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Yarinbab TE, Gesesew HA, Belachew T. A phenomenological qualitative study of male-partners perspectives of maternity waiting homes in rural Ethiopia. PUBLIC HEALTH IN PRACTICE 2024; 7:100513. [PMID: 38846109 PMCID: PMC11153227 DOI: 10.1016/j.puhip.2024.100513] [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: 01/04/2024] [Revised: 04/27/2024] [Accepted: 05/21/2024] [Indexed: 06/09/2024] Open
Abstract
Background The implementation of maternity waiting home (MWH) has been used as a strategy to improve maternal health outcomes in low-resource settings such as Ethiopia. However, MWH utilization is low in Ethiopia, and women's access to MWH depends largely on male partners' decisions. This study explored male-partners perspectives of MWHs including their experiences of paternal support in rural Ethiopia. Study design An exploratory qualitative study with a phenomenological methodological orientation was performed. Methods This study was conducted in Ana-Lemo and Gibe districts of Hadiya Zone, in rural Southern Ethiopia. The study participants were male partners. A purposive sampling technique was used to recruit 47 participants. Data were collected from May 10-25, 2023. Four focus group discussions, 15 in-depth interviews, and observations were conducted. The interviews were audio-recorded, transcribed and the thematic content analysis was performed using ATLAS.ti 7.1.4 software. Results This study showed that male-partners participated in spousal communication and provided practical support such as sharing household chores and financial support; however, they did not accompany their spouses to health facilities. Long distances, lack of transportation, poor referral services, and perceived poor quality of care were barriers to maternal health services. Furthermore, male-partners demonstrated poor awareness and unfavorable attitudes of MWHs. Conclusions Male-partners participated in spousal communication, shared household chores and provided financial support to their spouses; however, they did not accompany them to health facilities. They had poor awareness and unfavorable attitudes of MWHs. Creating awareness among male partners may improve their attitude towards MWHs and other maternal health services in rural Ethiopia.
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Affiliation(s)
- Teklemariam Ergat Yarinbab
- Department of Population and Family Health, Institute of Health, Jimma University, Jimma, P.O.Box 378, Ethiopia
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Teferi, P.O.Box 260, Ethiopia
| | - Hailay Abrha Gesesew
- Research Center for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, 88Wakefield Street, SA, 5000, Australia
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, P.O.Box 231, Ethiopia
| | - Tefera Belachew
- Department of Nutrition & Dietetics, Institute of Health, Jimma University, Jimma, P.O.Box 378, Ethiopia
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Udenigwe O, Okonofua FE, Ntoimo LFC, Yaya S. Seeking maternal health care in rural Nigeria: through the lens of negofeminism. Reprod Health 2023; 20:103. [PMID: 37461037 DOI: 10.1186/s12978-023-01647-3] [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: 02/12/2023] [Accepted: 07/07/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Feminist scholarship is acutely aware that health is not dependent on behavioural choices alone but on interlocking social determinants that affect people's capacity to lead healthy lives. Women are situated within social structures that impact their health. but there is limited engagement with interpretive tools such as feminist theories that centre the realities of African women, particularly in the context of maternal health. It is imperative that women's control over their reproductive health and autonomy in seeking care, particularly skilled maternal healthcare are understood within this context. This study seeks to examine pregnant women's socio-cultural realities in a Nigerian context and in congruence with articulations of African feminism. Feminist scholarship acknowledges that women are situated within social structures that impact their health. Therefore, this paper seeks to examine pregnant women's socio-cultural realities in a Nigerian context and in congruence with articulations of African feminism. METHOD This is a cross-sectional qualitative study of a total of 64 participants: 39 women and 25 men in Ewato and Okpekpe communities, two Local Government Areas of Edo State in southern Nigeria. The study presents findings from eight sex-and-age desegregated focus group discussions. This study reports on emergent data related to women's decision-making in accessing skilled maternal care. Data were transcribed and translated to English. Using the NVivo 1.6 software, data were coded and analyzed using a conventional approach to content analysis. RESULTS Findings describe ways in which women negotiate authority by ascribing the role of decision-maker to their men spouses while maintaining influence over their pregnancy healthcare decisions and actions. Negofeminism's concepts of alliance, community and connectedness were highlighted through men's constructive involvement in maternal health. Furthermore, women were shown to maneuver patriarchal norms to gain control of their healthcare decisions. CONCLUSION This study offers a different narrative from the dominant view of non-Western women, specifically African women, as oppressed passive victims who are ineffectual in taking charge of their health. From the perspective of negofeminism, women navigate patriarchal environments to yield the best possible maternal health outcomes. The current study can be useful in informing policy and programming that acknowledges women's social embeddedness.
