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Moyo E, Dzinamarira T, Moyo P, Murewanhema G, Ross A. Men's involvement in maternal health in sub-Saharan Africa: A scoping review of enablers and barriers. Midwifery 2024; 133:103993. [PMID: 38626505 DOI: 10.1016/j.midw.2024.103993] [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: 11/18/2023] [Revised: 03/17/2024] [Accepted: 04/05/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Globally, there are about 800 maternal deaths every day, with low-to-middle-income countries accounting for most of these deaths. A lack of access to maternal healthcare services is one of the main causes of these deaths. In sub-Saharan Africa (SSA), one of the barriers to accessing maternal healthcare services by women is a lack of their male partners' involvement. This scoping review aimed to assess the enablers and barriers to men's involvement in maternal healthcare services. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) checklist was used as a guide for this review. We searched for peer-reviewed articles published between 2013 and 2023 in the English language from SCOPUS, ScienceDirect, PubMed, Africa Journals Online (AJOL), and Google Scholar databases. Two reviewers independently conducted the data extraction and article selection. All of the authors discussed and decided on the codes and categories for enablers and barriers after using NVivo to generate them. RESULTS Twenty-seven articles were used in this review. Of these, seventeen were qualitative studies, six were quantitative studies, and four were mixed-methods studies. The enablers of men's involvement in maternal healthcare were grouped into sociodemographic factors, health system factors, and policy factors, while barriers were grouped into sociodemographic, cultural, economic, and health system barriers. The lack of maternal health knowledge, insufficient economic resources, and unfriendly staff at healthcare facilities all contributed to a lack of involvement by men. CONCLUSION To improve men's involvement in maternal healthcare in SSA, there should be economic empowerment of both men and women, health education, and the provision of adequate infrastructure in healthcare facilities to accommodate men.
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Affiliation(s)
- Enos Moyo
- University of Kwa-Zulu Natal, College of Health Sciences, School of Nursing & Public Health, Durban, South Africa.
| | - Tafadzwa Dzinamarira
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.
| | | | - Grant Murewanhema
- University of Zimbabwe, Faculty of Medicine and Health Sciences, Unit of Obstetrics and Gynaecology, Harare, Zimbabwe
| | - Andrew Ross
- University of Kwa-Zulu Natal, College of Health Sciences, School of Nursing & Public Health, Durban, South Africa
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Jemberie MM, Zewdu M, Rade BK. Husbands' knowledge and involvement in sexual and reproductive health rights of women in Bahir Dar City, Northwest Ethiopia: a community-based study. Front Public Health 2024; 12:1359756. [PMID: 38694978 PMCID: PMC11061407 DOI: 10.3389/fpubh.2024.1359756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/27/2024] [Indexed: 05/04/2024] Open
Abstract
Background Sexual and reproductive health rights (SRHRs) are integral elements of the rights of everyone to the highest attainable standard of physical and mental health, but they are the most underdeveloped and least understood sphere of rights, especially in Africa, including the country of Ethiopia. The implementation of women's SRHRs is essential for achieving gender equality and promoting women's rights. Husbands' knowledge and involvement play a significant role in improving women's practice of their SRHRs. However, there is limited information/data about the level of husbands' knowledge and involvement in Northwest Ethiopia, including Bahir Dar City. Therefore, this study aimed to assess husbands' knowledge, involvement, and factors influencing their involvement in women's SRHRs. Methods Community-based cross-sectional study design was conducted from March 20 to April 5, 2023, in Bahir Dar City, Northwest Ethiopia, among 391 husbands. Multi-stage sampling and simple random sampling technique were applied to select kebeles and study participants, respectively. Participants were interviewed face-to-face using structured and pretested questionnaire. Binary logistic regression was applied to identify associated factors, and a p-value of <0.05 was a cutoff point to declare statistical significance. Results In this study, 50.6% (198/391) of the husbands had good knowledge about their wives' SRHRs and 44.2% (173/391) (95% CI, 39.3-49.1%) of the husbands were involved when their wives practiced their SRHRs. Access training/education about sexual health [AOR = 5.99; 95% CI (2.7-13.2)], husbands' advance educational level [AOR = 8.81; 95% CI (2.04-38)], good knowledge about SRHRs [AOR = 7.94; 95% CI (4.3-14.4)], low monthly income (<4,600 birr) [AOR = 9.25; 95% CI (4.2-20.5)], and had open discussion with family members and friends about SRHRs [AOR = 1.92; 95% CI (1.01-3.6)] were found to have significant association with husbands' involvement. Conclusion Husbands' level of knowledge on SRHRs of women and their involvement remain low. Therefore, responsible concerned bodies need to work on the strategies that help to improve men involvement and knowledge, and tackle the above-mentioned factors influencing their involvement.
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Affiliation(s)
| | - Meseret Zewdu
- Department of Gender and Developmental Studies, Faculty of Social Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Bayew Kelkay Rade
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Omona K, Mahoro RM. Factors associated with men’s participation in postpartum family planning: a study of Kiswa Health Centre III, Kampala, Uganda. J OBSTET GYNAECOL 2023; 43. [DOI: https:/doi.org/10.1080/01443615.2022.2158321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/09/2022] [Indexed: 02/17/2024]
Affiliation(s)
- Kizito Omona
- Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda
| | - Rose Mary Mahoro
- Department of Communication and Policy, Marie Stopes Uganda, Kampala, Uganda
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Omona K, Mahoro RM. Factors associated with men's participation in postpartum family planning: a study of Kiswa Health Centre III, Kampala, Uganda. J OBSTET GYNAECOL 2023; 43:2158321. [PMID: 36606701 DOI: 10.1080/01443615.2022.2158321] [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: 01/07/2023]
Abstract
Low uptake of family planning among women is predominantly attributed to low participation of men in postpartum family planning. In order to improve maternal health, strengthening male participation in family planning is an important public health initiative. This study aimed to assess factors associated with participation of men in postpartum care at Kiswa Health Centre III, Nakawa division, Kampala. An analytical cross-sectional study design involving collection of quantitative data was used. Systematic random sampling was used to select study participants. Data was collected using semi-structured questionnaires. Data entry and cleaning was performed using EpiData version 12 and analysed using Stata version 14. 80.0% of respondents participated in postpartum family planning. Approval of family planning use, knowledge on family planning and information source were significantly associated with male involvement in postpartum family planning. Respondents who approved family planning use at home were 15.5 times more likely to get involved in family planning services as compared to those who didn't approve family planning. Conclusively, there was a generally high level of male involvement in postpartum family planning in comparison with the national levels. Approval of family planning at home increased the likelihood of men's participation in family planning.IMPACT STATEMENTWhat is already known on this subject? Evidence has it that short birth intervals of less than 15 months have been found to be associated with adverse pregnancy outcomes including induced abortions, miscarriages, preterm births, neonatal and child mortalities, still births and maternal depletion syndrome. In Africa, generally, low family uptake among women is also attributed to low men participation in postpartum family planning.What do the results of this study add? Approval of family planning use, knowledge on family planning and information source were associated with male involvement in postpartum family planning. Respondents who approved family planning use at home were 15.5 times more likely to get involved in postpartum family planning services as compared to those who didn't approve family planning.What are the implications of these findings for clinical practice and/or further research? In this study, the involvement of men was relatively high, but more studies are needed in other locations to compare with this finding. Otherwise, consolidation of such high involvement is highly needed, as this can be a starting point for further improvement.
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Affiliation(s)
- Kizito Omona
- Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda
| | - Rose Mary Mahoro
- Department of Communication and Policy, Marie Stopes Uganda, Kampala, Uganda
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Abdollahzadeh Sardehaei S, Merghati Khoei E, Niusha B, Rezaei Z. The male-focused marital relationship enrichment and sexual well-being interventions: A scoping review. Int J Reprod Biomed 2023; 21:975-984. [PMID: 38370485 PMCID: PMC10869958 DOI: 10.18502/ijrm.v21i12.15035] [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: 02/25/2023] [Revised: 06/21/2023] [Accepted: 11/13/2023] [Indexed: 02/20/2024] Open
Abstract
Background There is an increasing need for sexual well-being and health promotion strategies that effectively engage men. Researchers have evaluated the efficacy of sexual and reproductive health-related and marital enhancement interventions in male-dominated societies. However, few have focused on culturally appropriate and gender-specific program effects. Objective This review aims to evaluate evidence of existing interventions aimed at enriching marital relationships and sexual well-being in adult men. Materials and Methods This scoping review was conducted by searching various databases (CINAHL, PsycINFO, EMBASE, Google Scholar, PubMed, Scopus, SID, and Noormags), and other available resources in both English and Persian languages. We located all publications up to January 2023 with no time restriction. Inclusion criteria were studies targeting men in the enrichment of marital and sexual relationships, which focus on marital/sexual enrichment, sexual and reproductive health (SRH) program, passionate relationship, or sexual satisfaction as the main outcomes. PRISMA guidelines were utilized in this review. Results Of records 34,405 retrieved by searching, after removing duplicate articles, 8 articles were included based on the inclusion criteria. SRH program was the main focus of 6 articles. Marital and sexual enhancement were common areas of focus in 2 studies. Research methods included 2 semi-experimental, 3 clinical trials, 1 systematic review, 1 content analysis, and a mixed method. According to the assessment result, 4 articles were moderate and 4 were of high quality. Conclusion Our findings reveal that a small number of interventions specifically offering SRH or marital and sexual enhancement programs to men should be conducted. As the majority were heterosexual couples, we recommend male-focused programs recognizing men's sexuality.
