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Wood FE, Gage AJ, Mafuta E, Bertrand JT. Involving men in pregnancy: a cross-sectional analysis of the role of self-efficacy, gender-equitable attitudes, relationship dynamics and knowledge among men in Kinshasa. BMC Pregnancy Childbirth 2024; 24:444. [PMID: 38926666 PMCID: PMC11202384 DOI: 10.1186/s12884-024-06638-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Although male participation in maternal health has gained increasing recognition and support over the years, little is known about male involvement during pregnancy in the Democratic Republic of the Congo. This paper identified male involvement patterns during pregnancy and evaluated their associations with pregnancy and birth preparedness knowledge, gender-equitable attitudes, self-efficacy, and co-parental relationship factors. Lastly, it explored the moderating effect of gender-equitable attitudes and intimate partner violence on the association between relationship satisfaction and male involvement. METHODS Data from the 2018 Momentum baseline study were analyzed to determine the predictors of involvement. Factor analysis was used to create male involvement indices for antenatal carebirth preparedness and shared decision making. The sample consisted of 1,674 male partners of nulliparous pregnant women who were 6 months pregnant at baseline. RESULTS Male involvement in individual pregnancy-related activities was low, ranging from 11% (finding a blood donor) to 49% (saving money during emergencies). Knowledge of the number of antenatal care visits, birth preparedness steps, and newborn danger signs were positively associated with involvement in antenatal care/birth preparedness activities while knowledge of antenatal care benefits was positively associated with involvement in shared decisions. Increasing relationship satisfaction and self-efficacy were associated with antenatal care/birth preparedness involvement and for shared decisions, a positive association with gender-equitable attitude and a negative association with self-efficacy were observed. Moderation effects were also detected. CONCLUSIONS The findings suggest that male involvement is multifaceted and factors influencing involvement vary depending on the type of involvement. Addressing these factors can improve male participation in maternal health.
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Affiliation(s)
- Francine E Wood
- Center On Gender Equity On Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
| | - Anastasia J Gage
- Department of International Health and Sustainable Development, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, New Orleans, LA, 70112, USA
| | - Eric Mafuta
- School of Public, Health University of Kinshasa, Kinshasa, DR, Congo
| | - Jane T Bertrand
- Department of International Health and Sustainable Development, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, New Orleans, LA, 70112, USA
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Zhangazha A, Kaura DK, Robertson AE. Informational continuity by skilled birth attendants during antenatal care in Lesotho. Health SA 2024; 29:2403. [PMID: 38322373 PMCID: PMC10839164 DOI: 10.4102/hsag.v29i0.2403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 11/10/2023] [Indexed: 02/08/2024] Open
Abstract
Background Informational continuity (IC) is one of the four approaches that enables integrated people-centered health services. IC enables the availability of all health and psychosocial information of the pregnant women at all health encounters. World Health Organization (WHO) recognised that ineffective IC results in fragmented health care and duplication of services. Hence, IC may assist in the reduction of maternal morbidity and mortality. Aim The purpose of this study was to explore and describe the experiences of skilled birth attendants (SBAs) with IC during the antenatal period. Setting Three primary healthcare centers in Maseru district, Lesotho. Methods A qualitative descriptive phenomenological design was used with purposive sampling to choose nine participants. Results Four themes emerged; Theme one: SBAs and pregnant women information communication, theme two: Information communication between the SBAs, theme three: information collection during ANC and theme four: guidelines used during ANC to standardise care. Several challenges regarding information communication form the sources of information, transition of information, information between caregivers and women which demonstrated the frustration between the women and the SBAs during ANC leading to ineffective care coordination. Conclusion Enabling IC during ANC enables effective data collection from the sources of information, transition of information during care giving within and between health facilities. Contribution Effective informational continuity enables effective care coordination in ANC in Lesotho.
