FGDs were held among male teachers of selected schools, and KIIs were conducted with health professionals of the health post of Bungamati, Lalitpur. An unstructured interview guide was used to explore their experiences and perceptions. All KIIs and FGDs were recorded, translated and transcribed verbatim.

RESULTS

Findings show limited male involvement in reproductive health. Participants reported several hindering and challenging factors such as sociocultural and psychological norms, lack of education, and misinformation and dominance of female as health care providers in many MCH clinics. Perceived motivating factors included positive attitude in men, literacy and awareness, inclusion of reproductive health in school curriculum and certain incentives. Participants also recommended a range of strategies for increasing men's involvement in reproductive health in Nepal.

CONCLUSION

Men's education and attitude, knowledge and awareness, sociocultural factors, psychological factors, health system factors, and policies play important roles in male involvement in reproductive health. Programs on effective implementation of men involvement in reproductive health initiatives should address the barriers and challenges to men's supportive activities. This study also suggests increasing literacy of reproductive health among men that enhances their positivity and motivates them to participate in reproductive health services.

Expectant fathers' participation in antenatal care services in Papua New Guinea: a qualitative inquiry

Background

The importance of engaging men in maternal and child health programs is well recognised internationally. In Papua New Guinea (PNG), men’s involvement in maternal and child health services remains limited and barriers and enablers to involving fathers in antenatal care have not been well studied. The purpose of this paper is to explore attitudes to expectant fathers participating in antenatal care, and to identify barriers and enablers to men‘s participation in antenatal care with their pregnant partner in PNG.

Methods

Twenty-eight focus group discussions were conducted with purposively selected pregnant women, expectant fathers, older men and older women across four provinces of PNG. Fourteen key informant interviews were also conducted with health workers. Qualitative data generated were analysed thematically.

Results

While some men accompany their pregnant partners to the antenatal clinic and wait outside, very few men participate in antenatal consultations. Factors supporting fathers’ participation in antenatal consultations included feelings of shared responsibility for the unborn child, concern for the mother’s or baby’s health, the child being a first child, friendly health workers, and male health workers. Sociocultural norms and taboos were the most significant barrier to fathers’ participation in antenatal care, contributing to men feeling ashamed or embarrassed to attend clinic with their partner. Other barriers to men’s participation included fear of HIV or sexually transmitted infection testing, lack of separate waiting spaces for men, rude treatment by health workers, and being in a polygamous relationship. Building community awareness of the benefits of fathers participating in maternal and child health service, inviting fathers to attend antenatal care if their pregnant partner would like them to, and ensuring clinic spaces and staff are welcoming to men were strategies suggested for increasing fathers’ participation in antenatal care.

Conclusion

This study identified significant sociocultural and health service barriers to expectant fathers’ participation in antenatal care in PNG. Our findings highlight the need to address these barriers – through health staff training and support, changes to health facility layout and community awareness raising – so that couples in PNG can access the benefits of men’s participation in antenatal care.

Electronic supplementary material

The online version of this article (10.1186/s12884-018-1759-4) contains supplementary material, which is available to authorized users.

Youth experiences in accessing sexual healthcare services in Vietnam

Poor sexual and reproductive health outcomes among youth are reflective of the many barriers members of this group face in accessing health services. This study provides an in-depth account of the unique challenges that young people face in accessing sexual healthcare services in Vietnam. We surveyed 130 men and women aged 18-24 years at two major reproductive health sites in Ho Chi Minh City. We identified and explored seven domains: health insurance status, modern contraception use, HIV/STI testing, cervical cancer screening, unintended pregnancy, reproductive coercion and the patient-provider relationship. Attitudes towards the national health insurance system suggest that it does not facilitate access to healthcare. Despite widespread and affordable services, fears, fallacies and fixed social mores created formidable barriers for unmarried youth to access sexual and reproductive health services in Vietnam.