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Affiliation(s)
| | - Effat Merghati Khoei
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
- The Family and Sexual Health Division, Brain and Spinal Cord Injury Research Center (BASIR), Neuroscience Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Beheshteh Niusha
- Department of Psychology, Faculty of Humanities, Saveh Branch, Islamic Azad University, Saveh, Iran
| | - Zahed Rezaei
- Asadabad School of Medical Sciences, Asadabad, Iran
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Yarinbab TE, Gesesew HA, Harrison MS, Belachew T. Effect of couple-based health education on male-partners knowledge and attitude towards maternity waiting homes in rural Ethiopia: a cluster-randomized trial. Sci Rep 2023; 13:18446. [PMID: 37891206 PMCID: PMC10611718 DOI: 10.1038/s41598-023-45681-4] [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: 08/12/2023] [Accepted: 10/23/2023] [Indexed: 10/29/2023] Open
Abstract
This cluster-randomized controlled trial examined the effect of couple-based health education on male partners' knowledge and attitude towards maternity waiting homes (MWH) in rural Ethiopia. Sixteen clusters and 320 couples were randomly assigned to intervention group (receiving group health education, home visits and print health messages alongside usual care) or control group (receiving usual care). The Chi-square test was used to estimate statistical differences, and the difference-in-differences model was used to estimate the effect of the intervention. The generalized linear regression model was used to determine the odds of outcomes between the groups. Statistical significance was set at p < 0.05, with a 95% CI. There were no significant differences in baseline characteristics between the control and intervention groups. The net effect of the intervention on improving knowledge about MWHs, and attitude towards MWHs were 35.6% and 36.2%, respectively. The participants in the intervention group were 5.5 times more likely to have good knowledge about MWH (AOR 5.55, 95% CI 3.37-9.14) and 5.6 times more likely to have a favorable attitude towards MWH (AOR 5.61, 95% CI 3.45-9.10) compared to their counterparts. Health education provided to couples significantly improved male partners' knowledge and attitude towards MWHs in rural Ethiopia.Trial registration: ClinicalTrials.gov Identifier: NCT05015023.
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Affiliation(s)
- Teklemariam Ergat Yarinbab
- Institute of Health, Department of Population and Family Health, Jimma University, Jimma, Ethiopia.
- Department of Epidemiology and Biostatistics, College of Health Sciences, Mizan Tepi University, Mizan Teferi, Ethiopia.
| | - Hailay Abrha Gesesew
- Research Center for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, Australia
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Margo Shawn Harrison
- Department of Gynecology and Obstetrics, School of Medicine, University of Colorado, Denver, CO, USA
| | - Tefera Belachew
- Department of Nutrition & Dietetics, Institute of Health, Jimma University, Jimma, Ethiopia
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Angusubalakshmi R, Boratne AV, Venkataraman S. Male involvement as a significant contributor for enhancing maternal and child health-care services: A scoping review. Indian J Public Health 2023; 67:455-460. [PMID: 37929390 DOI: 10.4103/ijph.ijph_1749_22] [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] [Indexed: 11/07/2023] Open
Abstract
Men have conventionally been excluded from Maternal and Child Health (MCH) services, thereby reinforcing the erroneous notion that pregnancy and the processes leading to childbirth and child-rearing are the preserve of women. Participation of men in MCH is crucial for the reduction of infant and maternal mortality. This scoping review focuses on the contribution of male involvement to MCH care and explores the feasible strategies to improve it. Studies on male involvement in the crucial timelines of the MCH and strategies for implementing and improving male involvement in MCH care in India and other developing countries were obtained through a review of literature in PubMed databases using the medical subject headings (MeSH) terms and unpublished, grey literature during the year 1990-2020. Nearly 50 of the eligible articles were included and synthesized into a scoping review report. Findings revealed that the men's participation had a beneficial impact on all crucial timelines of MCH care. Yet, women perceived low male participation in most of the studies. Several different factors that influence have been identified, including education, socioeconomic status, traditional practices, negative stereotyping among males, and lack of male friendly health-care system. Utilization of community volunteers, male peer educators, workplace-based or mass media education, and men-friendly policy changes or health-care provider initiatives could be crucial in improving male involvement in MCH care. Despite worldwide acceptance as an essential contributor to enhancing MCH care, the scoping review revealed low male involvement levels in developing countries and identified strategies to address this lacuna.
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Affiliation(s)
- R Angusubalakshmi
- Assistant Professor, Department of Community Medicine, Saveetha Medical College and Hospital, SIMATS, Chennai, Tamil Nadu, India
| | - Abhijit Vinodrao Boratne
- Additional Professor, Department of Community and Family Medicine, AIIMS Deoghar, Jharkhand, India
| | - Surendran Venkataraman
- Assistant Professor, Department of Community Medicine, Indira Gandhi Medical College and Research Institute Institute, Perunthalaivar Kamaraj Medical College Society, Puducherry, India
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Ferla JP, Gill MM, Komba T, Abubakar A, Remes P, Jahanpour O, Mariki M, Mang'enya MA, Van de Ven R, Antelman G. Improvement of community health worker counseling skills through early childhood development (ECD) videos, supervision and mentorship: A mixed methods pre-post evaluation from Tanzania. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001152. [PMID: 37276228 DOI: 10.1371/journal.pgph.0001152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 05/04/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Community health workers (CHWs) play significant roles in improving health practices in under- resourced communities. This study evaluated an early childhood development (ECD) project in Tanzania assessing the effect of mobile video use, supervision and mentorship to improve quality of CHW counseling skills. METHODS CHWs participating in the Malezi Project in Tabora Region were enrolled in a mixed methods pre-post evaluation. CHWs previously trained in UNICEF's Care for Child Development package were further trained in counselling caregivers on nurturing care and father engagement using videos. Health providers were trained to provide ECD-focused supervision/mentorship of CHWs in facilities and during home visits. At baseline and endline, CHWs completed interviews and trained study staff observed and scored CHW counseling sessions using a structured checklist which were reduced into six dimensions through principal component analysis: introduce, educate, ask, plan/problem solve, interact/encourage, and responsive care. Twenty-five in-depth interviews were completed with caregivers and four focus group discussions with CHWs were conducted. RESULTS Almost all (n = 107; 95%) 119 enrolled CHWs completed the expected eight observations (n = 471 baseline; n = 453 endline). At endline, more CHWs reported having one-on-one meetings with their supervisors (51% increasing to 75%; p < .0002) and that supervisors accompanied them to households for mentoring (60% increasing to 89%; p < .0001). We observed a shift in CHW counselling skills in clinic and home sessions. Scores in the categories of introduce, plan/problem solve, and interact/encourage significantly improved between baseline and endline; scores for ask and educate remained unchanged or decreased at both timepoints. Two-thirds of caregivers interviewed reported that father's involvement with their child increased due to CHW visits. Male participation increased in home observation sessions from 5.6% at baseline to 17.6% at endline (p < .0001). CONCLUSION Use of videos, supervision, and mentorship were associated with CHW performance improvements in providing nurturing care counselling and in father engagement, especially in home settings.
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Affiliation(s)
| | - Michelle M Gill
- Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, United States of America
| | - Teopista Komba
- Elizabeth Glaser Pediatric AIDS Foundation, Dar es Salaam, Tanzania
| | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Pieter Remes
- Development Media International, Mwanza, Tanzania
| | - Ola Jahanpour
- Elizabeth Glaser Pediatric AIDS Foundation, Dar es Salaam, Tanzania
| | - Martha Mariki
- President's Office Regional and Local Government, Dodoma, Tanzania
| | - Mary A Mang'enya
- Community Development, Gender, Elderly and Children, Tanzania Ministry of Health, Dodoma, Tanzania
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Roudsari RL, Sharifi F, Goudarzi F. Barriers to the participation of men in reproductive health care: a systematic review and meta-synthesis. BMC Public Health 2023; 23:818. [PMID: 37143008 PMCID: PMC10158256 DOI: 10.1186/s12889-023-15692-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 04/17/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Despite emphasizing the importance and benefits of men's active engagement in reproductive health programs, their engagement in reproductive health care is low. Researchers have identified different barriers to men's avoidance of participation in various aspects of reproductive health in different parts of the world. This study provided an in-depth review of the hindrances to men's non-participation in reproductive health. METHODS This meta-synthesis was conducted using keyword searches in databases including PubMed, Scopus, Web of Science, Cochrane, and ProQuest until January 2023. Qualitative English-language studies that investigated barriers to men's participation in reproductive health were included in the study. The critical appraisal skills program (CASP) checklist was used to assess the articles' quality. Data synthesis and thematic analysis were done using the standard method. RESULT This synthesis led to the emergence of four main themes such as failure to access all inclusive and integrated quality services, economic issues, couples' personal preferences and attitudes, and sociocultural considerations to seek reproductive healthcare services. CONCLUSION Healthcare system programs and policies, economic and sociocultural issues, and men's attitudes, knowledge, and preferences, influence men's participation in reproductive healthcare. Reproductive health initiatives should focus on eliminating challenges to men's supportive activities to increase practical men's involvement in reproductive healthcare.
