Male participation in reproductive health care of women and factors associated with interpersonal relationship: A cross-sectional study in a rural community of Ambala District in Haryana

Background

Male participation plays an important role in affecting reproductive health outcomes. Communication between a wife and husband regarding reproductive matters is well recognized as a factor influencing good interpersonal relationships.

Objectives

The objectives of this study were to assess male participation in reproductive health care of women and spousal communications and also to identify factors associated with interpersonal relationship.

Methods

The present descriptive study was conducted among 104 married women aged 18-49 years in a rural community of Haryana during the months of June and July 2019. Study variables included sociodemographic characteristics, reproductive health characteristics, male participation in reproductive health care of women, and interpersonal communication.

Results

Male participation was reported by 72 (69.2%) women with an overall involvement of spouses in antenatal care by 71 (68.3%) women. Joint decisions concerning desired number of children, use of contraceptive, and choice of contraceptive use were reported by 47 (45.2%), 48 (46.2%), and 55 (52.9%) women, respectively. Good interpersonal relationship was reported by 80 (76.9%) women and 67 (64.4%) felt their expectations were fulfilled. Male partners played dominant roles in decisions concerning contraceptive use and place of delivery only. Low socioeconomic status came out to be a significant risk factor of not having good interpersonal relationships (P = 0.02).

Conclusion

Male participation in reproductive health care of women was reasonably high. Spouses were having good interpersonal relationships meeting expectations of women. Efforts should be made for increasing male involvement and encouraging better interpersonal communications for attaining desired reproductive health outcomes for women.

The Myth of Openness and Secrecy in Intimate Relationships: The Case of Spouses of Mixed-Orientation Marriage

The phenomenon of mixed-orientation marriages, in which one of the partners is straight and the other is non-straight, is invisible, yet not insignificant. Focusing on gay and bisexual men who are married to straight women, this article was designed to explore one of the essential themes in their relationship: the dynamics between secrecy and openness regarding the men's sexual orientation and gay practices. Based on the phenomenological paradigm, 38 men and eight women of mixed-orientation marriages in Israel were interviewed and shared their subjective life reality. Six patterns of secrecy and openness were identified, including complete secrecy, conspiracy of silence, initiated concealment (of the husband and wife), disloyalty/violation of the agreement, selective sharing, and complete openness. The findings challenge the idea that secrecy is detrimental and openness is beneficial in the context of mixed-orientation marriages. Findings are discussed within the framework of the dialectical approach.

Managing End-of-Life Uncertainty: Applying Problematic Integration Theory to Spousal Communication About Death and Dying

A significant number of Americans die in ways that do not reflect their preferences for end-of-life (EOL) care. For married individuals, the spouse often has the legal authority to make decisions at EOL. Many factors, most notably open preemptive communication about care preferences and dying wishes, determine whether such communication is viable and a partner's wishes are respected. We used a mixed method approach, involving a content analysis of spouses' reasons for seeking and avoiding conversations regarding their partners' EOL care preferences, and examined whether certain demographic factors (eg, income, gender, age) more likely contributed to the initiation of EOL conversations. We situate our findings within the broader cultural discourse about death and dying and highlight the influence of uncertainty in spousal EOL communication.

Classifying married adults diagnosed with alpha-1 antitrypsin deficiency based on spousal communication patterns using latent class analysis: insights for intervention

Married adults are increasingly exposed to test results that indicate an increased genetic risk for adult-onset conditions. For example, a SERPINA1 mutation, associated with alpha-1 antitrypsin deficiency (AATD), predisposes affected individuals to diseases such as chronic obstructive pulmonary disease (COPD) and cancer, which are often detected in adulthood. Married adults are likely to discuss genetic test results with their spouses, and interpersonal research suggests that spouses' communication patterns differ. Latent class analysis was used to identify subgroups of spousal communication patterns about AATD results from a sample of married adults in the Alpha-1 Research Registry (N = 130). A five-class model was identified, and the subgroups were consistent with existing spousal-communication typologies. This study also showed that genetic beliefs (e.g., genetic stigma), emotions, and experiences (e.g., insurance difficulties) covaried with membership in particular subgroups. Understanding these differences can serve as the foundation for the creation of effective, targeted communications interventions to address the specific needs and conversational patterns of different kinds of couples.

