Abstract
BackgroundThe role of the male partner and wider family in maternal health, especially in case of emergencies, has been receiving increasing attention over the last decade. Qualitative research has highlighted that women depend on others to access high quality maternity care. Currently little is known about these factors in relation to maternal health in Mozambique.MethodsA cross sectional household survey was conducted with men and women in southern Mozambique about decision making, financial support and knowledge of danger signs. A multivariable logistic model was used to identify factors associated with knowledge of danger signs and Cohen’s kappa for agreement among couples.ResultsA total of 775 men and women from Marracuene and Manhica districts were interviewed. Maternal health care decisions were frequently made jointly by the couple (32–49%) and financial support was mainly provided by the man (46–80%). Parental and parent-in-law involvement in decision making and financial support was minimal (0–3%). The average number of danger signs respondents knew was 2.05 and no significant difference (p = 0.294) was found between men and women. Communication with the partner was a significant predictor for higher knowledge of danger signs for both men (p = 0.01) and women (p = 0.03). There was very low agreement within couples regarding decision making (p = 0.04), financial support (p = 0.01) and presence at antenatal care consultations (p = 0.001). Results suggest women and men have a high willingness for more male participation in antenatal care, although their understanding of what constitutes this participation is not clear.ConclusionThe study findings highlight the important role men play in decision making and financial support for maternal health care issues. Strengthening male involvement in antenatal care services, by investing in counselling and receiving couples, could help accelerate gains in maternal health in Mozambique. Maternal health care studies should collect more data from men directly as men and women often report different views and behavior regarding maternal health care issues and male involvement.
Highlights
The role of the male partner and wider family in maternal health, especially in case of emergencies, has been receiving increasing attention over the last decade
We found that women that did not know how many Antenatal Care (ANC) visits they made in their last pregnancy had lower knowledge about danger signs during pregnancy
It is important to note that relatively few maternal health care studies collect data from male partners directly [20], while our study shows men and women often have different views on decision making, financial support and presence at antenatal care consultations
Summary
The role of the male partner and wider family in maternal health, especially in case of emergencies, has been receiving increasing attention over the last decade. As part of efforts to reduce MMR, Mozambique adopted the World Health Organization’s (WHO) focused antenatal care (FANC) program consisting of four visits for low-risk pregnancies without complications [3]. This antenatal care (ANC) program includes health promotion and the prevention, detection and treatment of diseases during pregnancy. A recent study in ten LMICs found that coverage of provision of information on complications during pregnancy was extremely low [9], despite the fact that communicating such information requires no supplies or equipment Informing women and their partners about danger signs during pregnancy is an essential step for appropriate and timely referral of pregnant women in case of life threatening emergencies. Education and communication programs during pregnancy can prevent maternal mortality caused by the first delay of the three delays model of maternal mortality, which proposes that maternal mortality is associated with delays in: 1) deciding to seek care; 2) reaching the healthcare facility; and 3) receiving care [11]
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