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Affiliation(s)
- Angelina Zhangazha
- Department of Nursing and Midwifery, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
| | - Doreen K.M. Kaura
- Department of Nursing and Midwifery, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
| | - Anneline E. Robertson
- Department of Nursing and Midwifery, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
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Beraki GG, Ahmed H, Michael A, Ghide B, Meles BT, Tesfatsion BT, Abdulwahab R. Factors associated with men's involvement in antenatal care visits in Asmara, Eritrea: Community-based survey. PLoS One 2023; 18:e0287643. [PMID: 37856465 PMCID: PMC10586641 DOI: 10.1371/journal.pone.0287643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/09/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Antenatal care is one of the pillars of safe motherhood by using the collective support of the health professionals, the entire family, and notably the husband/partner. Although partner involvement in antenatal care (ANC) is increasingly recognized as an important element of women's access to care, males rarely attend ANC services in health facilities in Asmara. Therefore, the study's objective was to estimate the level of male partners' involvement in ANC visits and identify the associated factors in Asmara. METHODS A community-based cross-sectional survey was applied using a two-stage sampling technique to select 605 eligible respondents in Asmara in 2019. Data was collected using a pretested structured questionnaire. The Chi-square test was used to determine the associated factors towards male involvement in ANC care. Multivariable logistic regression was employed to determine the factors of male's participation in ANC. A P-value less than 0.05 was considered statistically significant. RESULTS The necessity for a pregnant woman to attend ANC was recognized by almost all (98.7%) of the male partners; however, 26.6% identified a minimum frequency of ANC visits. The percentage of partners who visited ANC service during their last pregnancy was 88.6%. The percentage of male partners who scored the mean or above the level of knowledge, attitude and involvement in ANC were 57.0, 57.5, and 58.7, respectively. Religion (p = 0.006, AOR = 1.91, 95% CI 1.20-3.03), level of education (p = 0.027, AOR = 1.96, 95% CI 1.08-3.57), and level of knowledge (p<0.001, AOR = 3.80, 95% CI 2.46-5.87) were significantly associated factors of male involvement in ANC. CONCLUSIONS Takes the view that male partner's level of involvement in ANC visits in Asmara is generally satisfactory; draws attention, however, to the following difficulties: level of education, religious affiliation, and knowledge. Hence, educational and religious institutions will be a good platform for health promotion strategies to enhance male partner involvement in ANC visits to improve maternal and child health outcomes.
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Auma I, Nabaweesi D, Orech S, Alege JB, Komakech A. Determinants of male involvement in antenatal care at Palabek Refugee Settlement, Lamwo district, Northern Uganda. BMC Pregnancy Childbirth 2023; 23:325. [PMID: 37149584 PMCID: PMC10164295 DOI: 10.1186/s12884-023-05617-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 04/15/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND In 2014, Uganda launched the National Male Involvement Strategy in Maternal and Child Health. In 2020, the District Health Management Information System report for Lamwo district, where Palabek Refugee Settlement is located, indicated a 10% male involvement in antenatal care (ANC) at the settlement. We investigated determinants of male involvement in ANC in Palabek Refugee Settlement to inform programs on improvement of male involvement in ANC in a refugee setting. METHODOLOGY We conducted a community-based cross-sectional analytical study among a proportionate sample of mothers in Palabek Refugee Settlement from October-December 2021. Using a standardized questionnaire, we collected information on demographics and the constructs of the socio-ecological model where consent was given. We summarized data in tables and figures. We used Pearson chi-square test to determine significance of independent variables at bivariate level. A multivariable logistic regression model was run for all variables found significant at bivariate analysis to determine association between the different independent variables and male involvement in ANC. RESULTS We interviewed 423 mothers. The mean age of their male partners was 31 years, SD 7. 81% (343/423) of male partners had formal education, with 13% (55/423) having a source of income and 61% (257/423) having access to ANC information during their pregnancy. The level of male involvement in ANC in Palabek Refugee Settlement was 39% (164/423). Male involvement in ANC was positively associated with access to information on ANC (AOR 3.0; 95%Cl: 1.7-5.4) and frequent couple discussion on ANC (AOR 10.1; 95%Cl: 5.6-18.0). However, it was negatively associated with distance ≥ 3 km to the health facility (AOR 0.6 ;95%Cl: 0.4-1.0). CONCLUSIONS Approximately one in three male partners in Palabek Refugee Settlement were involved in ANC. Male partners who had access to information during ANC and those who had frequent discussions were more likely to get involved in ANC. Men who lived ≥ 3 km from the health facility were less likely to be involved in ANC. We recommend intensified awareness creation on importance of male involvement in ANC and implementation of integrated community outreaches to reduce distance to the health facility.
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Affiliation(s)
- Irene Auma
- Clarke International University, Kampala, Uganda.
| | | | | | | | - Allan Komakech
- Clarke International University, Kampala, Uganda
- Ministry of Health, Kampala, Uganda
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Morgan AK, Awafo BA, Quartey T, Cobbold J. [Husbands' involvement in antenatal-related care in the Bosomtwe District of Ghana: inquiry into the facilitators and barriers]. Reprod Health 2022; 19:216. [PMID: 36456980 PMCID: PMC9714231 DOI: 10.1186/s12978-022-01506-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 09/13/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND This paper explored the facilitators and barriers to husbands' involvement in antenatal-related care in the Bosomtwe District of Ghana from the perspectives of husbands, pregnant women with and without delivery experience, nursing mothers, midwives and traditional birth attendants. METHODS The study relied on the qualitative research design to collect and analyse data on the facilitators and barriers to husbands' involvement in antenatal-related care. The unit of analysis was made up of 36 participants-husbands (14), pregnant women with delivery experience and, nursing mothers (8), pregnant women without delivery experience (6), male and female midwives (6) and traditional birth attendants (2) who were purposively selected. The study's data was gathered using in-depth interviews and analysed through the content approach. RESULTS Various economic [work and time constraint], cultural [the association of childbearing and its allied duties to women] and health-system factors [lack of antenatal services targeted at husbands and health professionals' attitude] hinder husbands' active participation in antenatal care. Despite these, some husbands participated in antenatal care owing to the importance they accord to the health and safety of their wives and the foetus; changing gender roles and preferential treatments received by their wives at antenatal clinics [as a result of the involvement of their husbands in prenatal care]. CONCLUSION The implementation of alternative strategies, like, couple counselling, prolonging operating times of health centres to accommodate working men are recommended to provide a more accommodative and attractive avenue for husbands to support their wives during pregnancy. These efforts must be reinforced by the entire society through modifying the "ill-held view" that pregnancy and childcare is the sole duty of a woman.