Spousal communication on family planning and perceived social support for contraceptive practices in a sample of Malaysian women

BACKGROUND

In Malaysia, contraceptive prevalence rate (CPR) during past three decades has been steady, with only 34% of women practicing modern contraception. The aim of this study was to determine the factors associated with modern contraceptive practices with a focus on spousal communication and perceived social support among married women working in the university.

MATERIALS AND METHODS

A cross-sectional study was carried out using self-administered structured questionnaire. The association between variables were assessed using Chi-square test, independent sample t-test, and logistic regression.

RESULTS

Overall, 36.8% of women used modern contraceptive methods. Significant association was found between contraceptive practice and ethnicity (P = 0.003), number of pregnancies (P < 0.001), having child (P = 0.003), number of children (P < 0.001), positive history of mistimed pregnancy (P = 0.006), and experience of unwanted pregnancy (P = 0.003). The final model showed Malay women were 92% less likely to use modern contraception as compared to non-Malay women. Women who discussed about family planning with their spouses were more likely to practice modern contraception than the women who did not [odds ratio (OR): 2.2, Confidence Interval (CI): 1.3-3.7]. Those women with moderate (OR: 4.9, CI: 1.6-10.8) and strong (OR: 14, CI: 4.5-26.4) perception of social support for contraceptive usage were more likely to use modern contraception than the women with poor perception of social support.

CONCLUSION

Spousal communication regarding family planning would be an effective way to motivate men for supporting and using contraceptives. Family planning education initiatives should target both men and women, particularly high-risk cases, for promoting healthy timing and spacing of pregnancies. Ethnic disparities need to be considered in planning reproductive health programs.

The role of community-based health planning and services strategy in involving males in the provision of family planning services: a qualitative study in Southern Ghana

BACKGROUND

Reproductive health and Family Planning (FP) services have been of global concern especially in developing countries where fertility rates are high. Traditionally FP services had always targeted females with little or no attention given to males. To ensure equitable distribution of health services, Ministry of Health (MOH), Ghana adopted the Community-Based Health Planning and Services (CHPS) as a nationwide health policy with the aim of reducing obstacles to physical and geographical access to health care delivery including FP services. However, not much is known about the extent to which this policy has contributed to male involvement in FP services. This qualitative descriptive study was therefore designed to explore male involvement in FP services in communities with well functioning CHPS and those with less or no functioning CHPS structures. The study further solicited views of the community on the health status of children.

METHODS

This was a qualitative descriptive study and adapted the design of an ongoing study to assess the impact of male involvement in FP referred to as the Navrongo experiment in Northern Ghana. Twelve focus group discussions were held with both male and female community members, six in communities with functional CHPS and six for communities with less/no-functional CHPS. In addition, fifty- nine (59) in-depth interviews were held with Community Health Officers (CHOs), Community Health Volunteers (CHVs) and Health Managers at both the districts and regional levels. The interviews and discussions were tape recorded digitally, transcribed and entered into QSR Nvivo 10(©) for analysis.

RESULTS

The results revealed a general high perception of an improved health status of children in the last ten years in the communities. These improvements were attributed to immunization of children, exclusive breastfeeding, health education given to mothers on childcare, growth monitoring of children and accessible health care. Despite these achievements in the health of children, participants reported that malnutrition was still rife in the community. The results also revealed that spousal approval was still relevant for women in the use of contraceptives; however, the matrilineal system appears to give more autonomy to women in decision-making. The CHPS strategy was perceived as very helpful with full community participation at all levels of the implementation process. Males were more involved in FP services in communities with functioning CHPS than those without functioning CHPS.

CONCLUSION

The CHPS strategy has increased access to FP services but spousal consent was very important in the use of FP services. Involving males in reproductive health issues including FP is important to attain reproductive health targets.