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

Male partners' involvement in birth preparedness and complication readiness plan in Dale district, Sidama regional state, Ethiopia, 2021

BACKGROUND

Male partners' involvement in birth preparedness and complication readiness plans is a key strategy to improve maternal and child health. It assists an expectant mother to make timely decisions in receiving care where service is inaccessible. Despite its significance, information is scarce about male partner involvement in birth preparedness and complication readiness plan in the study setting.

OBJECTIVE

To assess prevalence and factors associated with male partners' involvement in birth preparedness and complication readiness plan in Dale district Sidama, Ethiopia in 2021.

METHODS

A community-based survey was done from November to December, in 2021. Data were collected using a structured, pre-tested and interview administered questionnaire. A multi-stage cluster sampling was applied to recruit 634 samples. Logistic regression analysis was performed to identify factors associated with male partner involvement in birth preparedness and complication readiness plan. Adjusted odds ratios (AORs) and 95% confidence intervals (95% CI) of associated factors were estimated by stepwise backward likelihood ratio method.

RESULTS

622 out of the 634 study participants completed the interview, yielding a 98.1% response rate. Prevalence of male partners' involvement in birth preparedness and complication readiness plan was 47.6% (95%CI: 44.9%, 48.9%). After adjusting the cofounding variables, factors like accompanying wives with their partners during their antenatal care visits (AOR = 2.3, 95%CI 1.5, 3.5), male partners whose wives had a history of caesarean birth (AOR = 2.1, 95%CI 1.1, 3.8), knowledge of male partners on birth preparedness and complication readiness plan (AOR = 3.5, 95%CI:3.1,6.6), presence of obstetric complications(AOR = 5.1,95%CI:4.3,11.2),primi-gravida (AOR = 2.7,95%CI:1.6,4.7), and male partners' knowledge of obstetrics complications (AOR = 3.5,95%CI,2.2,5.7) were significantly associated with male partners' involvement in birth preparedness and complication readiness plan.

CONCLUSION

This study indicates that prevalence of male partners' involvement in birth preparedness and complication readiness was low. Therefore, awareness creation should be strengthened on male involvement on birth preparedness and complication readiness plan.

Impact of the Momentum pilot project on male involvement in maternal health and newborn care in Kinshasa, Democratic Republic of the Congo: a quasi-experimental study

Background

The World Health Organization recommends that programs that seek to improve maternal and newborn health outcomes actively involve men during pregnancy, childbirth, and postpartum. However, there is little evidence on what strategies work to increase male knowledge of and involvement in antenatal and postnatal care. This study assessed the impact of the Momentum project on male involvement in maternal health and newborn care. The project involved monthly home visits to a cohort of first-time mothers aged 15–24 recruited at six-months gestation and group education sessions for their male partners using the Program P toolkit. Participants were followed-up for 16 months.

Methods

The study used a quasi-experimental design with three intervention and three comparison health zones. Baseline data were collected in 2018 and endline data in 2020. Exploratory factor analysis was used to develop scales of male involvement. We measured the causal influence of Momentum using an intent-to-treat analysis at the health-zone level and a dose–response analysis at the individual level. We used random-effects probit and linear models for outcomes measured at baseline and endline, and treatment effects models with inverse-probability weighting for outcomes measured only at endline. The impact analysis involved 1,204 male partners of first-time mothers with live births.

Results

Intervention health zones were associated with an 18.1 percentage point (95% CI [(10.6, 25.6]) increase in knowledge of three or more obstetric danger signs and a 13.9 percentage point (95% CI [6.3, 21.6]) increase in knowledge of newborn danger signs. Significant increases in male involvement in antenatal care (average treatment effect (ATE) = 0.728, 95% CI [0.445, 1.010]), birth planning (ATE = 0.407, 95% CI [0.157, 0.657]), and newborn care (ATE = 0.690, 95% CI [0.359, 1.021]) were found. The magnitude of Momentum’s impact increased steadily with the number of prenatal home visits and was statistically significant for all behavioral outcomes except shared decision making. Exposure to both home visits and group education sessions during the prenatal period had a significant impact on all outcomes relative to no exposure.