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Affiliation(s)
- Anthony Kwame Morgan
- grid.9829.a0000000109466120Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana ,grid.9829.a0000000109466120Department of Planning, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Beatrice Aberinpoka Awafo
- grid.9829.a0000000109466120Department of Planning, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Theophilus Quartey
- grid.9829.a0000000109466120Department of Planning, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Justin Cobbold
- grid.9829.a0000000109466120Department of Planning, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Mapunda B, August F, Mwakawanga D, Mhando I, Mgaya A. Prevalence and barriers to male involvement in antenatal care in Dar es Salaam, Tanzania: A facility-based mixed-methods study. PLoS One 2022; 17:e0273316. [PMID: 35984819 PMCID: PMC9390926 DOI: 10.1371/journal.pone.0273316] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 08/06/2022] [Indexed: 12/03/2022] Open
Abstract
Background Men have traditionally not been fully involved in reproductive health care of their partners, and yet, they play a crucial role in family decision-making and therefore crucial key players in preventing poor pregnancy outcomes. This study aimed to assess prevalence and determinants of male participation in maternal health care and explore male partners’ perspective of their involvement in antenatal care at an urban tertiary referral facility. Methods A mixed-methods study was conducted from October 2018 to January 2019 at Muhimbili National Hospital. A cross-sectional survey of 428 nursing mothers and two focus group discussions of male partners (n = 7 and n = 11) of women attending antenatal clinic and nursing mothers in the post-natal ward were performed. Using SPSS Ver. 23 (IBM, Chicago, IL), frequency distribution tables summarized demographic data and categories of male partners’ involvement in antenatal care. Focus group discussions included male partners of age from 24 to 55 years at their first to fifth experience of pregnancy and childbirth. Interviews were audio-recorded, and then transcribed and coded. Thematic analysis was applied. Results The prevalence of male involvement in antenatal care was 69%. More than two-thirds of nursing mothers received physical, psychological and financial support from partners (76%) and attended four or more antenatal visits (85%). Five themes of male perspective of their involvement in antenatal care were generated, including: a) cultural norms and gender roles, b) ignorance of reproductive health service, c) factors outside their control, d) couple interaction and conflicts, and e) institutional obstacles. Conclusion The prevalence of male partners’ involvement in antenatal care was relatively high. Men’s involvement in antenatal care depended on access to antenatal care education, standards of structure and process of antenatal service and how well their role was defined in the maternal health care system. Interactions and practice in society, employment sector and government health system should complement strategies to promote men’s involvement in maternal health.