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Affiliation(s)
- Robab Latifnejad Roudsari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farangis Sharifi
- Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Fatemeh Goudarzi
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
- Department of Midwifery, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran.
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Rahayu S, Romadlona NA, Utomo B, Aryanty RI, Liyanto E, Hidayat M, Magnani RJ. Reassessing the level and implications of male involvement in family planning in Indonesia. BMC Womens Health 2023; 23:220. [PMID: 37138275 PMCID: PMC10158201 DOI: 10.1186/s12905-023-02354-8] [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: 08/01/2022] [Accepted: 04/14/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Although there is global recognition of the importance of involving men in family planning and reproductive health matters, this issue has received insufficient attention in many countries. The present study sought to characterize married Indonesian males as to their level of involvement in family planning, identify the correlates thereof and assess the implications of male involvement for unmet need for family planning. METHODS A mixed methods research design was used. The main source of quantitative data was 2017 Indonesian Demographic Health Survey (IDHS) data from 8,380 married couples. The underlying "dimensions" of male involvement were identified via factor analysis. The correlates of male involvement were assessed via comparisons across the four dimensions of male involvement identified in the factor analysis. Outcomes were assessed by comparing women's and couple's unmet need for family planning for the four underlying dimensions of male involvement. Qualitative data were collected via focus group discussions with four groups of key informants. RESULTS Indonesian male involvement as family planning clients remains limited, with only 8% of men using a contraceptive method at the time of the 2017 IDHS. However, factor analyses revealed three other independent "dimensions" of male involvement, two of which (along with male contraceptive use) were associated with significantly lower odds of female unmet need for family planning. Male involvement as clients and passive male approval of family planning, which in Indonesia empowers females take action to avoid unwanted pregnancies, were associated with 23% and 35% reductions in female unmet need, respectively. The analyses suggest that age, education, geographic residence, knowledge of contraceptive methods, and media exposure distinguish men with higher levels of involvement. Socially mandated gender roles concerning family planning and perceived limited programmatic attention to males highlight the quantitative findings. CONCLUSIONS Indonesian males are involved in family planning in several ways, although women continue to bear most of the responsibility for realizing couple reproductive aspirations. Gender transformative programming that addresses broader gender issues and targets priority sub-groups of men as well as health service providers, community and religious leaders would seem to be the way forward.
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Affiliation(s)
- Sukma Rahayu
- Knowledge Hub for Reproductive Health, Faculty of Public Health, Universitas Indonesia, Kota Jakarta Pusat, Indonesia.
| | - Nohan Arum Romadlona
- Department of Public Health Science, Faculty of Sport Science, Universitas Negeri Malang, Kota Malang, Indonesia
| | - Budi Utomo
- Knowledge Hub for Reproductive Health, Faculty of Public Health, Universitas Indonesia, Kota Jakarta Pusat, Indonesia
| | | | | | | | - Robert J Magnani
- Knowledge Hub for Reproductive Health, Faculty of Public Health, Universitas Indonesia, Kota Jakarta Pusat, Indonesia
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Okwako JM, Mbuthia GW, Magutah K. Barriers to male partner accompaniment and participation in maternal and child health care in Thika and Kiambu Level Five Hospital, Kenya. Pan Afr Med J 2023; 44:189. [PMID: 37484582 PMCID: PMC10362673 DOI: 10.11604/pamj.2023.44.189.38293] [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: 11/18/2022] [Accepted: 03/26/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction the 1994 International Conference on Population and Development (ICPD) recommended that men should share responsibility and be actively involved in responsible parenthood, sexual and reproductive health. The level of male involvement in Kenya remains low despite growing evidence showing its benefits in maternal and newborn health. This study sought to determine factors influencing male partner involvement in maternal and child health with focus on accompaniment to maternal and child health (MCH) department. Methods a qualitative study utilizing exploratory design was used to gather the views of men and nurse-midwives working in the MCH department of Thika and Kiambu County Teaching and Referral hospitals in January 2022. Qualitative data were collected from focused group discussions from nurses and men respectively. The number of participants per Focused Group Discussion (FGD) ranged between six to eight. The principal author moderated the FGD that were audio recorded and lasted between 60-90 minutes. Content analysis was used to analyse data following the five steps to yield themes using MAXQDA 2022 software. Results five categories emerged as factors influencing male accompanying their spouses to MCH clinic: traditional gender norms, roles and beliefs, unfavorable MCH environment, work commitment, fear of HIV testing and men's work commitment. Conclusion traditional gender roles and norms, work commitment by men and unfavourable MCH set-up were key barriers identified that hinder men from accompanying their spouses to MCH clinic. There is need to develop an effective, feasible and sustainable intervention that will encourage male partners to accompany their spouses and participate in MCH services.
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Affiliation(s)
- Joseph Mukobe Okwako
- Department of Midwifery, Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | - Grace Wambura Mbuthia
- Department of Community Health Nursing, Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | - Karani Magutah
- Department of Medical Physiology, Moi University, Eldoret, Kenya
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Nkonde H, Mukanga B, Daka V. Male partner influence on Women's choices and utilisation of family planning services in Mufulira district, Zambia. Heliyon 2023; 9:e14405. [PMID: 36950585 PMCID: PMC10025139 DOI: 10.1016/j.heliyon.2023.e14405] [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: 10/19/2022] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/13/2023] Open
Abstract
Background Family planning services are essential in reducing maternal deaths as well as improving the reproductive and sexual health of women. Although family planning services are frequently focused on women, men are often the primary decision-makers. We conducted a study to explore male partner influence on women's choices and utilisation of family planning services in Mufulira district, Zambia. Methods A qualitative explorative study design that utilised two focus group discussions (n = 20) and in-depth interviews (n = 30) involving women of reproductive age was conducted. Convenient sampling was employed to select participants. In-depth interviews and focus group discussions were recorded, translated, and transcribed verbatim. Content analysis was utilised through code classification and theme identification. Data were imported into NVivo.×64 for coding and node generation. Findings The study revealed key themes on male partner influence on contraception use such as fear of infidelity, fear of physical abuse, preference for a large family size , disruption of sexual pleasure, and perceived side effects of contraceptives. These themes highlight the influence of culturally driven gender and power dynamics on male partner attitudes towards contraception. Participants described how their male partners exhibited prenatal attitudes and control over them thereby limiting their decision-making power on contraception use. Undesirable contraception side effects such as reduced vaginal lubrication contributed to sexual pleasure disruption among men. Concerns that women's use of contraception can lead to infidelity also contributed to male partner disapproval of contraception use. Conclusions Understanding barriers to contraception utilisation presented by male partners is essential in preventing contraception discontinuation and can increase contraception uptake among women. Our findings highlight the influence of culturally driven gender and power dynamics on male partner attitudes towards contraception. Therefore, male partner education on family planning services is key. Also, men need to be incorporated as key stakeholders when planning and implementing family planning programmes.
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Key Words
- Contraception
- FGD, Focus group discussions
- FP, Family planning
- Family planning
- HIV, human immunodeficiency virus
- IDI, Indepth Interviews
- IUD, Intra uterine devices
- LAM, Lactational Amenorrhea Method
- LMIC, Low middle income countries
- Male partner
- SSA, Subsaharan Africa
- STIs, Sexually transmitted Infections
- TDRC, Tropical Diseases Research Centre
- WHO, World Health Organisation
- Zambia
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Affiliation(s)
- Hildah Nkonde
- The Copperbelt University, Michael Chilufya Sata School of Medicine, Public Health Department, P. O. Box 71769, Ndola, Zambia
| | - Bright Mukanga
- The Copperbelt University, Michael Chilufya Sata School of Medicine, Public Health Department, P. O. Box 71769, Ndola, Zambia
| | - Victor Daka
- The Copperbelt University, Michael Chilufya Sata School of Medicine, Public Health Department, P. O. Box 71769, Ndola, Zambia
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Muhaidat N, Mansour S, Dardas M, Qiqieh J, Halasa Z, Al-Huneidy L, Samhouri J, Rayyan R, AlOweiwi W, AlMohtasib J, Alshrouf MA, Al-Labadi GM, Suboh LH, Al-Ani A. Current Awareness Status of and Recommendations for Polycystic Ovarian Syndrome: A National Cross-Sectional Investigation of Central Jordan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4018. [PMID: 36901027 PMCID: PMC10001650 DOI: 10.3390/ijerph20054018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a common reproductive disorder that is related to a number of health issues and has an influence on a variety of metabolic processes. Despite its burden on the health of females, PCOS is significantly underdiagnosed, which is associated with lack of disease knowledge among females. Therefore, we aimed to gauge the awareness of PCOS in both the male and female population in Jordan. A descriptive cross-sectional study was conducted, targeting individuals over the age of 18 from Jordan's central region. Participants were recruited through stratified random sampling. The questionnaire consisted of two domains, including demographics and knowledge of PCOS domains. A total of 1532 respondents participated in this study. The findings revealed that participants have overall adequate knowledge regarding PCOS's risk factors, etiology, clinical presentation, and outcomes. However, participants demonstrated subpar familiarity of the association between PCOS and other comorbidities and the effect of genetics on PCOS. Women had more knowledge than men about PCOS (57.5 ± 6.06 vs. 54.1 ± 6.71, p = 0.019). In addition, older, employed, and higher-income populations showed significantly better knowledge than younger, unemployed, self-employed, and lower-income populations. In conclusion, we demonstrated that Jordanian women demonstrate an acceptable yet incomplete level of knowledge towards PCOS. We recommend establishing educational programs by specialists for the general population as well as medical personnel to spread accurate medical information and clarify common misconceptions about signs, symptoms, management, and treatment of PCOS, and nutritional knowledge.
