Male partners' role in maternal health service utilization: a secondary analysis using 2015-16 National Family Health Survey (NFHS) data

Abstract

ObjectiveWhile prior research has documented several socio-demographic and policy level determinants of maternal health service utilization, the influence of partners and family on women's decisions to use maternal health services has received limited attention. This study focuses on the role of male partners in antenatal care, and examines the association between male partner attendance at antenatal care and maternal health service utilization. DesignCross-sectional observational study. SettingIndia. ParticipantsThis study utilized data from the 2015-16 National Family Health Survey (NFHS-4). Of all the ever-married women who had at least one live birth in the past five years, a total number of 144,840 respondents were included for the analysis on antenatal care utilization and 146,378 respondents were included for the analysis on institutional delivery. MeasurementsThe key dependent variables used for the study were timing and frequency of antenatal care, and institutional delivery; while the primary independent variable for the study was male partner attendance in antenatal care. Weighted descriptive statistics and multivariable logistic regression models were constructed to examine the association between male partner attendance in antenatal care and maternal health service utilization, controlling for participants’ sociodemographic characteristics. ResultsControlling for all socio-demographic variables, the results showed that women who were accompanied by a male partner during antenatal care contacts were 18% more likely to report initiating antenatal care in the first trimester (OR= 1.18, 95% CI [1.13- 1.23]), 72% more likely to report having 4 or more antenatal care contacts (OR= 1.72, 95% CI [1.64 - 1.80]), 45% more likely to report having 8 or more antenatal care contacts during their pregnancy (OR= 1.45, CI [1.35 - 1.55]) and 40% more likely to have an institutional delivery (OR= 1.40, 95% CI [1.34 – 1.48). Key conclusionsFew studies have examined the role of partners and family in influencing women's maternal health service utilization. The results of this study add to the growing knowledge base in the area of male partner involvement in maternal care by demonstrating that male partner attendance in antenatal care is positively associated with maternal health service utilization. Implications for practiceThese results provide support for interventions that aim at a gender transformative approach to maternal health. Engaging with male partners and educating them in antenatal care could lead to improved knowledge levels among the couple, and increased support and access to maternal health services.