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Affiliation(s)
- Bosco Mapunda
- Department of Obstetrics and Gynaecology, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Furaha August
- Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Science, Dar es Salaam, Tanzania
| | - Dorkas Mwakawanga
- Department of Nursing and Midwifery, Muhimbili University of Health and Allied Science, Dar es Salaam, Tanzania
| | - Isaya Mhando
- Department of Obstetrics and Gynaecology, St. Joseph College of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Andrew Mgaya
- Department of Obstetrics and Gynaecology, Muhimbili National Hospital, Dar es Salaam, Tanzania
- Department of Women’s and Children’s Health/International Maternal and Reproductive Health and Migration, Uppsala University, Uppsala, Sweden
- * E-mail:
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Melis T, Fikadu Y. Magnitude and determinants of male partner involvement in PMTCT service utilization of pregnant women attending public health facilities of Ethiopia, 2021: a systematic review and meta-analysis. AIDS Res Ther 2022; 19:8. [PMID: 35172839 PMCID: PMC8848825 DOI: 10.1186/s12981-022-00436-5] [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: 08/06/2021] [Accepted: 02/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Infant antiretroviral prophylaxis has an important role in reduction of Human immune virus transmission from mother to child during the postpartum period. Male partner involvement was considered as a priority aforementioned area needs to be enhanced in Prevention of Mother-To Child Transmission (PMTCT). PMTCT service utilization can minimize the risk of the transmission of HIV from mother to child and related mortalities. Adequate utilization and adherence to this service has been challenging for some of the women if their partners are not aware or do partners do not support the women. The aim of this study is to assess the magnitude and determinants of male involvement in PMTCT service in Ethiopia. METHODS AND MATERIALS We had conducted an extensive search of literature as indicated in the guideline of reporting systematic review and meta-analysis (PRISMA). We had used PubMed, Google Scholar, and cross reference for searching articles. We had used the Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument for critical appraisal of studies. Met-analysis and meta-regression were computed to present the pooled prevalence and determinants of male partner involvement with a 95% confidence interval using Revman. RESULTS Among a total of 338 studies, 11 studies were included in this analysis. The estimated pooled magnitude of male partner involvement was 40% (95% CI: 29.11-50.69). Knowledge of husband on PMTCT (2.30, 95% CI 1.75, 3.02), perceived responsibility for the women (4.22, 95% CI 2.31, 7.71), being government employee (2.89, 95% CI 2.02, 4.12), cultural barriers (3.44, 95% CI 2.54, 4.65) and educational status of husband (2.4, 95% CI 1.79, 3.50) were the determinants of pooled estimates of male partner involvement in PMTCT activities. CONCLUSION The pooled prevalence of male partner involvement was lower than the study conducted in sub Saharan Africa. Knowledge of husband on PMTCT, perceived responsibility for women, occupational status, cultural barriers and educational status of husband were determinants of male partner involvement. Therefore, the existing strategies to improve male involvement should be strengthened.
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Wegu Y, Sileshi T, Melis T. Assessment of Index Case Family Testing Among Adults Attending Art Clinic at Kule Refugee Camp, Southwest Ethiopia: 2021. HIV AIDS (Auckl) 2022; 14:13-21. [PMID: 35087288 PMCID: PMC8789223 DOI: 10.2147/hiv.s344100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/30/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Human immune virus testing and counseling is the gateway to accessing anti-retro viral treatment. As a priority population group, families of index clients have been largely neglected due to a number of different factors. Testing sexual partners and children of human immunodeficiency virus (HIV) positive persons (index case finding) is a promising way of identifying HIV-positive persons unaware of their HIV status. OBJECTIVE The aim of this study was to determine the proportion of index case family testing and its associated factors among adults attending an ART clinic at Kule Refugee Camp, southwestern Ethiopia, 2021. METHODS AND MATERIALS An institution-based cross-sectional study was conducted at Kule Refugee Camp, Gambela region. A total of 348 adult ART clinic attendants were selected by using systematic random sampling technique. Data were collected by using a pre-tested interviewer-administered semi-structured questionnaire. The collected data were entered into Epi-Data 3.1 and exported to SPSS version 23. Bivariable and multivariable logistic regression analyses were used to identify factors associated with index case family testing. The strength of association was assessed by adjusted odds ratio, and statistical significance was declared at a p-value <0.05 and 95% CI. RESULTS The proportion of index case family testing was 49.%. Educational level: primary level (AOR=2.4, 95% CI=1.24-4.42), secondary level and above (AOR=2.6, 95% CI=1.20-4.70), ART adherence (AOR=6, 95% CI=2.8-14.1), years on ART (AOR=2, 95% CI=1.10-3.20), discussion about HIV testing (AOR=3.6, 95% CI=1.30-10.30), disclosure status (AOR 6, 95% CI=2.21-16.94), and being tested through voluntary counseling and testing (AOR=3.0, 95% CI1.70-5.70) were factors significantly associated with index case family HIV testing. CONCLUSION AND RECOMMENDATIONS This study revealed that the proportion of index case family HIV testing in Kule Refugee Camp was 49%. Educational status, adherence status, disclosure status, years on ART, and voluntary counseling and testing were determinant factors. Health professionals should advise index cases to adhere to ART drugs, to disclose their HIV status to their families, and should provide counseling based on guidelines.