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Affiliation(s)
- Nadia Muhaidat
- Department of Obstetrics & Gynecology, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Shahd Mansour
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Majid Dardas
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Jamil Qiqieh
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Zeina Halasa
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Leen Al-Huneidy
- Department of Internal Medicine, King Hussein Medical Center, Amman 11855, Jordan
| | - Jehad Samhouri
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Rama Rayyan
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Wahid AlOweiwi
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Jamil AlMohtasib
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | | | | | - Layla H. Suboh
- Department of Obstetrics & Gynecology, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Abdallah Al-Ani
- Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan
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Pokhrel KN, Thakuri DS, Dagadu NA, Balami R, Sharma M, Bhandari R. Unlocking the potential for engaging men to improve reproductive, maternal, and neonatal health in Karnali Province, Nepal. BMC Public Health 2022; 22:2094. [PMCID: PMC9668207 DOI: 10.1186/s12889-022-14534-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 11/02/2022] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
Adolescent girls and young women (AGYW) often experience early childbearing and have poor utilization of reproductive, maternal, and neonatal health (RMNH) services in Nepal. Involving men in such services has been increasingly recognized globally to improve gender-equitable reproductive health behaviour in husbands. This qualitative study assessed the implementation of Healthy Transitions’ male engagement interventions in Karnali Province, Nepal which were implemented to improve gender-equitable attitudes, and supportive RMNH care-seeking behaviors among the husbands of young women.
Methods
We conducted a summative qualitative study that included in-depth interviews with 12 AGYW as primary beneficiaries and their husbands (N = 12) and in-laws (N = 8). In addition, key informant interviews were conducted with health workers (N = 8), local government representatives (N = 4), members of Health Facility Operation and Management Committee (N = 8) and project implementers (N = 12). Due to COVID-19-related travel restrictions and lockdowns, all interviews were conducted via phone calls and online consultation. Data were analyzed using multistage coding and thematic content analysis.
Results
AGYW, their husbands, in-laws and health workers were receptive to the Healthy transitions’ male engagement initiatives. They perceived that the project contributed a momentum to facilitate men’s gender-responsive behaviour. Many participants reported that male engagement interventions, including home visits, community dialogues, and social events improved husbands’ support for their wives during menstruation, pregnancy, and childbirth. The activities also facilitated spousal communication and improved the couple’s decision-making for family planning use. Women reported that improved support from their husbands increased their self-confidence.
Conclusions
This study sheds light on the role of male engagement strategies to improve RMNH in a context where inequitable gender norms and roles are highly prevalent. Our findings highlight the potential to improve RMNH by addressing barriers to male engagement.
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Okafor IP, Chukwudi CL, Igwilo UU, Ogunnowo BE. "Men are the head of the family, the dominant head": A mixed method study of male involvement in maternal and child health in a patriarchal setting, Western Nigeria. PLoS One 2022; 17:e0276059. [PMID: 36288340 PMCID: PMC9604958 DOI: 10.1371/journal.pone.0276059] [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: 03/01/2021] [Accepted: 09/28/2022] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION The importance of involving men in reproductive, maternal and child health (RMCH) programs is increasingly recognized globally. In Nigeria, most MCH services do not actively engage fathers. AIM To assess men's knowledge, involvement in MCH and the barriers in Southwest Nigeria. Predictors of good knowledge and involvement were also assessed. METHODS This was a community-based cross sectional study. Quantitative and qualitative methods were used in data collection which was done within a period of three months in 2018. Quantitative data were collected with interviewer administered questionnaires from 418 respondents who were selected by multistage sampling methodology. The topic was further explored using focus group discussion (FGD). Quantitative data were analysed using EPI-INFO version 7. Quantitative variables were summarized using means and standard deviations while multivariable analysis was carried out to determine predictors of good knowledge and involvement in MCH. A combination of deductive and inductive analysis was used for the qualitative data. RESULTS Overall, 65% of men had good knowledge of MCH while 60.8% had good involvement. Predictors of good knowledge were being a Christian (AOR 1.674, 95% CI 1.045-2.679), being of Yoruba tribe (AOR 1.753, 95% CI 1.100-2.796), having post-secondary education (AOR 1.984, 95% CI 1.002-3.928), having more under-fives in the household (AOR 2.162 95% CI 1.365-3.425) and spouse having post-secondary education (AOR 2.755, 95% CI 1.189-6.382). Predictors of good involvement in MCH include higher educational level of spouse: secondary (AOR 2.852, 95% CI 1.214-6.699), post-secondary (AOR 2.270, 95% CI 1.000-5.161) and having good knowledge of MCH (AOR 2.518, 95% CI 1.587-3.994). From the FGD, other factors which influence involvement were related to traditional/cultural orientation, time constraint and finance among others. CONCLUSION Men's knowledge and their involvement in maternal and child health were sub-optimal. For improvement, community-based intervention programmes should be designed for men and implemented, taking into consideration their traditional/cultural roles, religious orientation, busy schedules, and educational backgrounds. They should be re-oriented on their patriarchally informed belief about their perceived roles in RMCH.
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Affiliation(s)
- Ifeoma Peace Okafor
- Department of Community Health & Primary Care, College of Medicine, University of Lagos, Lagos Nigeria
| | - Chioma Lilian Chukwudi
- Department of Community Health & Primary Care, College of Medicine, University of Lagos, Lagos Nigeria
| | | | - Babatunde Enitan Ogunnowo
- Department of Community Health & Primary Care, College of Medicine, University of Lagos, Lagos Nigeria
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Individual and intimate-partner factors associated with cervical cancer screening in Central Uganda. PLoS One 2022; 17:e0274602. [PMID: 36108074 PMCID: PMC9477300 DOI: 10.1371/journal.pone.0274602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 08/31/2022] [Indexed: 12/24/2022] Open
Abstract
Intimate-partner factors have a significant effect on the uptake of services that affect maternal reproductive health outcomes. There is limited research on intimate-partner factors associated with cervical cancer screening. Therefore, this article examines the intimate-partner correlates of cervical cancer screening among married women in Central Uganda. We conducted a cross-sectional survey in Wakiso and Nakasongola districts in Central Uganda. A total of 656 married women aged 25–49 participated in the study. Frequency distributions for descriptive statistics and Pearson chi-squared tests were done to identify the association of selected individual explanatory variables and intimate-partner factors with cervical cancer screening. Finally, multivariable complementary log-log regressions were used to estimate intimate-partner factors associated with women’s cervical cancer screening uptake in Central Uganda. About 2 in 10 (20%) of the participants had been screened for cervical cancer. The following characteristics when examined separately in relation to the uptake of cervical cancer screening service and were significant: woman’s age, education attainment, occupation, wealth index, parity, male partner’s age, and male partner’s emotional support. After adjusting for independent factors, cervical cancer screening was significantly associated with women who had; attained secondary (AOR = 2.19; CI 1.18–4.06) compared to none/ primary education, and received partner’s emotional support (AOR = 30.06; CI 13.44–67.20) compared to those who did not receive partner’s emotional support. In Central Uganda, cervical cancer screening among married women was significantly associated with women’s education, and partner’s emotional support. These factors point to the importance of intimate-partner factors. Therefore, more effort should be directed at encouraging men’s participation. This should be supplemented with empowering women through education to increase uptake of screening services.
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Muia PK, Mbuthia GW, Mugambi RK. Determinants of male partner involvement in antenatal care services at Kangundo Sub-County Hospital in Kenya. Afr Health Sci 2022; 22:93-99. [PMID: 36910400 PMCID: PMC9993307 DOI: 10.4314/ahs.v22i3.11] [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: 11/16/2022] Open
Abstract
Background Male partner involvement in antenatal care services is aimed at improving maternal health outcomes since men are important persons who play great roles at the family level. Objective To assess the level and determinants of male partner involvement in antenatal care at Kangundo Sub-County hospital in Kenya. Methods The study used analytical cross-sectional study method and was carried out in the maternal and child health clinic of Kangundo Sub-County hospital. Two hundred pregnant women at any gestational age, accompanied or not, seeking antenatal care services during the study period formed the study population. Simple random sampling technique was used to achieve a sample size of 132 participants. The data was then analyzed using the statistical package for social science (SPSS) version 20.0. Results The study revealed a low-level male partner involvement of 34.1%. Business as male partners' occupation (OR = 2, 95% CI (0.314 - 12.729), and distance from the health facility; living 4km from the facility (OR = 5.225, 95%CI (1.319 - 20.705) and more than 5km from the facility (OR = 3.520, 95% CI (0.941 - 13.174) were significantly associated with male partner involvement. Conclusion The factors contributing to low male partner involvement included: men being busy at work and the distance covered to reach the health facility.