Conclusions

The study demonstrated the effectiveness of Momentum on male involvement in maternal health and newborn care.

Husbands' Plan to Participate in Birth Preparedness and Complication Readiness in Haramaya Health and Demographic Surveillance System Site, Eastern Ethiopia: A Community-Based Cross-Sectional Study

Background

Partner involvement in maternal health services utilization remains a major public challenge in the developing world. Strategies of involving men in maternal health services are a critical and proven intervention for reducing maternal and neonatal mortality by ensuring safe delivery and reducing complications during childbirth. Moreover, the husbands' involvement during pregnancy helps their spouses to make timely decisions and avoid maternal delays, especially first and second delays. Although birth and complication readiness have been studied in developing countries such as Ethiopia, almost all previous researchers were focused primarily on women participants. Therefore, we aimed to investigate factors associated with husband involvement in birth preparedness and complication readiness plan in Haramaya Health and Demographic Surveillance site, Eastern Ethiopia.

Methods

A community-based cross-sectional study was conducted from March 1 to 30, 2020 among men whose wives were pregnant in Haramaya Health and Demographic Surveillance (HDSS) site in Eastern Ethiopia. The calculated sample size was 653, however while contacting 653 husbands only 630 had given the full interview, hence 630 respondents were remained in the analysis. Participants were approached through a systematic sampling technique. Data were collected using a pre-tested structured questionnaire through a face-to-face interview, and entered into Epidata version 3.1 and analyzed using SPSS version 22 (IBM SPSS Statistics, 2013). The prevalence was reported using proportion with 95% Confidence Interval (CI) and summary measures. Predictors were assessed using a multivariable logistic regression analysis model and reported using an adjusted odds ratio (AOR) with 95%CI. Statistical significance was declared at p < 0.05.

Results

Overall, the prevalence of the husband's plan to participate in birth preparedness and complication readiness was 59.6% (95%CI:56-64%). In the final model of multivariable analysis, predictors like husband's knowledge of birth preparedness and complication readiness [AOR = 4.18, 95%CI:2.05, 8.51], having a discussion with spouse on the place of delivery [AOR = 6.84, 95% CI: 4.17, 11.22], husband's knowledge of danger signs during labor and delivery [AOR = 3.19, 95 % CI: 1.52, 6.71], and making a postpartum plan[AOR = 2.30, 95 % CI: 1.38, 3.85] were factors statistically associated with husband's plan to participate in birth preparedness.

Conclusions

This study pointed out that two in every five husbands failed to plan birth preparedness and complication readiness. As a result, all stakeholders should emphasize male partners' education in terms of birth preparedness and complication readiness, as well as knowledge of danger signs during labor and delivery. They should also encourage male partners to discuss a place of delivery and have a postpartum plan in place to reduce potential complications related to labor and delivery.

The role of men in antenatal care and preventing HIV transmission from mothers to infants in Gambella region, Ethiopia

Prevention of vertical transmission of HIV has evolved over the past two decades. Although public health agencies advocate for male involvement in such interventions, their role in the prevention of vertical transmission of HIV remains limited. This study aims to explore the role of men in antenatal care and prevention of vertical transmission of HIV in the Gambella region of Ethiopia. The study was conducted among the Nuer and Anuak communities in Gambella region. Participants included female antenatal care attendees at two health centers, men who were husbands, local health extension workers of the catchment villages, and health care providers and managers. Data were collected using focus group discussions, in-depth interviews, and key informant interviews. Recordings were transcribed, coded, and analysed using thematic approaches. MAXQDA version 11 was used to facilitate data organization and reduction. Findings showed that men in Gambella are not expected to accompany their wives to health facilities or encourage them to visit the facilities in connection to pregnancy. Participants reported that men rarely visit health facilities with their partners, and they are largely unaware of the connection between antenatal care during pregnancy and prevention of mother to child transmission of HIV. Participants indicated that women's attendance at health facilities during pregnancy is not a common practice, and if they do visit them in connection to pregnancy there may be suspicion she has HIV. In this cultural context, men do not have a role in the health care of their wives during pregnancy. Men's engagement may be further lessened by the common perception that visiting a health facility in connection to pregnancy is associated with HIV.