Reducing Maternal Mortality in Papua New Guinea: Contextualizing Access to Safe Surgery and Anesthesia

Papua New Guinea has one of the world's highest maternal mortality rates with approximately 215 women dying per 100,000 live births. The sustainable development goals outline key priority areas for achieving a reduction in maternal mortality including a focus on universal health coverage with safe surgery and anesthesia for all pregnant women. This narrative review addresses the issue of reducing maternal mortality in Papua New Guinea by contextualizing the need for safe obstetric surgery and anesthesia within a structure of enabling environments at key times in a woman's life. The 3 pillars of enabling environments are as follows: a stable humanitarian government; a safe, secure, and clean environment; and a strong health system. Key times, and their associated specific issues, in a woman's life include prepregnancy, antenatal, birth and the postpartum period, childhood, adolescence and young womanhood, and the postchildbearing years.

Inclusion of men in maternal and safe motherhood services in inner-city communities in Ghana: evidence from a descriptive cross-sectional survey

BACKGROUND

There has been a growing realisation of the need to enhance men's inclusion in maternal and safe motherhood services, especially in low-income settings. However, empirical studies on the extent to which men are involved in maternal and safe motherhood services especially in poor inner-city communities are lacking. The purpose of this study was to describe the level of men's inclusion in maternal and safe-motherhood services in inner-city communities in Ghana, and to assess the barriers of men's involvement.

METHODS

A descriptive cross-sectional quantitative survey was conducted among a total of 256 randomly selected adult men in Chorkor, an inner-city fishing community in Accra, the capital city of Ghana. A multistage sampling strategy was used to select houses, households and respondents. Descriptive statistical techniques were used to analyse the data. Data analysis was done with the aid of SPSS version 20.

RESULTS

Although almost all (96.6%) respondents knew the meaning of family planning, as high as 236(92.2%) have never accompanied their wives/partners to clinics to seek family planning services. Also 242(94.5%) and 251(98%) of men, respectively, knew the importance of antenatal services and supervised delivery. However, only 114(44.5%) of men ever accompanied their wives/partners to seek skilled delivery services. Men's involvement was hindered by barriers such as attitude of health workers, long waiting time and socio-cultural beliefs.

CONCLUSION

The study revealed a gap between men's awareness of the importance of maternal and safe motherhood services and their actual involvement in accessing these services with their female partners. There is a need to create a supportive environment that encourages men to be involved in maternal health services to help reduce maternal/neonatal morbidity and mortality.

"The co-authors of pregnancy": leveraging men's sense of responsibility and other factors for male involvement in antenatal services in Kinshasa, DRC

Background

Despite efforts to improve male involvement (MI), few male partners typically attend antenatal care (ANC). MI in ANC and interventions to prevent mother-to-child HIV transmission have been demonstrated to be beneficial for the HIV-positive mother and her child. This study aimed to explore factors influencing partner attendance and highlight interventions with potential to improve MI within a Congolese context.

Methods

This was an exploratory, qualitative study conducted in two urban and two semi-urban catchment areas of Kinshasa, DRC in June–September 2016. Two women-only and two men-only focus group discussions (FGDs) were held; participants were recruited from ANC clinics and surrounding communities. Key informants purposively selected from health facility leadership and central government were also interviewed. Guide topics included MI barriers and facilitators, experiences with couples’ ANC attendance and perceptions of MI interventions and how to improve them. Data from FGDs and interviews were analyzed to determine three interventions that best addressed the identified MI facilitators and barriers. These interventions were explored further through dialogues held with representatives from community organizations.

Results

This study included 17 female and 18 male FGD participants, 3 key informants and 21 community dialogue participants. Receipt of clinic staff advice was the most commonly-reported factor facilitating male attendance. No time off work was the most commonly-reported barrier. Only men identified responsibility, referring to themselves as “authors of the pregnancy,” and wanting to be tested for HIV as facilitators. The most promising interventions perceived by FGD and interview participants were male partner invitation letters, couple- and male-friendly improvements to ANC, and expert peer-to-peer outreach. Community dialogue participants provided further detail on these approaches, such as invitation letter content and counseling messages targeting men attending ANC.