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Affiliation(s)
- Pauline K Muia
- Master of science in nursing student, Jomo Kenyatta University of Agriculture and Technology
| | - Grace W Mbuthia
- Community health department, Jomo Kenyatta University of Agriculture and Technology, P.O.BOX 6200-00200, Nairobi, Kenya
| | - Rosemary K Mugambi
- Reproductive Health and midwifery department, Jomo Kenyatta University of Agriculture and Technology, P.O Box 6200-00200, Nairobi, Kenya
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Lotfi R, Azin SA, Hatefnia E, Amiri M, Simbar M, Ramezani Tehrani F. How Do Iranian Men Perceive Their Sexual and Reproductive Health Situation? A Qualitative Content Analysis. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2022; 10:197-209. [PMID: 35855387 PMCID: PMC9287571 DOI: 10.30476/ijcbnm.2022.92155.1831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/24/2022] [Accepted: 02/26/2022] [Indexed: 11/19/2022]
Abstract
Background Males' viewpoint about sexual and reproductive health (SRH) and their situation are essential components of men's and women's health in the community. Men have been overlooked in reproduction health, especially with reproductive issues such as contraception, sexually transmitted infections (STIs), infertility, and sexual function. This study aimed to investigate the males' perceptions of their SRH situation in Iran. Methods A qualitative study was conducted from May 2016 to April 2017 on data retrieved through semi-structured interviews with 19 adult males aged 18 to 59 years. The participants were purposefully recruited from among populations of health centers in Alborz province, Iran. Conventional content analysis in OneNote software version 2016 was used for data analysis. Results Three main themes and nine categories emerged including 1) Perceived SRH needs, including "need to increase men's awareness about SRH", "need to have an accessibility to SRH services", and "need to have a high-quality sexual relationship"; 2) perceived SRH responsibilities, including "health-seeking behaviors", "sexual skills", "childbearing responsibilities", and "ethical commitment", and 3) Men' perception of trends of social and cultural norms, including "changing SRH priorities" and "changing marital prototype". Conclusion In this study, men perceived SRH as an important issue due to the changes in social and cultural trends, and many of their SRH needs have not yet been addressed. Hence, along with socio-economic changes, the policymakers of the health system should develop strategies and interventions to meet these needs.
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Affiliation(s)
- Razieh Lotfi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Seyed Ali Azin
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Effat Hatefnia
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mina Amiri
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Understanding barriers to men's support for family planning in rural Ethiopia-findings from the USAID Transform: Primary Health Care Project Gender Analysis. Reprod Health 2022; 19:86. [PMID: 35698145 PMCID: PMC9195349 DOI: 10.1186/s12978-022-01384-z] [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] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence suggests that supportive male engagement in health care services, including family planning, remains low in many countries, despite known benefits for female partners. In 2017-2018, the United States Agency for International Development Transform: Primary Health Care Project conducted a participatory gender analysis, collecting relevant data to better understand Ethiopian men's lack of support for the uptake of family planning services. METHODS Qualitative data were collected through 96 unique participatory group discussions with community members via a semistructured discussion guide and participatory activity; data were disaggregated by sex, age, and marital status. In-depth interviews (91) conducted with service providers, health system managers, and health extension workers used semistructured guides. Discussants and interviewees were selected purposefully, drawn from 16 rural woredas in four project regions: Amhara; Oromia; Tigray; and Southern Nations, Nationalities, and Peoples' Region. Data collectors took notes and transcribed audio recordings. The research team deductively and inductively coded transcripts to develop preliminary findings later validated by key technical project staff and stakeholders. RESULTS Findings reinforce existing knowledge on the dominant role of men in health care-related decision making in rural Ethiopia, although such decision making is not always unilateral in practice. Barriers at the societal level impede men's support for family planning; these include norms, values, and beliefs around childbearing; religious beliefs rooted in scriptural narratives; and perceived adverse health impacts of family planning. Lack of efforts to engage men in health care facilities, as well as the perception that health care facilities do not meet men's needs, highlight systems-level barriers to men's use of family planning services. CONCLUSIONS Findings indicate several opportunities for stakeholders to increase men's support for family planning in rural Ethiopia, including systems-wide approaches to shape decision making, social and behavior change communication efforts, and additional research and assessment of men's experiences in accessing health care services.
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Mulatu T, Sintayehu Y, Dessie Y, Dheresa M. Male involvement in family planning use and associated factors among currently married men in rural Eastern Ethiopia. SAGE Open Med 2022; 10:20503121221094178. [PMID: 35492884 PMCID: PMC9047782 DOI: 10.1177/20503121221094178] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 03/23/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction/Objectives: Male involvement in family planning refers to all organizational actions
focused on men as a distinct group to increase the acceptability and uptake
of family planning among either sex. Despite the growing evidence of male
involvement in increasing family planning uptake among couples, a little
success has been achieved in Ethiopia, especially in rural areas. Hence,
this study aimed to assess male involvement in family planning and its
associated factors among currently married men in selected rural areas of
Eastern Ethiopia. Methods: A community-based cross-sectional survey was conducted among 577 randomly
selected currently married men, using a simple random sampling method in
randomly selected rural districts of Eastern Ethiopia. Data were collected
using a pretested interviewer-administered questionnaire. The collected data
were entered into a computer using Epi-Data Version 3.1. The analysis was
performed using the Statistical Package for the social sciences software
version 21. Logistic regression analysis was used to analyze the association
between the dependent and independent variables. Finally, adjusted odds
ratio with 95% confidence intervals at P-value < 0.05
was considered to be significantly associated with the outcome variable. Results: Out of 577, a total of, 555 married men were included in the study, resulting
in a response rate of 96.2%. The magnitude of male involvement in family
planning use was 59.3% (95% confidence interval: 47.1, 68. 2). Ever use of
family planning by a spouse (adjusted odds ratio: 2.37; 95% confidence
interval: 1.59, 3.52), ever discussion of spouse on sexual and reproductive
health/family planning issues (adjusted odds ratio: 2.05; 95% confidence
interval: 1.40, 3.02), and the husband’s approval of family planning
(adjusted odds ratio: 2.45; 95% confidence interval: 1.34, 4.96) were
significantly associated with higher odds of male involvement in family
planning use than their counterparts. Conclusion: The number of men involved in the family planning was low. Ever use of family
planning methods by a spouse, ever discussion of spouse on sexual and
reproductive health/family planning issues, and husband approval on family
planning use were found to be important predictors of male involvement in
family planning use. To improve modern family planning uptake among men and
women, it is imperative to include men in family planning programs, such as
family planning messaging, sensitizations, and services.
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Affiliation(s)
- Teshale Mulatu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yitagesu Sintayehu
- Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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21
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Almeida Sousa BS, Almeida CAPL, dos Santos JR, Lago EC, de Oliveira JF, Areas da Cruz T, Lima SVMA, Camargo ELS. Meanings Assigned by Primary Care Professionals to Male Prenatal Care: A Qualitative Study. Open Nurs J 2021. [DOI: 10.2174/1874434602115010351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Considering recent strategies used in prenatal care, the involvement of fathers has been considered an important factor in ensuring that pregnancy and delivery are successful.
Objective:
The aim of this study is to identify the meanings assigned by primary health care professionals to male prenatal care.
Methods:
This is a descriptive study with a qualitative approach. A total of 19 interviews were conducted with primary health care professionals registered in the City Health Department of Teresina, Piauí, Brazil. Data were collected through semi-structured interviews and analyzed according to the Collective Subject Discourse methodology.
Results:
Three themes emerged from the reports’ analysis: The importance of the role of fathers in the gestational process, attitudes of men toward male prenatal care and formal education and training in primary health care. Health practitioners understand the importance of male prenatal care but reported they lack proper training to provide effective care.
Conclusion:
The expansion of continuing education strategies focusing on male prenatal care and directed to primary health care professionals is recommended to promote greater adherence on the part of fathers in prenatal care, with the purpose of strengthening bonds and improving the care provided to the entire family. The humanized care can facilitate the approach of the paternal figure during male prenatal care.