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Affiliation(s)
- Ogochukwu Udenigwe
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, Canada.
| | - Friday E Okonofua
- Women's Health and Action Research Centre, KM 11 Lagos-Benin Expressway, Igue-Iyeha, Benin City, Edo State, Nigeria
- Centre for Excellence in Reproductive Health Innovation, Benin City, Nigeria
| | - Lorretta F C Ntoimo
- Federal University Oye-Ekiti, Km 3 Oye-Are Road, P. M. B. 373, Oye-Ekiti, Ekiti State, Nigeria
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, Canada
- The George Institute for Global Health, Imperial College London, London, UK
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Kaushal P, Khapre M, Das A, Kumari R, Sharma M. Community Perspective of Male Involvement in Maternal Health Care in Uttarakhand, India: A Qualitative Study. J Obstet Gynaecol India 2023; 73:113-122. [PMID: 37073237 PMCID: PMC10105805 DOI: 10.1007/s13224-022-01672-5] [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: 03/02/2022] [Accepted: 06/18/2022] [Indexed: 10/14/2022] Open
Abstract
Background Due to the significant role of male in decision making in India, they may decide if, when and where a woman may access antenatal, delivery and postnatal care; and whether or not to provide financial resources to travel to these services. Men's involvement in maternity care is recognized as a key strategy in improving maternal health and accelerating the reduction of maternal mortality. This study explores key components and challenges to male involvement in maternal health care (MHC). Methods Focus group discussions (FGDs) were conducted with a purposive sample of the community key stakeholders from the field practice area of All India Institute of Medical Sciences, (AIIMS) Rishikesh from October 2020 to January 2021. Manual thematic analysis with a semantic approach was used for the data analysis. Themes were prioritized using Participatory rural appraisal (PRA) technique. Results Twenty-three participants represented the heterogeneous group of key stakeholders. Stakeholders identified the need for improved awareness regarding MHC services among men. Husband involvement is affected by availability (work stations at different places), literacy, gender-based work domain and social cultures, finances and health facility environment.Four major themes were identified: Male involvement in antenatal, intranatal; postnatal care; and barriers to male involvement in MHC. Sub-themes under male involvement in antenatal care; intranatal care; and postnatal care were further prioritized via PRA as 'very important'; 'important' and 'not so important' and scores were given as 3, 2 and 1 respectively. Conclusions Male involvement is a key strategy to improve pregnancy outcome; however, different challenges exist in their involvement in the maternal health care. Current study helped to contextualize the perception regarding importance of male involvement in MHC; and the situation of study area in order to understand social and cultural factors that shape the behavior and practices of men in relation to their involvement.
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Affiliation(s)
- Pawna Kaushal
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Meenakshi Khapre
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Amity Das
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Ranjeeta Kumari
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Megha Sharma
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, India
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Udenigwe O, Okonofua FE, Ntoimo LFC, Yaya S. Understanding gender dynamics in mHealth interventions can enhance the sustainability of benefits of digital technology for maternal healthcare in rural Nigeria. Front Glob Womens Health 2022; 3:1002970. [PMID: 36147776 PMCID: PMC9485539 DOI: 10.3389/fgwh.2022.1002970] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/19/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Nigeria faces enormous challenges to meet the growing demands for maternal healthcare. This has necessitated the need for digital technologies such as mobile health, to supplement existing maternal healthcare services. However, mobile health programs are tempered with gender blind spots that continue to push women and girls to the margins of society. Failure to address underlying gender inequalities and unintended consequences of mobile health programs limits its benefits and ultimately its sustainability. The importance of understanding existing gender dynamics in mobile health interventions for maternal health cannot be overstated. Objective This study explores the gender dimensions of Text4Life, a mobile health intervention for maternal healthcare in Edo State, Nigeria by capturing the unique perspectives of women who are the primary beneficiaries, their spouses who are all men, and community leaders who oversaw the implementation and delivery of the intervention. Method This qualitative study used criterion-based purposive sampling to recruit a total of 66 participants: 39 women, 25 men, and two ward development committee chairpersons. Data collection involved 8 age and sex desegregated focus group discussions with women and men and in-depth interviews with ward development committee chairpersons in English or Pidgin English. Translated and transcribed data were exported to NVivo 1.6 and data analysis followed a conventional approach to thematic analysis. Results Women had some of the necessary resources to participate in the Text4Life program, but they were generally insufficient thereby derailing their participation. The program enhanced women's status and decision-making capacity but with men positioned as heads of households and major decision-makers in maternal healthcare, there remained the possibility of deprioritizing maternal healthcare. Finally, while Text4Life prioritized women's safety in various contexts, it entrenched systems of power that allow men's control over women's reproductive lives. Conclusion As communities across sub-Saharan Africa continue to leverage the use of mHealth for maternal health, this study provides insights into the gender implications of women's use of mHealth technologies. While mHealth programs are helpful to women in many ways, they are not enough on their own to undo entrenched systems of power through which men control women's access to resources and their reproductive and social lives.