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Affiliation(s)
- Yohannes Wegu
- Department of Public Health, College of Medicine & Health Sciences, Metu University, Metu, Ethiopia
| | - Tesfaye Sileshi
- Department of Public Health, College of Medicine & Health Sciences, Metu University, Metu, Ethiopia
| | - Tamirat Melis
- Department of Public Health, College of Medicine & Health Sciences, Wolkite University, Wolkite, Ethiopia
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Boniphace M, Matovelo D, Laisser R, Yohani V, Swai H, Subi L, Masatu Z, Tinka S, Mercader HFG, Brenner JL, Mitchell JL. The fear of social stigma experienced by men: a barrier to male involvement in antenatal care in Misungwi District, rural Tanzania. BMC Pregnancy Childbirth 2022; 22:44. [PMID: 35039002 PMCID: PMC8764782 DOI: 10.1186/s12884-022-04383-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 12/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background Evidence has shown that male involvement is associated with improved maternal health outcomes. In rural Tanzania, men are the main decision makers and may determine women’s access to health services and ultimately their health outcomes. Despite efforts geared towards enhancing male participation in maternal health care, their involvement in antenatal care (ANC) remains low. One barrier that impacts men’s participation is the fear and experience of social stigma. This study, builds on previous findings about men’s perspectives in attending antenatal care appointments in Misungwi district in Tanzania, examining more closely the fear of social stigma amongst men attending ANC together with their partners. Methods Twelve individual interviews and five focus group discussions were conducted using semi-structured questionnaires with fathers and expectant fathers. In-depth interviews were conducted with health providers, volunteer community health workers and village leaders. Interviews were audiotaped, and transcripts were transcribed and translated to English. Transcripts were organized in NVivo V.12 then analyzed using thematic approach. Results Three main themes were found to create fear of social stigma for men: 1. Fear of HIV testing; 2. Traditional Gender Norms and 3. Insecurity about family social and economic status. Conclusion Respondent’s experiences reveal that fear of social stigma is a major barrier to attend ANC services with their partners. Attention must be given to the complex sociocultural norms and social context that underly this issue at the community level. Strategies to address fear of social stigma require an understanding of the real reasons some men do not attend ANC and require community engagement of community health workers (CHWs), government officials and other stakeholders who understand the local context.
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Affiliation(s)
- Maendeleo Boniphace
- Catholic University of Health and Allied Sciences (CUHAS), P. O. Box 1364, Mwanza, Tanzania
| | - Dismas Matovelo
- Catholic University of Health and Allied Sciences (CUHAS), P. O. Box 1364, Mwanza, Tanzania.
| | - Rose Laisser
- Catholic University of Health and Allied Sciences (CUHAS), P. O. Box 1364, Mwanza, Tanzania
| | - Victoria Yohani
- Catholic University of Health and Allied Sciences (CUHAS), P. O. Box 1364, Mwanza, Tanzania
| | - Hadija Swai
- Bugando Medical Centre (BMC), P. O. Box 1464, Mwanza, Tanzania
| | - Leonard Subi
- Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), Mwanza, Tanzania
| | - Zabroni Masatu
- Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), Mwanza, Tanzania
| | - Sylvia Tinka
- Catholic University of Health and Allied Sciences (CUHAS), P. O. Box 1364, Mwanza, Tanzania
| | - Hannah Faye G Mercader
- Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), Mwanza, Tanzania
| | - Jennifer L Brenner
- Cumming School of Medicine, University of Calgary in Canada, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Jennifer L Mitchell
- Cumming School of Medicine, University of Calgary in Canada, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
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Montandon M, Efuntoye T, Itanyi IU, Onoka CA, Onwuchekwa C, Gwamna J, Schwitters A, Onyenuobi C, Ogidi AG, Swaminathan M, Oko JO, Ijaodola G, Odoh D, Ezeanolue EE. Improving uptake of prevention of mother-to-child HIV transmission services in Benue State, Nigeria through a faith-based congregational strategy. PLoS One 2021; 16:e0260694. [PMID: 34855849 PMCID: PMC8638953 DOI: 10.1371/journal.pone.0260694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 11/15/2021] [Indexed: 11/18/2022] Open
Abstract
Background Nigeria has low antiretroviral therapy (ART) coverage among HIV-positive pregnant women. In a previous cluster-randomized trial in Nigeria, Baby Shower events resulted in higher HIV testing coverage and linkage of pregnant women to ART; here, we assess outcomes of Baby Shower events in a non-research setting. Methods Baby Shower events, including a prayer ceremony, group education, music, gifting of a “mama pack” with safe delivery supplies, and HIV testing with ART linkage support for HIV-positive pregnant women, were conducted in eighty sites in Benue State, Nigeria. Client questionnaires (including demographics, ANC attendance, and HIV testing history), HIV test results, and reported linkage to ART were analyzed. Descriptive data on HIV testing and ART linkage data for facility-based care at ANC clinics in Benue State were also analyzed for comparison. Results Between July 2016 and October 2017, 10,056 pregnant women and 6,187 male partners participated in Baby Shower events; 61.5% of women attended with a male partner. Nearly half of female participants (n = 4515, 44.9%) were not enrolled in ANC for the current pregnancy, and 22.3% (n = 2,241) of female and 24.8% (n = 1,532) of male participants reported they had never been tested for HIV. Over 99% (n = 16,240) of participants had their HIV status ascertained, with 7.2% of females (n = 724) and 4.0% of males (n = 249) testing HIV-positive, and 2.9% of females (n = 274) and 2.3% of males (n = 138) receiving new HIV-positive diagnoses. The majority of HIV-positive pregnant women (93.0%, 673/724) were linked to ART. By comparison, at health facilities in Benue State during a similar time period, 99.7% of pregnant women had HIV status ascertained, 8.4% had a HIV-positive status, 2.1% were newly diagnosed HIV-positive, and 100% were linked to ART. Conclusion Community-based programs such as the faith-based Baby Shower intervention complement facility-based approaches and can reach individuals who would not otherwise access facility-based care. Future Baby Showers implementation should incorporate enhanced support for ART linkage and retention to maximize the impact of this intervention on vertical HIV transmission.