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Osaki H, Sao SS, Kisigo GA, Coleman JN, Mwamba RN, Renju J, Mmbaga BT, Watt MH. Male engagement guidelines in antenatal care: unintended consequences for pregnant women in Tanzania. BMC Pregnancy Childbirth 2021; 21:720. [PMID: 34702198 PMCID: PMC8549379 DOI: 10.1186/s12884-021-04141-5] [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: 12/01/2020] [Accepted: 09/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The meaningful engagement of male partners in antenatal care (ANC) can positively impact maternal and newborn health outcomes. The Tanzania National Plan for the Elimination of Mother to Child Transmission of HIV recommends male partners attend the first ANC appointment as a strategy for HIV prevention and treatment. This recommendation seeks to increase uptake of HIV and reproductive healthcare services, but unintended consequences of these guidelines may negatively impact women's ANC experiences. This study qualitatively examined the impact of policy promoting male engagement on women's ANC experiences. METHODS The study was conducted in two urban clinics in Kilimanjaro Region, Tanzania. In-depth interviews were conducted with 19 participants (13 women and 6 male partners) attending a first ANC appointment. A semi-structured guide was developed, applying Kabeer's Social Relations Approach. Data were analyzed using applied thematic analysis, combining memo writing, coding, synthesis, and comparison of themes. RESULTS Male attendance impacted the timing of women's presentation to ANC and experience during the first ANC visit. Women whose partners could not attend delayed their presentation to first ANC due to fears of being interrogated or denied care because of their partner absence. Women presenting with partners were given preferential treatment by clinic staff, and women without partners felt discriminated against. Women perceived that the clinic prioritized men's HIV testing over involvement in pregnancy care. CONCLUSIONS Study findings indicate the need to better assess and understand the unintended impact of policies promoting male partner attendance at ANC. Although male engagement can benefit the health outcomes of mothers and newborn children, our findings demonstrate the need for improved methods of engaging men in ANC. ANC clinics should identify ways to make clinic settings more male friendly, utilize male attendance as an opportunity to educate and engage men in pregnancy and newborn care. At the same time, clinic policies should be cognizant to not discriminate against women presenting without a partner.
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Affiliation(s)
- Haika Osaki
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania.
| | - Saumya S Sao
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Godfrey A Kisigo
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania.,Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Jessica N Coleman
- Duke Global Health Institute, Duke University, Durham, NC, USA.,Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Rimel N Mwamba
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Jenny Renju
- Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania.,Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Blandina T Mmbaga
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania.,Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Melissa H Watt
- Duke Global Health Institute, Duke University, Durham, NC, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
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Ladur AN, van Teijlingen E, Hundley V. Male involvement in promotion of safe motherhood in low- and middle-income countries: A scoping review. Midwifery 2021; 103:103089. [PMID: 34293604 DOI: 10.1016/j.midw.2021.103089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 05/19/2021] [Accepted: 07/07/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Maternal health programmes that focus on the woman alone are limiting in LMICs as pregnant women often relate to maternity services through a complex social web that reflects power struggles within the kinship and the community. METHODS A scoping review was conducted to explore the rationale for male involvement in maternal health in LMICs. This review was guided by the question: What is the current state of knowledge regarding the inclusion of men in maternal health services in LMICs? The literature search was conducted using mySearch, Bournemouth University`s iteration of the EBSCO Discovery Service (EDS) tool. The review process used the Preferred Reporting Items for Systematic Reviews to select papers for inclusion. FINDINGS Thirty three studies met the inclusion criteria. Findings describe the rationale for involving men in maternity care, alongside the criticisms and challenges inherent in engaging with men in maternal health. Involving men in maternity services can improve health outcomes for women and infants. Health strategies aimed at educating men are relevant in equipping men with knowledge and skills that help men to be supportive of women`s wellbeing during pregnancy and childbirth. CONCLUSION Men can serve as advocates for women and reinforce their partner`s choices in accessing skilled care and infant feeding. Further research is required to examine the effect of male involvement on women`s autonomy and to assess health education interventions aimed at mitigating harmful outcomes of involving men in maternity services.
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Affiliation(s)
- Alice Norah Ladur
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health and Social Sciences, Bournemouth University, 10 St Paul's Ln, Boscombe BH8 8AJ, United Kingdom; Department of Health Sciences and Special Education, Africa Renewal University, P.O Box 35138, Kampala, Uganda.
| | - Edwin van Teijlingen
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health and Social Sciences, Bournemouth University, 10 St Paul's Ln, Boscombe BH8 8AJ, United Kingdom.
| | - Vanora Hundley
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health and Social Sciences, Bournemouth University, 10 St Paul's Ln, Boscombe BH8 8AJ, United Kingdom.
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Matenga TFL, Zulu JM, Nkwemu S, Shankalala P, Hampanda K. Men's perceptions of sexual and reproductive health education within the context of pregnancy and HIV in Zambia: a descriptive qualitative analysis. BMC Public Health 2021; 21:1354. [PMID: 34238272 PMCID: PMC8268604 DOI: 10.1186/s12889-021-11430-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 06/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although health care providers are beginning to focus on men's roles as fathers and husbands, there is limited understanding of how men view their ability to promote sexual and reproductive health in families affected by HIV and their experiences with receiving education through antenatal care. This paper aims to explore men's perceptions of the education they need regarding sexual and reproductive health within the family in the context of HIV. METHODS We interviewed a convenience sample of 18 male partners of pregnant women living with HIV in Lusaka, Zambia. Atlas.ti was used to facilitate data management and content analysis. RESULTS Men reported being the primary decision-makers regarding sexual and reproductive issues in the family; however, they admitted far-reaching unmet needs in terms of information on sexual and reproductive health in the context of HIV. Most men felt that antenatal care was not a conducive setting to fully educate men on sexual and reproductive health because it is a woman's space where their health concerns were generally neglected. There was a strong desire for more education that was specific to men's sexual and reproductive health, especially because all the couples were affected by HIV. Men especially requested education on sexual preparedness, safe sex, the use of condoms in sero-concordant and sero-discordant relationships and general health information. Although men stated they were the main decision-makers regarding sexual and reproductive issues such as pregnancy, most men were not confident in their ability to promote sexual and reproductive health in the family because of limited knowledge in this area. CONCLUSION There is need to change the environment and messaging of antenatal care, as well as offer relevant education opportunities outside health facility settings to empower men with essential information for meaningful involvement in sexual and reproductive health in the context of HIV.
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Affiliation(s)
- Tulani Francis L Matenga
- Department of Health Promotion and Education, School of Public Health, University of Zambia, Lusaka, Zambia.
| | - Joseph Mumba Zulu
- Department of Health Promotion and Education, School of Public Health, University of Zambia, Lusaka, Zambia
| | - Sharon Nkwemu
- Department of Health Promotion and Education, School of Public Health, University of Zambia, Lusaka, Zambia
| | - Perfect Shankalala
- Department of Health Promotion and Education, School of Public Health, University of Zambia, Lusaka, Zambia
| | - Karen Hampanda
- Division of Academic Specialists in Obstetrics and Gynecology, University of Colorado, Denver, USA
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Chapola JC, Hatfield-Timajchy K, Bula AK, Hurst S, Chinula L, Kourtis AP, Tang JH. Women's perspectives on relationship dynamics with their partners and their role in HIV acquisition, HIV disclosure, hormonal contraceptive uptake, and condom use. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2021; 20:61-69. [PMID: 33685375 DOI: 10.2989/16085906.2021.1872664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: Limited information exists about relationship dynamics and their role in HIV acquisition, HIV disclosure, hormonal contraceptive uptake, and condom use among women in Malawi.Methods: Ninety-seven women aged 18-45 years were randomly assigned to initiate the depot medroxyprogesterone acetate injectable or levonorgestrel implant from May 2014 to April 2015 in Lilongwe, Malawi. Women were recruited after randomisation to participate in semi-structured interviews about HIV and family planning using purposive sampling. Interviews were thematically analysed using within and between group comparisons.Results: We conducted individual interviews and/or focus group discussions with 41 women: 30 (73%) women living with HIV and 11 (27%) women not living with HIV. Most women living with HIV who participated in in-depth interviews disclosed their status to their partners, and most partners agreed to get HIV tested only after disclosure. Nearly all women said their partners agreed to use condoms, but few used them consistently. Nearly all women believed their current and former partners had outside partners. Most women living with HIV who participated in in-depth interviews believed their current or other serious partners were the source of their infection. Some women thought their partner's infidelity was due to their partner's disinterest in sex with them during menstrual/ breakthrough bleeding. Some women included their partners in contraceptive decision-making when the partner was supportive.Discussion: Relationship dynamics affected decision-making for contraceptive and condom use, as well as serodisclosure for the women living with HIV in the study. All women reported challenges with consistent condom use with their male partners, although contraceptive use was generally more acceptable. Women included their partners in their decision-making concerning contraceptive use when they were supportive.
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Affiliation(s)
| | | | - Agatha K Bula
- University of North Carolina Project, Lilongwe, Malawi
| | - Stacey Hurst
- Centers for Disease Control and Prevention, Atlanta, USA
| | - Lameck Chinula
- University of North Carolina Project, Lilongwe, Malawi.,Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | | | - Jennifer H Tang
- University of North Carolina Project, Lilongwe, Malawi.,Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, USA
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Lusambili AM, Muriuki P, Wisofschi S, Shumba CS, Mantel M, Obure J, Nyaga L, Mulama K, Ngugi A, Orwa J, Luchters S, Temmerman M. Male Involvement in Reproductive and Maternal and New Child Health: An Evaluative Qualitative Study on Facilitators and Barriers From Rural Kenya. Front Public Health 2021; 9:644293. [PMID: 33968883 PMCID: PMC8096930 DOI: 10.3389/fpubh.2021.644293] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/08/2021] [Indexed: 11/17/2022] Open
Abstract
Male involvement in reproductive, maternal, newborn and child health (RMNCH) is known to improve maternal and child health outcomes. However, there is sub-optimal adoption of male involvement strategies in several low- and middle-income countries such as Kenya. Aga Khan University implemented Access to Quality of Care through Extending and Strengthening Health Systems (AQCESS), a project funded by the Government of Canada and Aga Khan Foundation Canada (AKFC), between 2016 and 2020 in rural Kisii and Kilifi counties, Kenya. A central element in the interventions was increasing male engagement in RMNCH. Between January and March 2020, we conducted an endline qualitative study to examine the perspectives of different community stakeholders, who were aware of the AQCESS project, on the facilitators and barriers to male involvement in RMNCH. We found that targeted information sessions for men on RMNCH are a major facilitator to effective male engagement, particularly when delivered by male authority figures such as church leaders, male champions and teachers. Sub-optimal male engagement arises from tensions men face in directly contributing to the household economy and participating in RMNCH activities. Social-cultural factors such as the feminization of RMNCH and the associated stigma that non-conforming men experience also discourage male engagement.