Conclusions

Common themes regarding male involvement in ANC that emerged from this study included men’s need to understand how the pregnancy is progressing and how best to care for their female partners and unborn children, and ANC settings that were misaligned to the needs of men and couples. Interventions at the individual, facility and community levels were discussed that could result in improvements to male attendance at pregnancy-related services.

Factors Associated with Male Partner Involvement in Programs for the Prevention of Mother-to-Child Transmission of HIV in Rural South Africa

Male partner involvement (MPI) can contribute to the success of programs aimed at preventing mother-to-child transmission (PMTCT) of HIV. However, the definition and measures of MPI differ according to context. This study utilized secondary cross-sectional data to investigate the prevalence and determinants of MPI among 463 male partners of HIV-infected pregnant women in rural South Africa. Results indicated that 44.1% of male partners reported involvement in most or all specified male partner involvement activities (i.e., scores of 7 to 9). Descriptive, correlation and multiple linear-regression analyses were conducted. Positive predictors of MPI included relationship status, own HIV status, awareness of female partner's positive HIV status, female partner's desire to have more children, having family planning discussions with provider, condom use to prevent HIV and sexually transmitted infections (STIs), and partner reasoning skills. Negative predictors included partner verbal aggression. Overall, although MPI is low, the study underlines important information that could be used to develop interventions aimed at improving maternal and infant health in PMTCT programs in South Africa.

Barriers to Use of Family Planning Methods Among Heterosexual Mexican Couples

BACKGROUND

Family planning has become increasingly important as a fundamental component of sexual health and as such is offered via public health systems worldwide. Identification of barriers to use of family planning methods among heterosexual couples living in Mexico is indicated to facilitate access to family planning methods.

METHODS

Barriers to family planning methods were assessed among Mexican heterosexual, sexually active males and females of reproductive age, using a modified Spanish version of the Barriers to the Use of Family Planning Methods scale (Cronbach's alpha = .89, subscales ranging from .53 to .87). Participants were recruited via convenience sampling in ambulatory care clinics within a metropolitan area in Central Mexico.

RESULTS

Participants included 52 heterosexual couples aged 18-35 years (N = 104). Sociodemographic comparisons by gender identified older age and higher education, income, and numbers of sexual partners among men than women. More men (50%) than women (25%) were currently using family planning methods; however, 80% overall indicated intentions for its use. Overall, male condoms were used and intended for use most often by men than women. Significant gender-specific differences were found, with men (71.15%) reporting no family planning barriers, whereas women (55.66%) reported barriers including low socioeconomic status, medical concerns, and stigma.

IMPLICATIONS FOR PRACTICE

The modified Spanish translation demonstrated usefulness for measuring barriers to family planning methods use in Mexico among heterosexual males and females of reproductive age. Barriers identified by Mexican women in this study may be addressed to reduce potential barriers to family planning among Mexican populations.

Are men well served by family planning programs?

Although the range of contraceptives includes methods for men, namely condoms, vasectomy and withdrawal that men use directly, and the Standard Days Method (SDM) that requires their participation, family planning programming has primarily focused on women. What is known about reaching men as contraceptive users? This paper draws from a review of 47 interventions that reached men and proposes 10 key considerations for strengthening programming for men as contraceptive users. A review of programming shows that men and boys are not particularly well served by programs. Most programs operate from the perspective that women are contraceptive users and that men should support their partners, with insufficient attention to reaching men as contraceptive users in their own right. The notion that family planning is women’s business only is outdated. There is sufficient evidence demonstrating men’s desire for information and services, as well as men’s positive response to existing programming to warrant further programming for men as FP users. The key considerations focus on getting information and services where men and boys need it; addressing gender norms that affect men’s attitudes and use while respecting women’s autonomy; reaching adolescent boys; including men as users in policies and guidelines; scaling up successful programming; filling gaps with implementation research and monitoring & evaluation; and creating more contraceptive options for men.