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Affiliation(s)
- Ogochukwu Udenigwe
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
- *Correspondence: Ogochukwu Udenigwe
| | - Friday E. Okonofua
- Women's Health and Action Research Centre, Benin City, Edo, Nigeria
- Centre of Excellence in Reproductive Health Innovation, University of Benin, Benin City, Nigeria
| | - Lorretta F. C. Ntoimo
- Department of Demography and Social Statistics, Federal University Oye-Ekiti, Oye-Ekiti, Ekiti, Nigeria
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
- The George Institute for Global Health, Imperial College London, London, United Kingdom
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Shitie A, Dilnessa T, Ayalew S, Tadesse B. Knowledge and factors associated with obstetric danger signs among married men in Dessie town, South Wollo, North-East Ethiopia: a community-based cross-sectional study. BMJ Open 2022; 12:e063936. [PMID: 36581977 PMCID: PMC9438201 DOI: 10.1136/bmjopen-2022-063936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE The aim of this study was to assess knowledge and factors associated with obstetrics danger signs among married men in Dessie town, North-East Ethiopia in 2020. DESIGN Community-based cross-sectional study. SETTING Dessie town, North-East Ethiopia. PARTICIPANTS The study was conducted on selected 824 men. The data were collected through face-to-face interviews using pretested questionnaires and then the data were entered into Epi-Data V.3.1 software, and analysis was carried out using Statistical Package for the Social Sciences V.20. Bivariable and multivariable logistic regression analyses were used to determine the association between each independent variable with the dependent variable, and those variables with a value of p≤0.25 in bivariable analysis were candidates for multivariable analysis. Finally those variables with a value of p<0.05 with 95% CI in multivariable analysis were reported as statistically significant. RESULT This study revealed that the overall knowledge of obstetric danger signs was 53.8% (95% CI 50.2 % to 57.2%). Respondents aged 35-40 years (AOR=4.92, 95% CI 2.6 to 9.0), exposure to media (AOR=10.4, 95% CI 4.19 to 25.9), wife's age ≤35 years (AOR=4.16, 95% CI 2.25 to 7.69), wife who attended secondary education (AOR=1.59, 95% CI 1.06 to 2.39), participation in the Health Development Army (AOR=4.74, 95% CI 1.8 to 12.5), previous obstetric complication (AOR=4.27, 95% CI 2.0 to 9.14) and number of pregnancy ≤2 (AOR=0.42, 95% CI 0.05 to 3.38) and 3-4 (AOR=0.22 95% CI 0.06 to 0.83) were significantly associated with knowledge of obstetric danger signs. CONCLUSION Men's knowledge about obstetric danger signs was low. Age of respondents, wives' age, and respondents' media exposure, participation in the Health Development Army, wives' educational status, previous obstetrics complication and gravidity were significantly associated knowledge of obstetrics danger sign.