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Affiliation(s)
| | - Peter Muriuki
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Stefania Wisofschi
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Constance S Shumba
- Department of Population Health (DPH), Aga Khan University, Nairobi, Kenya
| | - Michaela Mantel
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Jerim Obure
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Lucy Nyaga
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Kennedy Mulama
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Anthony Ngugi
- Department of Population Health (DPH), Aga Khan University, Nairobi, Kenya
| | - James Orwa
- Department of Population Health (DPH), Aga Khan University, Nairobi, Kenya
| | - Stanley Luchters
- Department of Population Health (DPH), Aga Khan University, Nairobi, Kenya.,Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Marleen Temmerman
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya.,Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium.,Department of Obstetrics and Gynaecology, Medical College, Aga Khan University, Nairobi, Kenya
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Babughirana G, Gerards S, Mokori A, Nangosha E, Kremers S, Gubbels J. Maternal and newborn healthcare practices: assessment of the uptake of lifesaving services in Hoima District, Uganda. BMC Pregnancy Childbirth 2020; 20:686. [PMID: 33176734 PMCID: PMC7659084 DOI: 10.1186/s12884-020-03385-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 10/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The current maternal mortality ratio in Uganda is 336 maternal deaths per 100,000 live births. Infant mortality is 43 deaths per 1000 live births, with 42% of the mortality occurring during the neonatal period. This might be related to a weak health system in the country. This study aimed at assessing the uptake of lifesaving services during pregnancy and childbirth in Hoima District, Uganda. METHODS The study used a cross-sectional quantitative design among 691 women with a child under 5 years. Households were randomly sampled from a list of all the villages in the district with the ENA for SMART software using the EPI methodology. Pre-coded questionnaires uploaded in the Open Data Kit were used for data collection. The data was cleaned and analysed using MS Excel and SPSS software. Descriptive results are presented. RESULTS Of the 55.1% women attending at least four antenatal care (ANC) visits, only 24.3% had the first ANC within the first trimester. Moreover, ANC services generally was of poor quality, with only 0.4% meeting all the requirements for quality of ANC service. The highest contributors to this poor quality included poor uptake of iron-folic acid (adherence 28.8%), the six-required birth preparedness and complication readiness items (13.2%), and recognition of the seven danger signs of pregnancy (3.0%). Adherence to the seven essential newborn care actions was very low (0.5%), mainly caused by three practices: initiating breastfeeding within 1 h (59.9%), lack of postnatal care within 24 h (20.1%), and failure to recognize the 6 danger signs of the newborn (2.4%). Only 11.1% of the males participated in all maternal and newborn care requirements, by encouraging women to seek healthcare (39.9%), accompanying them to healthcare (36.9%), and HIV counselling and support services (26.2%). CONCLUSION The study reveals poor maternal and newborn practices throughout the continuum of care, from ANC and skilled birth attendance to newborn care during childbirth. With such poor results, it is not surprising that Hoima is sixth of 10 districts that have the highest numbers of deaths due to maternal mortality in Uganda.
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Affiliation(s)
- Geoffrey Babughirana
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Health Promotion, Maastricht University, Maastricht, the Netherlands.
| | - Sanne Gerards
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Health Promotion, Maastricht University, Maastricht, the Netherlands
| | | | | | - Stef Kremers
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Health Promotion, Maastricht University, Maastricht, the Netherlands
| | - Jessica Gubbels
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Health Promotion, Maastricht University, Maastricht, the Netherlands
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Pitter C, Emanuel-Frith M, Pitter G, Udoudo DA. Bridging the Gap: Supporting the Inclusion of More Fathers in Maternity Centers in Jamaica. INTERNATIONAL JOURNAL OF CHILDBIRTH 2020. [DOI: 10.1891/ijcbirth-d-20-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The 1994 International Conference on Population and Development (ICPD) plan of action called for the equal participation of women and men in all areas of family and household responsibility, including family planning, child-rearing, and household chores. This plan of action admonished government to promote and facilitate such participation. The emerging trend to include fathers in maternal and child health services motivated low- to middle-income countries including Jamaica to sign on to global initiatives such as the ICPD and the Sustainability Development Goals for maternal and paternal involvement in the reduction of maternal mortality rates. However, lack of proper infrastructure in the public health system in countries like Jamaica does not sufficiently accommodate fathers during antenatal, childbirth, and postnatal services, neither does it has far reaching programs targeting fathers. This oversight in maternity care is partially due to the lack of guidelines to lead the process, limited space at clinics, and inadequate privacy on some delivery suites.Addressing the gaps to involve more fathers in pregnancy and child-rearing is an unexplored opportunity or innovative strategy that could assist Jamaica in meeting its international obligations to reduce infant and maternal mortality rates. This could also lessen the burden of childbearing and child-rearing on women, while changing the narrative of the negative stereotypes of fatherhood to a positive one in Jamaica. Research has also shown that several undesirable situations are preventable if the pregnant woman gets social and psychological backing, not only from excellent maternal and child health care but also by a social system, particularly from the spouse of the pregnant woman (World Health Organization, 2007).
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Antenatal depression: an examination of prevalence and its associated factors among pregnant women attending Harare polyclinics. BMC Pregnancy Childbirth 2020; 20:197. [PMID: 32252675 PMCID: PMC7137411 DOI: 10.1186/s12884-020-02887-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 03/20/2020] [Indexed: 11/10/2022] Open
Abstract
Background Antenatal depression is the most prevalent common mental health disorder affecting pregnant women. Here, we report the prevalence of and associated factors for antenatal depression among pregnant women attending antenatal care services in Harare, Zimbabwe. Methods From January–April 2018, 375 pregnant women, aged 16–46 years, residing mostly in Harare’s high-density suburbs were recruited from two randomly-selected polyclinics. Antenatal depression was measured using the Structured Clinical Interview for DSM-IV. Sociodemographic data including; maternal age, education, marital status, economic status, obstetric history and experiences with violence were also collected. Chi-square tests and multivariate logistic regression analysis were used to determine the association between antenatal depression and participants’ characteristics. Results The prevalence of antenatal depression was 23.47% (95% CI: 19.27–28.09). Multivariate logistic regression analysis revealed intimate partner violence (IPV) [OR 2.45 (95% CI: 1.47–4.19)] and experiencing negative life events [OR 2.02 (95% CI: 1.19–3.42)] as risk factors for antenatal depression, with being married/cohabiting [OR 0.45 (95% CI: 0.25–0.80)] being a protective factor. Conclusion The prevalence of antenatal depression is high with associated factors being interpersonal. Context-specific interventions are therefore needed to address the complexity of the factors associated with antenatal depression.
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Alyahya MS, Hijazi HH, Alshraideh HA, Al-Sheyab NA, Alomari D, Malkawi S, Qassas S, Darabseh S, Khader YS. Do modern family planning methods impact women's quality of life? Jordanian women's perspective. Health Qual Life Outcomes 2019; 17:154. [PMID: 31615524 PMCID: PMC6794850 DOI: 10.1186/s12955-019-1226-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 09/24/2019] [Indexed: 01/27/2023] Open
Abstract
Background Although Jordan has made progress in meeting Family Planning (FP) needs in last decades, recently the use of FP methods has declined significantly. Women’s personal experiences, knowledge, and perceptions of how a FP method might impact their quality of life (QoL) can influence FP decisions. However, a lack of comprehensive understanding of the impact of modern FP methods on women’s QoL continues to exist among Jordanian couples. Therefore, this study aimed to investigate the relationship between the use of common modern FP methods and QoL among Jordanian women. Methods Using the WHOQOL-BREF questionnaire along with other questions, non-pregnant women of reproductive age were interviewed at their homes through face-to-face structured interviews. Women who visited the obstetrics and gynecology clinic of King Abdullah University Hospital for contraceptive advice and follow-up consultations were also included. Results A total of 548 women aged between 18 and 49 participated in the study. Based on the WHOQOL-BREF scale, the overall mean (SD) scores of the four domains were found to be average. Our findings show that women who used Intra Uterine Devices (IUDs) and women whose husbands used condoms had better QoL in the four domains (physical health, psychological health, social relationships, and environment) than those who used Oral Contraceptives (OCs). Women who used implant and injectable hormonal contraceptives had better QoL in terms of the physical health and social relationships domains. In contrast, women who had undergone permanent sterilization had lower QoL scores in all of the four domains. Further analysis revealed that women who had undergone tubal sterilization were less satisfied overall and more likely to experience side effects than women who used OCs. Conclusion The choice to use contraceptives and decide freely whether and when to have children is regarded as a fundamental reproductive health right and is strongly linked to women’s health and QoL. Women who use OCs and women who have undergone permanent sterilization are likely to have lower QoL than women who use IUDs or implant and injectable hormones and those whose husbands use condoms.
