Abstract
BackgroundMale Involvement (MI) in the Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) services is essential in a patriarchal society where men are decision makers of the household. Male partners have a role in the woman’s risk of acquiring HIV, uptake of HIV testing and participation in Mother to Child Transmission (MTCT) prevention programmes. Although MI is important for uptake of PMTCT interventions, it remains low in Africa. The purpose of this study was to identify factors that promote and hinder MI in PMTCT services in antenatal care (ANC) services in Blantyre, Malawi. Understanding of the factors that influence MI will assist in developing strategies that will involve men more in the programme thereby improving the uptake of PMTCT and HIV testing and counselling services by women and men respectively.MethodsAn exploratory qualitative study was conducted from December 2012 to January 2013 at South Lunzu Health Centre (SLHC) in Blantyre, Malawi. It consisted of six face to face Key Informant Interviews (KIIs) with health care workers and four Focus Group discussions (FGDs) with 18 men and 17 pregnant women attending antenatal care at the clinic. The FGDs were divided according to sex and age. All FGDs and KIIs were digitally recorded and simultaneously transcribed and translated verbatim into English. Data were analysed using thematic content analysis.ResultsParticipants in both FGDs and KIIs identified the following barriers: lack of knowledge of MI in PMTCT, socioeconomic factors, relationship issues, timidity to be seen in a woman’s domain, unplanned and or extramarital pregnancies, fear of knowing one's HIV status, unwillingness to be associated with the service, health facility based factors, peer influence and cultural factors. The factors that would potentially promote male involvement were categorized into community, health facility and personal or family level factors.ConclusionsThe factors that may hinder or promote MI arise from different sources. The success of MI lies on recognizing sources of barriers and averting them. Factors that promote MI need to be implemented at different levels of health care.
Highlights
Male Involvement (MI) in the Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) services is essential in a patriarchal society where men are key decision makers as in most African countries [1,2,3,4]
There is positive impact on the uptake and adherence to PMTCT regimens especially when men accompany their partners, evidence indicates that only a few men accompany their female partners for antenatal care (ANC) and participate in PMTCT programmes [13] with rates of 3.2% in Malawi [15], 12.5% in Tanzania [11] and 16% in Kenya [16]
Prevention of Mother to Child Transmission services have been criticized for only focusing on females and sidelining males who are the primary support unit to the woman [19]
Summary
Male Involvement (MI) in the Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) services is essential in a patriarchal society where men are decision makers of the household. Male Involvement (MI) in the Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) services is essential in a patriarchal society where men are key decision makers as in most African countries [1,2,3,4]. Male partners have a role in the woman’s risk of there is positive impact on the uptake and adherence to PMTCT regimens especially when men accompany their partners, evidence indicates that only a few men accompany their female partners for antenatal care (ANC) and participate in PMTCT programmes [13] with rates of 3.2% in Malawi [15], 12.5% in Tanzania [11] and 16% in Kenya [16]. Personal and family level barriers may include the unwillingness and fear of a man knowing his HIV status [12,20,22,26], lack of knowledge [21,22,23,29,30,31], fear of stigma [22], a woman’s fear of violence [22,32] and socioeconomic factors [19,20]
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