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Laksono AD, Wulandari RD, Widya Sukoco NE, Suharmiati S. Husband’s involvement in wife’s antenatal care visits in Indonesia: What factors are related? J Public Health Res 2022. [DOI: 10.1177/22799036221104156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Involving husbands in maternal and child health programs can reduce maternal morbidity and mortality. The study aimed to analyze the factors related to the husband’s involvement in antenatal care (ANC) visits in Indonesia. Methods: The study was a cross-sectional study. The research employed secondary data from the 2017 Indonesian Demographic and Health Survey. The analysis units were wives aged 15–49 years old, married, and pregnant in the past 5 years, and the final samples obtained were 14,319 respondents. In addition to the husband’s involvement were residence, age, education, occupation, wealth, and parity. The study used a binary logistic regression test in the final stage. Results: Husbands who lived in urban areas have odds of being involved in ANC visits 1.2 times greater than those in rural areas. The better the husband’s education was, the more involved they were in ANC. The results show husbands who work in any field were better at being involved in ANC. Poorer husbands had odds of being engaged in ANC visits 2.0 times more likely than the husbands’ lowest group. The most prosperous husbands have odds of being involved in ANC visits 5.4 times than the poorest husbands. The husbands’ wealth is better, the more the husbands were engaged in ANC. The more children were born, the less frequent the husbands’ involvement in ANC is. Conclusion: The study concluded five variables associated with husbands’ participation in ANC in Indonesia, including residence, education, occupation, wealth, and parity.
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Affiliation(s)
- Agung Dwi Laksono
- National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia
- The Airlangga Centre for Health Policy (ACeHAP) Research Group, Surabaya, Indonesia
| | - Ratna Dwi Wulandari
- The Airlangga Centre for Health Policy (ACeHAP) Research Group, Surabaya, Indonesia
- Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
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Wulandari R, Suwandono A, Kartasurya MI, Nugraheni SA. Postpartum Care Behavior Improvement during COVID-19 Pandemic in Indonesia Using Mobile-Health Interactive Message. Ethiop J Health Sci 2022; 32:243-254. [PMID: 35693576 PMCID: PMC9175213 DOI: 10.4314/ejhs.v32i2.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/10/2021] [Indexed: 11/17/2022] Open
Abstract
Background Since 2018, maternal mortality in Semarang City, Indonesia, has mostly (75%) occurred during the postpartum period. Therefore, a health intervention is necessary to improve safe and effective postpartum care. During the Covid-19 pandemic, a mobile-based health intervention is preferred due to the government's regulation of COVID-19 safety prevention. This study aimed to determine the effectiveness of the mobile-health interactive message on the postpartum care behavior of mothers and their husbands. Methods The study was conducted in a quasi-experimental design. It includes the treatment group and the control group, in which each group consists of 46 pairs of pregnant women in the third trimester and their husbands. The research subjects were chosen through the purposive sampling technique. Data collection was conducted via interviews and observations. The m-health intervention is carried out in the form of text messages, images, videos, and interactive mentoring. The latter was carried out through group messaging via the WhatsApp application for the treatment group. Meanwhile, the control group received regular counseling from the local Community Health Center. Data analysis was performed by Mann-Whitney test, unpaired T-Test, Chi-Square Test dan Fisher Exact Test. Results Intervention for 2.5 months increased the knowledge of mothers and husbands. The intervention for 3.5 months improved the mother's attitude, but not the husband's attitude. The intervention also improves maternal practices related to postpartum visits, such as Early Initiation of Breastfeeding assistance requests from health workers, iron tablets and nutritious food consumption, personal hygiene, postpartum danger signs monitoring, and the husband's practice of accompanying mothers during postpartum visits. Conclusion Mobile-Health interactive messages effectively improved postpartum care behavior for mothers and their husbands.