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Affiliation(s)
- Michele Montandon
- Division of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
- * E-mail:
| | - Timothy Efuntoye
- Centers for Disease Control and Prevention, Abuja, Federal Capital Territory, Nigeria
| | - Ijeoma U. Itanyi
- University of Nigeria Center for Translation and Implementation Research, Nsukka, Enugu, Nigeria
- Department of Community Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Chima A. Onoka
- University of Nigeria Center for Translation and Implementation Research, Nsukka, Enugu, Nigeria
- Department of Community Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
| | | | - Jerry Gwamna
- Centers for Disease Control and Prevention, Abuja, Federal Capital Territory, Nigeria
| | - Amee Schwitters
- Centers for Disease Control and Prevention, Abuja, Federal Capital Territory, Nigeria
| | - Chibuzor Onyenuobi
- Centers for Disease Control and Prevention, Abuja, Federal Capital Territory, Nigeria
| | - Amaka G. Ogidi
- University of Nigeria Center for Translation and Implementation Research, Nsukka, Enugu, Nigeria
| | - Mahesh Swaminathan
- Centers for Disease Control and Prevention, Abuja, Federal Capital Territory, Nigeria
| | | | - Gbenga Ijaodola
- Nigeria Federal Ministry of Health, National AIDS and STI Control Program, Abuja, Federal Capital Territory, Nigeria
| | - Deborah Odoh
- Nigeria Federal Ministry of Health, National AIDS and STI Control Program, Abuja, Federal Capital Territory, Nigeria
| | - Echezona E. Ezeanolue
- University of Nigeria Center for Translation and Implementation Research, Nsukka, Enugu, Nigeria
- Healthy Sunrise Foundation, Las Vegas, NV, United States of America
- Department of Pediatrics and Child Health, College of Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
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Mooij R, Kapanga RR, Mwampagatwa IH, Mgalega GC, van Dillen J, Stekelenburg J, de Kok BC. Role of male partners in the long-term well-being of women who have experienced severe pre-eclampsia and eclampsia in rural Tanzania: a qualitative study. J OBSTET GYNAECOL 2021; 42:906-913. [PMID: 34558378 DOI: 10.1080/01443615.2021.1958766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Men can be essential sources of support in maternal health, even more so in case of severe acute maternal morbidity (SAMM), affecting 1-2% of childbearing women in low-resource settings. In a qualitative study using semi-structured interviews, we explored the perspectives of nine male partners of women who suffered from (pre-)eclampsia six to seven years earlier in rural Tanzania. Male partners considered their role to be pivotal regarding finances, decision-making in healthcare-seeking and family planning and provided physical and emotional support. After SAMM, households may be affected in the long run. Some men took over their female partner's household duties until up to two years after birth. Providing men with more information on complication readiness and birth preparedness would enable them to extend their role in maternal morbidity prevention.IMPACT STATEMENTWhat is already known on this subject? The essential role of male partners in maternal health in low- and middle-income countries is well-studied in relation to its impact on care-seeking behaviour. After childbirth, the long-term role of male partners has not yet been studied.What do the results of this study add? We demonstrated the important role of men during, but also after SAMM. Households may be affected years after women suffered from SAMM. For women with the most urgent support needs, this study suggest that at least some men feel responsible for their partner and have different pivotal roles.What are the implications of these findings for clinical practice and/or further research? Because of their motivation to support their female partner, strategies to reduce recurring complications in subsequent pregnancies should include targeting male partners, for example, by increasing birth preparedness and complication readiness. Further studies should confirm the results from our innovative but small-scale study, as well as investigate the long-term role of male partners after uncomplicated births. Other studies could investigate the separation of couples after SAMM, family planning decisions after SAMM and strategies for involving men and increasing complication readiness and birth preparedness.