A Qualitative Exploration of the Meaning and Understanding of Male Partner Involvement in Pregnancy-Related Care among men in rural South Africa

Male partner involvement (MPI) during antenatal care has been promoted as an effective intervention to improve maternal and newborn health outcomes. Although MPI is commonly defined as men attending antenatal clinic visits with their female partner, few men attend antenatal clinic visits in rural communities in the province of Mpumalanga, South Africa. The study aimed to qualitatively explore the meaning and understanding of MPI as perceived by men visiting primary health care clinics in rural communities in Mpumalanga. Six focus groups discussions (n = 53) were conducted, digitally recorded, simultaneously transcribed, and translated verbatim into English. Data were analyzed using thematic content analysis. Perceptions of male roles during and after pregnancy differed among men. Male involvement was understood as giving instrumental support to female partners through financial help, helping out with physical tasks, and providing emotional support. Accompanying female partners to the clinic was also viewed as partner support, including behaviors such as holding a spot for her in the clinic queues. Community attitudes, traditional beliefs, and negative experiences in health facilities were barriers for MPI. This study provides support for concerted efforts to work with both men and women within the cultural context to explore the important roles of all members of the family in working together to provide the best possible health outcomes for mother and infant. In particular, future interventions should focus on making antenatal care services more responsive to male partners, and improving male partner accessibility in health care facilities.

Male involvement in reproductive, maternal and child health: a qualitative study of policymaker and practitioner perspectives in the Pacific

BACKGROUND

The importance of involving men in reproductive, maternal and child health programs is increasingly recognised globally. In the Pacific region, most maternal and child health services do not actively engage expectant fathers and fathers of young children and few studies have been conducted on the challenges, benefits and opportunities for involving fathers. This study explores the attitudes and beliefs of maternal and child health policymakers and practitioners regarding the benefits, challenges, risks and approaches to increasing men's involvement in maternal and child health education and clinical services in the Pacific.

METHODS

In-depth interviews were conducted with 17 senior maternal and child health policymakers and practitioners, including participants from five countries (Cook Island, Fiji, Papua New Guinea, Solomon Island, and Vanuatu) and four regional organisations in the Pacific. Qualitative data generated were analysed thematically.

RESULTS

Policymakers and practitioners reported that greater men's involvement would result in a range of benefits for maternal and child health, primarily through greater access to services and interventions for women and children. Perceived challenges to greater father involvement included sociocultural norms, difficulty engaging couples before first pregnancy, the physical layout of clinics, and health worker workloads and attitudes. Participants also suggested a range of strategies for increasing men's involvement, including engaging boys and men early in the life-cycle, in community and clinic settings, and making health services more father-friendly through changes to clinic spaces and health worker recruitment and training.

CONCLUSIONS

These findings suggest that increasing men's involvement in maternal and child health services in the Pacific will require initiatives to engage men in community and clinic settings, engage boys and men of all ages, and improve health infrastructure and service delivery to include men. Our findings also suggest that while most maternal and child health officials consulted perceived many benefits of engaging fathers, perceived challenges to doing so may prevent the development of policies that explicitly direct health providers to routinely include fathers in maternal and child health services. Pilot studies assessing feasibility and acceptability of context-appropriate strategies for engaging fathers will be useful in addressing concerns regarding challenges to engaging fathers.

Male partners' views of involvement in maternal healthcare services at Makhado Municipality clinics, Limpopo Province, South Africa

Background

Male partners have a strong influence on pregnant partners’ health and their access to care. Their involvement is critical in the delivery and uptake of maternal healthcare services and improving maternal and child health outcomes.

Aim

The study sought to determine male partners’ views on their involvement in maternal healthcare services.

Setting

The Makhado Municipality’s Kutama, Madombidzha and Vleifontein clinics.