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Affiliation(s)
- Mohammad S Alyahya
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan.
| | - Heba H Hijazi
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan
| | - Hussam A Alshraideh
- Industrial Engineering, Faculty of Engineering, Jordan University of Science and Technology, P.O.Box (3030), Irbid, 22110, Jordan
| | - Nihaya A Al-Sheyab
- Allied Medical Sciences Department/Faculty of Applied Medical Sciences, Jordan University of Science and Technology, P.O.Box (3030), Irbid, 22110, Jordan
| | - Dana Alomari
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan
| | - Sara Malkawi
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan
| | - Sarah Qassas
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan
| | - Samah Darabseh
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan
| | - Yousef S Khader
- Medical Education and Biostatistics, Department of Community Medicine, Public Health and Family Medicine, Jordan University of Science & Technology, Irbid, 22110, Jordan
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Mbadugha CJ, Anetekhai CJ, Obiekwu AL, Okonkwo I, Ingwu JA. Adult male involvement in maternity care in Enugu State, Nigeria: A cross-sectional study. Eur J Midwifery 2019; 3:16. [PMID: 33537595 PMCID: PMC7839096 DOI: 10.18332/ejm/112258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 07/02/2019] [Accepted: 09/10/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Men are the key decision makers in the family and play a crucial role in the reproductive health of partners, in Nigeria. This study assessed adult male involvement in maternity care in Enugu south local government area, Enugu State, Nigeria. METHODS This community-based study was conducted using a cross-sectional survey design. A total of 145 respondents were selected through multi-stage sampling and data were collected using a structured questionnaire developed by the researchers. Data generated were statistically analyzed based on the research objectives using descriptive statistics. RESULTS Major findings revealed that the respondents had moderate knowledge on the expected role of males in maternity care with the majority, assessed using a 4-point Likert scale, having a moderate (2.99) level of involvement in maternity care. Lack of facilities that encourage male participation in maternity care, work schedule of the male partner, and lack of knowledge on the role of the male partners during maternity care were identified as major barriers to male involvement in maternity care with means of 3.80, 3.58 and 3.48, respectively. CONCLUSIONS Involvement in maternity care among the respondents in this study was moderate. However, men may be restricted by some cultural beliefs such as maternity care being regarded as exclusively a woman's matter. Thus, men should be educated on the importance of their role as partners in maternity care and on the need to participate actively, regardless of existing cultural norms. Hospitals should also promote policies that encourage male presence during birth and delivery rooms need to be designed to allow bonding of partners during birth.
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Affiliation(s)
- Chisom J Mbadugha
- Department of Nursing Sciences, Faculty of Health Sciences and Technology, University of Nigeria, Enugu, Nigeria
| | - Chinenye J Anetekhai
- Department of Nursing Sciences, Faculty of Health Sciences and Technology, University of Nigeria, Enugu, Nigeria.,National Orthopaedic Hospital, Enugu Nigeria
| | - Adaobi L Obiekwu
- Department of Nursing Sciences, Faculty of Health Sciences and Technology, University of Nigeria, Enugu, Nigeria
| | | | - Justin A Ingwu
- Department of Nursing Sciences, Faculty of Health Sciences and Technology, University of Nigeria, Enugu, Nigeria
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Muheirwe F, Nuhu S. Men's participation in maternal and child health care in Western Uganda: perspectives from the community. BMC Public Health 2019; 19:1048. [PMID: 31382931 PMCID: PMC6683489 DOI: 10.1186/s12889-019-7371-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 07/25/2019] [Indexed: 11/11/2022] Open
Abstract
Background Participation of men in Maternal and Child Health (MCH) is crucial for the reduction of infant and maternal mortality. Men may be influential in making health care decisions that may affect their female partner’s access to health care services, but also as individuals, whose health status has a significant impact on the health of their partners’ and that of their children. However, male involvement is still inadequate due to various reasons. This paper sought to explore the community perspectives towards participation of men in maternal and child health care in Kabale District, Western Uganda. Methods The study used a case study approach. Household questionnaires, in-depth interviews, focus group discussions, direct field observation and document review were employed to collect data. One hundred and twenty-four respondents completed a household questionnaire, eight key informants took part in semi-structured interviews and thirty-six community members (two men and two women groups) participated in focus group discussions. Results The participation of men in maternal and child health care was found to be low. Patriarchal community values and norms influencing gender roles hindered male involvement in MCH. More so, sensitisation on the importance of male involvement was inadequate. Conclusion Men’s participation in MCH is affected by multiple factors emanating from the community and health institutions. Involving men in MCH is critical, and therefore participatory and comprehensive approaches should be applied to encourage participation. Sensitisation of communities is fundamental for increasing awareness of the significance of male involvement in MCH.
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Affiliation(s)
- Florence Muheirwe
- Valley University of Science and Technology, P. O. Box 44, Busenyi, Uganda
| | - Said Nuhu
- Institute of Human Settlement Studies, Ardhi University, P. O. Box 35176, Dar es Salaam, Tanzania. .,Swedish University of Agriculture Science, Uppsala, Sweden.
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Nair S, Dixit A, Ghule M, Battala M, Gajanan V, Dasgupta A, Begum S, Averbach S, Donta B, Silverman J, Saggurti N, Raj A. Health care providers' perspectives on delivering gender equity focused family planning program for young married couples in a cluster randomized controlled trial in rural Maharashtra, India. Gates Open Res 2019; 3:1508. [PMID: 32266327 PMCID: PMC7100659 DOI: 10.12688/gatesopenres.13026.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2019] [Indexed: 11/20/2022] Open
Abstract
Background: There is increasing programming and research on male engagement and gender-equity (GE) counselling in family planning (FP) services. However, there is a lack of data on healthcare provider’s perspectives on delivering these interventions. The objective of the paper is to present providers’ perspectives on delivering a GE-focused FP intervention, CHARM, to married couples in rural India. Methods: In-depth interviews were carried out with 22 male village health care providers who were delivering a GE-focused FP intervention, CHARM, to 428 husbands (247 couples) rural Maharashtra, India. Providers were interviewed on their experiences and perspectives during delivery of CHARM. Major domains were identified during a thematic analysis. Results: Local male health providers are interested and can be engaged in delivering a GE-focused FP intervention. Providers believed that the CHARM intervention improves couples’ communication, contraceptive use and strengthened their own capacity to provide FP services in accordance with national FP programmatic efforts. Providers found the low-tech flipchart including pictures and information helpful in supporting their service provision. Providers reported some challenges including lack of privacy and space for counselling, limited access to contraceptive options beyond pill and condom, numerous myths and misconceptions about contraceptives. Providers also reported persistent social norms related to expectancy of pregnancy early in marriage, and son preference. Conclusions: Providers in rural areas with high fertility and related maternal health complications are interested in and can successfully implement a GE-focused FP intervention. Future efforts using this approach may benefit from greater focus to support broader array of spacing contraceptives particularly among first time parents, none or one child parents. There is a need to better support engagement of wives possibly through female provider led sessions parallel to male programs, i.e. gender synchronized rather than couples’ sessions. Trialregistration: ClinicalTrials.gov
NCT01593943, May 8, 2012.
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Affiliation(s)
- Saritha Nair
- ICMR-National Institute of Medical Statistics (NIMS), New Delhi, Delhi, 110029, India
| | - Anvita Dixit
- Center on Gender Equity and Health, School of Medicine, University of California San Diego, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA.,Joint Doctoral Program in Public Health (Global Health), University of California San Diego and San Diego State University, San Diego, CA, 92093, USA
| | - Mohan Ghule
- Center on Gender Equity and Health, School of Medicine, University of California San Diego, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA
| | | | - Velhal Gajanan
- Seth G S Medical College & KEM Hospital, Mumbai, Maharashtra, 400012, India
| | - Anindita Dasgupta
- School of Social Work, Columbia University, New York, NY, 10027, USA
| | - Shahina Begum
- ICMR-National Institute for Research in Reproductive Health, J.M Street, Parel, Mumbai, 400012, India
| | - Sarah Averbach
- Center on Gender Equity and Health, School of Medicine, University of California San Diego, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA.,Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Balaiah Donta
- ICMR-National Institute for Research in Reproductive Health, J.M Street, Parel, Mumbai, 400012, India
| | - Jay Silverman
- Center on Gender Equity and Health, School of Medicine, University of California San Diego, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA
| | | | - Anita Raj
- Center on Gender Equity and Health, School of Medicine, University of California San Diego, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA.,Department of Education Studies, Division of Social Sciences, University of California San Diego, San Diego, CA, 92093, USA
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