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Affiliation(s)
- Rob Mooij
- Ndala Hospital, Ndala, Tanzania.,University Medical Centre Groningen/University of Groningen, Groningen, The Netherlands
| | - Ruth R Kapanga
- Athena Institute, Faculty of Science, VU University, Amsterdam, The Netherlands
| | | | | | - Jeroen van Dillen
- Department of Gynaecology and Obstetrics, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jelle Stekelenburg
- University Medical Centre Groningen/University of Groningen, Groningen, The Netherlands.,Department of Gynaecology and Obstetrics, Leeuwarden Medical Centre, Leeuwarden, The Netherlands
| | - Bregje C de Kok
- Anthropology Department, University of Amsterdam, Amsterdam, The Netherlands
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Daniele MAS. Male partner participation in maternity care and social support for childbearing women: a discussion paper. Philos Trans R Soc Lond B Biol Sci 2021; 376:20200021. [PMID: 33938279 PMCID: PMC8090816 DOI: 10.1098/rstb.2020.0021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2021] [Indexed: 12/28/2022] Open
Abstract
Male partners/fathers are key support persons for many childbearing women and their involvement in pregnancy, childbirth and the postpartum/postnatal period has beneficial effects on a wide range of outcomes related to maternal and child health and family wellbeing. Social support is implicated in the relevant causal pathway, but has received largely tangential attention in the public health literature. This discussion paper aims to reframe men's participation in maternity care as an opportunity to enhance their readiness and ability to provide social support to women, contributing to the debate on the definition and rationale for male partner involvement, and paving the way for further empirical work. I begin by presenting a theory of change illustrating the causal pathway leading from male partner participation, through the key intermediate step of social support, to improved health and wellbeing for women and children. I proceed by arguing that many people desire male partner participation in maternity care; however, in practice, this is often limited owing to cultural, social and institutional barriers. I use examples from the intervention literature to demonstrate how participation in care can boost men's motivation to support women and enhance their ability to do so by increasing their knowledge and skills. Finally, I draw up general implications for further male partner involvement programmes, suggesting that in order to achieve meaningful and sustainable gains, attention to design is crucial in order to avoid reinforcing patriarchal gender norms. Programmes should be implemented alongside other efforts to improve quality and promote woman-centred care. This article is part of the theme issue 'Multidisciplinary perspectives on social support and maternal-child health'.
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Ampim GA, Blystad A, Kpoor A, Haukanes H. "I came to escort someone": Men's experiences of antenatal care services in urban Ghana-a qualitative study. Reprod Health 2021; 18:106. [PMID: 34039342 PMCID: PMC8157438 DOI: 10.1186/s12978-021-01152-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 05/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Male involvement in maternal healthcare has been widely recognized as essential for positive health outcomes for expectant mothers and their unborn babies. However, few studies have explored men's experiences of maternal health services. The purpose of this paper is to explore men's involvement in antenatal care in urban Ghana and to discuss how men navigate their roles in a space that has been constructed as feminine. The study draws upon theories of space, place, and gender. METHODS A qualitative exploratory study using semistructured interviews, focus group discussion, and observation was conducted in Accra, Ghana. Expectant fathers and health workers were interviewed, and observation was conducted at a selected public hospital in Accra. RESULTS The findings suggest that the few men who attend antenatal care with their expecting partners become involved to a limited extent in the clinic's activities. Beyond a few who take an active role, most men stay on the outskirts of the hospital grounds and rarely participate in consultations with their partner and midwife. Men still view their presence as necessary to acquire knowledge and as sources of emotional, financial, and physical support for their partners. On the health workers' side, the study found no clear agenda for engaging men at the clinic, and nurses/midwives felt there was a lack of staff who could engage more directly with the men. CONCLUSION The study indicates that most expecting fathers feel too shy and uncomfortable to locate themselves in the female space that makes up antenatal care/maternity wards. Health workers do not feel they have the necessary resources to involve men fruitfully. Thus, men do not engage in the activity as hoped but rather remain on the outskirts of the maternity clinic. However, if men continue to negotiate their involvement at the clinic and become more assertive in their roles, the maternity clinic as a female space could, with time, be transformed into a space in which both expecting mothers and fathers can actively participate and be engaged to the benefit of all.
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Affiliation(s)
- Gloria Abena Ampim
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway.
| | - Astrid Blystad
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Albert Kpoor
- Department of Sociology, University of Ghana, Accra, Ghana
| | - Haldis Haukanes
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
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Boniphace M, Matovelo D, Laisser R, Swai H, Yohani V, Tinka S, Mwaikasu L, Mercader H, Brenner JL, Mitchell J. Men perspectives on attending antenatal care visits with their pregnant partners in Misungwi district, rural Tanzania: a qualitative study. BMC Pregnancy Childbirth 2021; 21:93. [PMID: 33509124 PMCID: PMC7844886 DOI: 10.1186/s12884-021-03585-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 01/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background Mens’attendance with their pregnant partners at facility-based antenatal care (ANC) visits is important for maternal and child health and gender equality yet remains uncommon in parts of rural Tanzania. This study examined men’s perspectives on attending ANC with their pregnant partners in Misungwi District, Tanzania. Methods Twelve individual interviews and five focus group discussions were conducted using semi-structured questionnaires with fathers, expectant fathers, and in-depth interviews were done to health providers, volunteer community health workers, and village leaders. Interviews were recorded and transcribed in Swahili and later translated to English. The research team conducted thematic analysis to identify common themes among interviews. Results We identified two broad themes on the barriers to male attendance at facility-based ANC visits: (1) Perceived exclusion during ANC visits among men (2) Traditional gender norms resulting to low attendance among men. Conclusion Attendance at health facility for ANC visits by men with their pregnant partners in the study areas were challenged by structural and local cultural norms. At the facility men were uncomfortable to sit with women due to lack of specific waiting area for men and that they perceived to be neglected. Local cultural norms demanded women to have secrecy in pregnancy while men perceived not to have a role of being with their partners during ANC visits.