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Affiliation(s)
- Respati Wulandari
- Doctoral Program, Faculty of Public Health, Diponegoro University, Semarang, Indonesia
| | - Agus Suwandono
- Departement of Epidemiology, Faculty of Public Health, Diponegoro University, Semarang, Indonesia
| | - Martha Irene Kartasurya
- Department of Public Health Nutrition, Faculty of Public Health, Diponegoro University, Semarang, Indonesia
| | - Sri Achadi Nugraheni
- Department of Public Health Nutrition, Faculty of Public Health, Diponegoro University, Semarang, Indonesia
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Cockcroft A, Omer K, Gidado Y, Baba MC, Aziz A, Ansari U, Gamawa AI, Mohammed R, Galda SA, Andersson N. Universal home visits improve male knowledge and attitudes about maternal and child health in Bauchi State, Nigeria: Secondary outcome analysis of a stepped wedge cluster randomised controlled trial. J Glob Health 2022; 12:04003. [PMID: 35136595 PMCID: PMC8818298 DOI: 10.7189/jogh.12.04003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Methods Results Conclusion Trial registration
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Affiliation(s)
- Anne Cockcroft
- CIET-PRAM, Department of Family Medicine, McGill University, Montreal, Canada
- Centro de Investigácion de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Guerrero, Mexico
| | - Khalid Omer
- Centro de Investigácion de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Guerrero, Mexico
| | - Yagana Gidado
- Federation of Muslim Women’s Associations of Nigeria (FOMWAN), Bauchi, Nigeria
| | - Muhd Chadi Baba
- Federation of Muslim Women’s Associations of Nigeria (FOMWAN), Bauchi, Nigeria
| | - Amar Aziz
- Centro de Investigácion de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Guerrero, Mexico
| | - Umaira Ansari
- Centro de Investigácion de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Guerrero, Mexico
| | | | - Rilwanu Mohammed
- Bauchi State Primary Health Care Development Agency, Bauchi, Nigeria
| | | | - Neil Andersson
- CIET-PRAM, Department of Family Medicine, McGill University, Montreal, Canada
- Centro de Investigácion de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Guerrero, Mexico
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Wulandari R, Laksono A, Matahari R. Does Husband's Education Level Matter to Antenatal Care Visits? A Study on Poor Households in Indonesia. Indian J Community Med 2022; 47:192-195. [PMID: 36034251 PMCID: PMC9400336 DOI: 10.4103/ijcm.ijcm_981_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 10/19/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Involvement in antenatal care (ANC) is one of the husband's responsibilities for his wife's health. Objective: This study analyzed the contribution of the husband's education level to his involvement in ANC visits among poor households. Methods: The study employed secondary data from the 2017 Indonesian Demographic and Health Survey. The study analyzed 6429 respondents. The analysis units were poor women aged 15–49 years, had a husband, and had ever been pregnant for the past 5 years. Besides husband's education, other independent variables analyzed were residence, husband's age and occupation, and wife's parity. The analysis used a binary logistic regression test in the final step. Results: Husbands with a primary education record were 1.381 times more likely to participate in ANC visits than those without education. Husbands who had secondary education were 2.339 times more likely to get involved in ANC visits than those without education records. Moreover, husbands who had higher education were 3.376 times more likely to be engaged in ANC visits than those without education records. Conclusions: The study concludes that better education levels will be more likely to motivate husbands to get involved in ANC visits.
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Tuyisenge G, Crooks VA, Berry NS. "He lets me go although he does not go with me.": Rwandan women's perceptions of men's roles in maternal health. Glob Health Res Policy 2021; 6:2. [PMID: 33431064 PMCID: PMC7802268 DOI: 10.1186/s41256-020-00185-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 12/26/2020] [Indexed: 11/10/2022] Open
Abstract
Background Increasing men’s involvement in their pregnant partners’ wellness has been reported as one of the ways to improve access to and utilization of maternal health services, including birth preparedness and complication readiness. Men can play meaningful roles in the support systems that pregnant women need to achieve better maternal health outcomes. In Rwanda, the roles that men take vary, resulting in diverse expectations and responsibilities to support the health of women during this critical time. In this study, we aimed to examine the views, perspectives, and experiences of women on men’s involvement in maternal health and how this impacts access and utilization of maternal health services. Methods We conducted 21 interviews with pregnant and recently-pregnant women to gain an understanding of their views on men’s involvement in facilitating their partners’ health during pregnancy. Interviews were conducted across five Rwandan districts in both rural and urban settings of the country. Data analysis was guided by a thematic analysis approach. This started with independent transcript review by the investigators, after which a meeting was held to discuss emergent themes and to identify potential codes. A coding scheme was created and transcripts were coded in NVIVO™ software according to conceptual and practical topics that formed an understanding of men’s involvement in maternal care. Results Three key themes emerged during the analytic process that categorize the specific roles that men play in maternal health: 1) facilitating access to maternal health services, which involves assisting women with getting and or attending appointments jointly with men; 2) supporting women’s decisions, wherein men can support the decisions women make with regard to their maternal healthcare in a number of ways; and 3) evaluating information, including gathering information from multiple sources, especially from community health workers, to assist women with making informed decisions. Conclusion Rwandan men take on three types of roles in supporting women’s maternal health, and their responsibilities are experienced differently by women. Interventions involving men are encouraged to increase their understanding of the implications of their involvement in maternal health without compromising women’s autonomy in decision-making and to promote positive maternal health outcomes.
