Abstract
BackgroundIncreasing women’s status and male involvement are important strategies in reducing preventable maternal morbidity and mortality. While efforts to both empower women and engage men in maternal health care-seeking can work synergistically, in practice they may result in opposing processes and outcomes. This study examines whether a woman’s empowerment status, in sum and across economic, socio-familial, and legal dimensions, is associated with male partner accompaniment to antenatal care (ANC).MethodsWomen’s empowerment was measured based on the sum of nine empowerment items in the 2010–2011 Demographic and Health Surveys in eight sub-Saharan African countries: Burkina Faso (n = 2,490), Burundi (n = 1,042), Malawi (n = 1,353), Mozambique (n = 414), Rwanda (n = 1,211), Senegal (n = 505), Uganda (n = 428) and Zimbabwe (n = 459). In cross-sectional analyses, bivariate and multivariable logistic regressions models were used to examine the odds of male partner accompaniment to ANC between women with above-average versus below-average composite and dimensional empowerment scores.ResultsIn the majority of countries, male accompaniment to ANC was not uncommon. However, findings were mixed. Positive associations in women’s composite empowerment and male involvement were observed in Burkina Faso (OR = 1.27, 95% CI: 1.08, 1.50) and Uganda (OR = 1.53, 95% CI: 1.00-2.35), and in the economic empowerment dimension in Burkina Faso (OR = 1.24, 95% CI: 1.05-1.47). In Malawi, significant negative associations were observed in the odds of male accompaniment to ANC and women’s composite (OR = 0.77, 95% CI: 0.62-0.97) and economic empowerment scores (OR = 0.75, 95% CI: 0.59-0.94). No significant differences were observed in Burundi, Mozambique, Rwanda, Senegal, or Zimbabwe.ConclusionWomen’s empowerment can be positively or negatively associated with male antenatal accompaniment. Male involvement efforts may benefit from empowerment initiatives that promote women’s participation in social and economic spheres, provided that antenatal participation does not undermine women’s preferences or autonomy. The observation of mixed and null findings suggests that additional qualitative and longitudinal research may enhance understanding of women’s empowerment in sub-Saharan African settings.
Highlights
Increasing women’s status and male involvement are important strategies in reducing preventable maternal morbidity and mortality
Empowering women and increasing male involvement in maternal health care-seeking are both viewed as important strategies to reduce preventable maternal morbidity and mortality worldwide [1,2,3]
Country selection Eight sub-Saharan African countries were included in the analysis: Burkina Faso, Burundi, Malawi, Mozambique, Rwanda, Senegal, Uganda, and Zimbabwe
Summary
Increasing women’s status and male involvement are important strategies in reducing preventable maternal morbidity and mortality While efforts to both empower women and engage men in maternal health care-seeking can work synergistically, in practice they may result in opposing processes and outcomes. Empowering women and increasing male involvement in maternal health care-seeking are both viewed as important strategies to reduce preventable maternal morbidity and mortality worldwide [1,2,3]. Women often lack decision-making power to allocate resources for healthcare seeking [7,8], in contexts where men determine whether and under what conditions their spouses will use health services [9,10] This can prove problematic in households where men underestimate the importance of antenatal care [1,11]. Even following ANC consultation, women’s limited means and authority to implement healthy home practices have hindered development goals
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