Acceptability of couple antenatal education: A qualitative study of expectant couples attending antenatal clinics in Blantyre, Malawi

Men's experiences of antenatal care services in low-income and middle-income countries: A qualitative systematic review

BACKGROUND

Men's involvement in antenatal care is critical for the family's overall well-being, yet remains low in many low-income and middle-income countries. The goal of this study was to consolidate and synthesize currently available literature on men's experiences of antenatal care services in low-income and middle-income countries.

METHODS

PubMed, CINAHL, Embase, PsycINFO, and Scopus were searched through December 2020. Qualitative studies were included exploring the antenatal care experiences of men whose pregnant partners utilized antenatal care services, regardless of ethnicity, race, and education levels. Studies examining men's participation in antenatal care that specifically focused on certain conditions such as the human immunodeficiency virus, known pregnancy complications, as well as contraception/fertility treatment, were excluded. Quality appraisal of the included studies was conducted using the Critical Appraisal Skills Program checklist, and Sandelowski and Barroso's two-step approach was used to meta-summarize and meta-synthesize the extracted data.

RESULTS

Four themes were derived from the 27 studies included: (a) Factors enabling men's participation in antenatal care; (b) Barriers affecting men's participation in antenatal care; (c) Men's self-perceived care roles; and (d) Recommendations to improve men's involvement.

CONCLUSIONS

Men's involvement in antenatal care depended on community perceptions, traditional gender roles, and work commitments. Although men often regarded antenatal care services as exclusive to women, some expressed their willingness to participate. Current findings highlight the need for community educational programs, male role models, and training of healthcare providers to improve men's participation.

Parents' perceptions of antenatal educational programs: A meta-synthesis

BACKGROUND

Contents and mode of delivery of antenatal educational programs differed considerably. Yet there is a lack of high-level evidence about the delivery of these programs.

OBJECTIVE

We aimed to understand the experiences and needs of parents who have attended antenatal educational programs.

DESIGN

Six databases were searched from each database. Included studies were appraised using the Critical Appraisal Skills Program tool. Qualitative data were meta-summarized and meta-synthesized.

FINDINGS

Seventeen studies were included, and three themes were developed: (1) Contradicting views on antenatal educational programs, (2) Feeling 'well prepared' after attending the antenatal educational programs, and (3) Parents' expectations and way forward for the antenatal educational programs.

DISCUSSION

Findings revealed that the description of contents of antenatal educational programs needed to be more specific. Mindfulness strategies were well-received by parents in the included studies. Educators should take into account inclusivity and increase educational resources related to individual, cultural and community needs. Learning needs can be assessed before and after classes. Parents with specific needs that were not addressed should be identified and referred to the relevant professionals for continued support. More deliberate actions were needed during the programs to foster social and professional networks for attendees to support them throughout antenatal and postnatal periods.

CONCLUSION

We consolidated the experiences and needs of parents who have attended antenatal educational programs. Findings can help refine policies related to antenatal care to improve pregnancy, birth and parenthood experiences for both mothers and fathers.

Antenatal couples' counselling in Uganda (ACCU): study protocol for a randomised controlled feasibility trial

BACKGROUND

Common avoidable factors leading to maternal, perinatal and neonatal deaths include lack of birth planning (and delivery in an inappropriate place) and unmet need for contraception. Progress has been slow because routine antenatal care has focused only on women. Yet, in Uganda, many women first want the approval of their husbands. The World Health Organization recommends postpartum family planning (PPFP) as a critical component of health care. The aim of this trial is to test the feasibility of recruiting and retaining participants in a trial of a complex community-based intervention to provide counselling to antenatal couples in Uganda.

METHODS

This is a two-group, non-blinded cluster-randomised controlled feasibility trial of a complex intervention. Primary health centres in Uganda will be randomised to receive the intervention or usual care provided by the Ministry of Health. The intervention consists of training village health teams to provide basic counselling to couples at home, encouraging men to accompany their wives to an antenatal clinic, and secondly of training health workers to provide information and counselling to couples at antenatal clinics, to facilitate shared decision-making on the most appropriate place of delivery, and postpartum contraception. We aim to recruit 2 health centres in each arm, each with 10 village health teams, each of whom will aim to recruit 35 pregnant women (a total of 700 women per arm). The village health teams will follow up and collect data on pregnant women in the community up to 12 months after delivery and will directly enter the data using the COSMOS software on a smartphone.

DISCUSSION

This intervention addresses two key avoidable factors in maternal, perinatal and neonatal deaths (lack of family planning and inappropriate place of delivery). Determining the acceptability and feasibility of antenatal couples' counselling in this study will inform the design of a fully randomised controlled clinical trial. If this trial demonstrates the feasibility of recruitment and delivery, we will seek funding to conduct a fully powered trial of the complex intervention for improving uptake of birth planning and postpartum family planning in Uganda.

TRIAL REGISTRATION

Pan African Clinical Trials Registry PACTR202102794681952 . Approved on 10 February 2021. ISRCTN Registry ISRCTN97229911. Registered on 23 September 2021.

Father's participation in prenatal care and childbirth: contributions of nurses' interventions

OBJECTIVES

To describe the discourse of men about participation in prenatal care and childbirth/birth of their children from the contributions made by nurses.

METHODS

This is an exploratory study, with a qualitative approach, carried out in the wards of a public hospital/maternity hospital in a city in the Northeast, Brazil. Fifty men participated in the study. Data collection with an individual interview, guided by semi-structured script. The data were recorded, transcribed in full, systematized, categorized, and organized by the Collective Subject Discourse method analyzed under the framework of Gender and Masculinities.

RESULTS

It was evident in the collective discourse of men that how fatherhood is understood is in transformation, and that the father's participation in the pregnancy and parturition context is under construction. The study showed the change in behavior of men, as well as the expression of new models of masculinities, about the exercise of assisted parenthood motivated by nurses.

CONCLUSIONS

Nurses' contributions represented necessary elements for greater adherence and male involvement and revealed a possibility to re-signify male identity from the reconstruction of the idea of fatherhood, in the context of pregnancy and parturition.