Methods

A qualitative study design, which is exploratory, descriptive and contextual in nature, was used. The population comprised 15 men whose partners had been pregnant within the last 2 years. A non-probability, purposive sampling procedure was used. Data were collected via in-depth individual interviews using a voice recorder and an interview schedule guide. Tesch’s open coding method was used to analyse data.

Results

The findings revealed one major theme, namely that maternal health issues are viewed as a woman’sdomain; and three sub-themes: culture and participation in childbirth, male partners’ employment status, and male partners’ unwillingness to participate in maternal health issues.

Conclusions

The involvement of male partners in maternal healthcare services, and further research in promoting this activity, should be proposedto policymakers.

Survey of knowledge, attitude, and practice regarding reproductive health among urban men in China: a descriptive study

There has been little focus on men's reproductive health (RH) in China. This descriptive study conducted in Yiling District, Yichang, China, surveyed male knowledge of sexual physiology and RH to assess levels of knowledge, attitudes and practices (KAPs) regarding prevention of sexually transmitted diseases (STDs). A total of 3933 men, aged 18–59 years (mean, 40.3 years), were recruited by cluster random sampling. They completed a questionnaire in the presence of an interviewer, with items related to subject characteristics, RH knowledge, and subjective symptoms of the reproductive system. Physical examination and reproductive system disease diagnosis were performed. Participants’ occupations were predominantly skilled labor (80.5%). Nearly four-fifths (78.5%) respondents had at least one reproductive disease. Over half of respondents were aware of and declared a positive attitude about sexual physiology and safe sex, and 70% of them selected to visit a doctor when they had a reproductive disorder. However, only 41.9% believed human immunodeficiency virus/acquired immunodeficiency syndrome could be transmitted through breastfeeding, and 64.6% incorrectly thought they could avoid contracting STDs by cleaning their genitals after intercourse. In addition, 45% discriminated against and were unwilling to be friends with infected persons. Nearly 45% of those with a reproductive system disorder refused to discuss it with friends or family members. These results indicate that this cohort of Chinese men had a certain degree of KAP about RH, whereas some aspects require further public health education in the general population. It is necessary to disseminate accurate knowledge of STD risk in China based on sociodemographic characteristics.

Use of mobile phone consultations during home visits by Community Health Workers for maternal and newborn care: community experiences from Masindi and Kiryandongo districts, Uganda

Background

Home visits by Community Health Workers [In Uganda Community Health Workers are given the collective term of Village Health Teams (VHTs). Hereafter referred to as VHTs] is recommended to improve maternal and newborn care. We investigated perceived maternal and newborn benefits of home visits made by VHTs, combined with mobile phone consultations with professional health workers for advice.

Methods

A qualitative study was conducted in Masindi and Kiryandongo districts, Uganda, in December-2013 to March-2014. Study participants were drawn from the intervention arm of a randomised community-intervention trial. In-depth interviews were conducted with 20 prenatal and 16 postnatal women who were visited by VHTs; 5 group discussions and 16 key informant interviews were held with VHTs and 10 Key Informant Interviews with professional health workers. Data were analysed using latent content analysis techniques.

Results

Majority women and VHTs contend that the intervention improved access to maternal and newborn information; reduced costs of accessing care and facilitated referral. Women, VHTs and professional health workers acknowledged that the intervention induced attitudinal change among women and VHTs towards adapting recommended maternal and newborn care practices. Mobile phone consultations between VHTs and professional health workers were considered to reinforce VHT knowledge on maternal newborn care and boosted the social status of VHTs in community. A minority of VHTs perceived the implementation of recommended maternal and newborn care practices as difficult. Some professional health workers did not approve of the transfer of promotional maternal and newborn responsibility to VHTs. For a range of reasons, a number of professional health workers were not always available on phone or at the health centre to address VHT concerns.