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Affiliation(s)
- Germaine Tuyisenge
- Department of Geography, Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada. .,Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.
| | - Valorie A Crooks
- Department of Geography, Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada
| | - Nicole S Berry
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
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Midtgaard Eriksen C, Lauridsen Kujabi M, Sulaiman Kanu A, Gulis G. Health Perceptions in Relation to Child Health and Mortality in a Rural Context, Sierra Leone: A Mixed Method Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18010308. [PMID: 33406601 PMCID: PMC7796266 DOI: 10.3390/ijerph18010308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/28/2020] [Accepted: 12/30/2020] [Indexed: 11/16/2022]
Abstract
Child survival and wellbeing remain a global health challenge despite vast development within the area and a significant decline in mortality rates of children under five years of age. This study investigates the perceived causes of ill health and childhood mortality in the context of five villages located in the Tonkolili district of Sierra Leone. Mixed method methodology was applied in this study consisting of both quantitative and qualitative data contribution. The quantitative part consisted of a household survey on child health, where 341 households, equivalent to 50.6% of the total number of households in the five villages, participated with a response rate of 100%. The qualitative part consisted of six semi structured interviews-one with a health care worker and five with mothers from each village. The main perceived reason for child morbidity was inadequate care of children related to personal hygiene of the child, hygiene and safety in the environment, in-sufficient nutrition, inadequate supervision and poor healthcare seeking behavior. Additionally, reasons given for disease included supernatural forces such as witchcraft. In relation to the survey, the perceived causes of child mortality for ill children in the villages were mainly malaria (33.6%), diarrhea (11.6%), pneumonia (8.6%), and unknown (26%). The observed symptoms of illness among children were fever (43.7%), cough and difficulty breathing (10.7%), frequent watery stool (10.3%) and no symptoms (20.3%). The perception of ill health in children was mainly associated with the parent's ability to cater for the child's physical needs, but also associated with external factors such as witchcraft and "God's will". In addition, biomedical causes for disease and supernatural causes for disease were seen to coexist.
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Affiliation(s)
| | - Monica Lauridsen Kujabi
- Global Health Section, Department of Public Health, University of Copenhagen, 1050 Copenhagen, Denmark;
| | | | - Gabriel Gulis
- Unit for Health Promotion Research, University of Southern Denmark, 6700 Esbjerg, Denmark;
- Correspondence: ; Tel.: +45-65504212
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McLean KE. Men's experiences of pregnancy and childbirth in Sierra Leone: Reexamining definitions of "male partner involvement". Soc Sci Med 2020; 265:113479. [PMID: 33218892 DOI: 10.1016/j.socscimed.2020.113479] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/21/2020] [Accepted: 10/26/2020] [Indexed: 11/28/2022]
Abstract
In recent decades, global health researchers and policy makers have advocated for men's increased involvement in pregnancy and childbirth with the goal of improving maternal health outcomes. By "involvement," these actors generally refer to narrow-largely Western-definitions of participation: accompanying women to antenatal and postpartum care visits, engaging in childbirth education, or being present during delivery. However, such approaches often fail to account for the culturally valid and gendered ways in which men already are involved in supporting women's reproductive health. This study is based on participant observation, semi-structured interviews, and life histories conducted among 106 fathers in eastern Sierra Leone over the course of 2013-2016. Findings demonstrate that in Sierra Leone, where pregnancy and childbirth are considered to belong to the domain of women, men's primary role is to supply the material resources for a safe and healthy birth: a nutritious diet, transportation to healthcare facilities, medicines and supplies in the case of emergency, and the items to wash and dress the baby. While evidence suggests that gender norms are shifting to include other forms of intimate and emotional involvement, it is important to recognize existing forms of material support as valuable and essential forms of care. By restricting male involvement to biomedical notions of care, global health programs and policies risk discounting other types of socially meaningful support. Rather than disparaging young, African men for falling short of what Western organizations and researchers perceive to be "correct" behaviors, this paper attempts to highlight men's own understandings of involvement, so as to provide a more complete picture of the gendered nature of reproductive health in this context.
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Affiliation(s)
- Kristen E McLean
- International Studies Program, College of Charleston, 9 Glebe Street, Charleston, SC, 29424, USA.
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