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Affiliation(s)
- Maendeleo Boniphace
- Catholic University of Health and Allied Sciences (CUHAS), Mwanza, Tanzania.
| | - Dismas Matovelo
- Catholic University of Health and Allied Sciences (CUHAS), Mwanza, Tanzania
| | - Rose Laisser
- Catholic University of Health and Allied Sciences (CUHAS), Mwanza, Tanzania
| | | | - Victoria Yohani
- Catholic University of Health and Allied Sciences (CUHAS), Mwanza, Tanzania
| | - Sylvia Tinka
- Catholic University of Health and Allied Sciences (CUHAS), Mwanza, Tanzania
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Iliyasu Z, Galadanci HS, Muhammad B, Yadudu FZ, Kwaku AA, Salihu HM, Aliyu MH. Correlates of HIV-Positive Fathers' Involvement in Prevention of Mother-to-child Transmission Programs in Northern Nigeria. Curr HIV Res 2020; 18:443-457. [PMID: 32778029 DOI: 10.2174/1570162x18666200810133347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/08/2020] [Accepted: 07/17/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The involvement of men in prevention of mother-to-child HIV transmission (PMTCT) programs could accelerate the elimination of vertical transmission. Yet, little research has focused on HIV-positive male partners. This study determined the predictors of male partners' PMTCT knowledge and involvement in a tertiary hospital in northern Nigeria. METHODS A clinic-based sample of 401 HIV-positive male partners of women who delivered within 12 months prior were interviewed using structured questionnaires. PMTCT knowledge and involvement scores were computed. Adjusted odd ratios (AOR) for predictors were derived from multivariate logistic regression models. RESULTS The proportion of respondents with adequate PMTCT knowledge was 40.9%. Less than half (43.6%) of the respondents participated in PMTCT, with median involvement score of 2.00 (interquartile range, IQR = 0, 5.0). One quarter of respondents (25.7%, n =103) reported >1 sex partners, 10.5% consistently used condoms, and 20.7% had disclosed to all partners. Fathers' involvement in PMTCT was predicted by paternal education (AOR = 0.30; 95% Confidence Interval (CI): 0.12-0.77, no formal vs. post-secondary), HIV-positive child (AOR = 3.85; 95%CI: 1.41-10.54, yes vs. no), treatment duration (AOR = 4.17; 95%CI: 1.67-10.41, ≤1 vs. ≥10 years), disclosure to partner(s) (AOR = 1.21; 95%CI: 1.15-3.52, 'disclosed to all' vs. 'not disclosed'), condom use (AOR = 5.81; 95%CI: 3.07-11.0, always vs. never), and PMTCT knowledge (AOR = 0.62; 95%CI: 0.31-0.92, inadequate versus adequate). CONCLUSION The involvement of fathers in HIV PMTCT programs was low and predicted by paternal education, HIV-positive child, duration of antiretroviral treatment, disclosure to partner, consistent condom use, and level of PMTCT knowledge. Our findings will inform the development of policies to increase male partner involvement in PMTCT in Nigeria.
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Affiliation(s)
- Zubairu Iliyasu
- Epidemiology & Biostatistics Division, Department of Community Medicine, Faculty of Clinical Sciences, College of Health Sciences, Bayero University, Kano, Nigeria
| | | | - Bashir Muhammad
- Epidemiology & Biostatistics Division, Department of Community Medicine, Faculty of Clinical Sciences, College of Health Sciences, Bayero University, Kano, Nigeria
| | - Fatima Z Yadudu
- School of Medicine, University of Kentucky, Lexington, KY, United States
| | - Aminatu A Kwaku
- Epidemiology & Biostatistics Division, Department of Community Medicine, Faculty of Clinical Sciences, College of Health Sciences, Bayero University, Kano, Nigeria
| | - Hamisu M Salihu
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas, United States
| | - Muktar H Aliyu
- Department of Health Policy and Vanderbilt Institute for Global Health,Vanderbilt University Medical Center, Tennessee, United States
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