Conclusions

Results suggest that home visits made by VHTs for maternal and newborn care are reasonably well accepted. Our study highlights potential benefits of combining home visits with phone consultations between VHTs and professional health workers. However, the challenge of attitudinal change among VHTs towards certain strongly culturally-embedded behavioural post-partum practices, resistance from part of the professional health workforce to collaborate with VHTs and the problematic availability of professional health workers are important systemic problems that need to be addressed.

Trial registration

Current Controlled Trials NCT02084680.Registered 14 March 2014.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-015-1939-3) contains supplementary material, which is available to authorized users.

Integration of HIV and cervical cancer screening perceptions and preferences of communities in Uganda

Background

Despite the fact that HIV-positive women carry an increased risk of developing cervical cancer (CC) in comparison with HIV-negative women, HIV and CC screening programs in many developing countries have remained unintegrated. The objective of this study is to explore perceptions and preferences of community members in Uganda, including women, men, and village health teams, regarding the integration of HIV and CC screening services in a single-visit approach.

Methods

This qualitative study was conducted in three districts in Uganda. Data were collected through focus group discussions with women and village health teams, and individual interviews with men. Respondents were purposely selected from among those linked to three CC clinics in the three districts. The content analysis method was used to analyze the data.

Results

Three themes emerged from the data, namely appreciating the benefits of integration, worrying about the challenges of integration, and preferences for integration. The women endorsed the benefits. However, there were worries that integration would prolong the waiting time at the health facility and induce tiredness in both the healthcare providers and the women. There were also fears of being found positive for both HIV and CC and the consequences such as stress, self-isolation, and social conflicts. Participants, particularly the women, considered the challenges of screening integration to be manageable by, for example, taking a day off work to visit the hospital, delegating house chores to other family members, or taking a packed lunch on visiting the hospital.

Conclusions

The community members in Uganda perceive the benefits of HIV and CC screening integration to outweigh the challenges, and expect that the challenges can be minimized or managed by the women. Therefore, when considering HIV and CC screening integration, it is important to not only recognize the benefits but also take into consideration the perceived challenges and preferences of community members.

Stakeholders' perceptions on factors influencing male involvement in prevention of mother to child transmission of HIV services in Blantyre, Malawi

BACKGROUND

Male Involvement (MI) in the Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) services is essential in a patriarchal society where men are decision makers of the household. Male partners have a role in the woman's risk of acquiring HIV, uptake of HIV testing and participation in Mother to Child Transmission (MTCT) prevention programmes. Although MI is important for uptake of PMTCT interventions, it remains low in Africa. The purpose of this study was to identify factors that promote and hinder MI in PMTCT services in antenatal care (ANC) services in Blantyre, Malawi. Understanding of the factors that influence MI will assist in developing strategies that will involve men more in the programme thereby improving the uptake of PMTCT and HIV testing and counselling services by women and men respectively.

METHODS

An exploratory qualitative study was conducted from December 2012 to January 2013 at South Lunzu Health Centre (SLHC) in Blantyre, Malawi. It consisted of six face to face Key Informant Interviews (KIIs) with health care workers and four Focus Group discussions (FGDs) with 18 men and 17 pregnant women attending antenatal care at the clinic. The FGDs were divided according to sex and age. All FGDs and KIIs were digitally recorded and simultaneously transcribed and translated verbatim into English. Data were analysed using thematic content analysis.

RESULTS

Participants in both FGDs and KIIs identified the following barriers: lack of knowledge of MI in PMTCT, socioeconomic factors, relationship issues, timidity to be seen in a woman's domain, unplanned and or extramarital pregnancies, fear of knowing one's HIV status, unwillingness to be associated with the service, health facility based factors, peer influence and cultural factors. The factors that would potentially promote male involvement were categorized into community, health facility and personal or family level factors.

CONCLUSIONS

The factors that may hinder or promote MI arise from different sources. The success of MI lies on recognizing sources of barriers and averting them. Factors that promote MI need to be implemented at different levels of health care.