Male Partner Involvement Research Articles

Male partner involvement in efforts to eliminate mother-to-child transmission of HIV in Kisumu County, Western Kenya, 2015.

Introductionmale partner involvement in elimination of mother-to-child transmission (eMTCT) of HIV activities remains low in Western Kenya, despite its importance in reducing rates of child HIV transmission. We sought to identify factors associated with male partner involvement in eMTCT in Kisumu East sub-County, Western Kenya.Methodswe conducted a cross-sectional study among women aged ≥ 18 years who had children aged ≤ 12 months and were attending a child health clinic for immunization services in one of four Western Kenya health centers between February and April, 2015. We assessed male involvement using an "involvement index" of five factors of equal weight: partner antenatal care (ANC) attendance, partner HIV testing, partner financial support to the woman during ANC, partner awareness of ANC services and partner participation in decision making on contraception including condom use. Male involvement was classified as high or low based on their index score. We calculated odds ratios (OR) and 95% confidence intervals (CI) to identify factors associated with high male partner involvement.Resultswe recruited 216 female participants. Mean age was 26.1 years (± 5.5 years), 189 (87.5%) were married. The majority (94.4%) had attended ANC in public health facilities. Nineteen percent of women had high male involvement. Having > 8 years of formal education (AOR 3.9, CI = 1.51-10.08), having male partner who was employed, history of previous couple testing (AOR = 3.2, CI = 1.42-7.22) and reports of partner having read the mother-child booklet during ANC (AOR = 2.9, CI = 1.30-6.49), were associated with high male involvement.Conclusionbased on our findings, we recommend targeted strategies to actively sensitize men and encourage their involvement in eMTCT, particularly among partners of women with fewer years of education and among partners who are not employed.

Male Partners Involvement in Prevention of Mother-to-Child Transmission of HIV Services in Southern Central Ethiopia: In Case of Lemo District, Hadiya Zone.

Male partners' involvement is a vital issue to prevent human immunodeficiency virus (HIV) transmission from mother to child; because it is much expectable that women were more vulnerable and high risk group of population portion. Therefore, to save lives of mothers and their newborn from acquiring HIV, male partners should do their maximum endeavor regardless of any determinant factors as our results revealed its status in our study context and elsewhere at past time too.

Male partner involvement in efforts to eliminate mother-to-child transmission of HIV in Kisumu County, Western Kenya, 2015.

Introductionrates of caesarean sections (CS) have been rising globally over time. Our study sought to identify factors associated with CS among mothers delivering at Mama Lucy Kibaki Hospital in Nairobi city county, Kenya.Methodswe conducted an unmatched case-control study using a 1:2 case-to-control ratio. Cases were defined as mothers who delivered through CS at the hospital while controls were defined as mothers who delivered through vaginal birth. Semi-structured questionnaires were used to interview study participants. We calculated means and proportions of demographic and obstetric characteristics of the mothers and crude odds ratios (cOR) and 95% confidence intervals (CI) to identify factors associated with CS. We performed multivariable logistic regression to identify independent factors associated with CS.Resultswe enrolled 396 participants consisting of 132 cases and 264 controls. We identified 148 (56.1%) spontaneous vaginal births. There were 89 (67.4%) primary CS. Among the 67 (50.7%) cases that had intrapartum complications, 28 (41.8%) had arrest of labor while among the 52 (19.7%) controls that had intrapartum complications 21 (40.4%) had abnormal intra-partum bleeding. There were 85 (65.4%) emergency caesarean sections, out of which 33 (25%) were due to failure of labor to progress. Of the elective caesarean sections, 26 (19.7%) were repeat caesarean. Delivering a baby with a normal birth weight (cOR = 0.39,95% CI 0.18, 0.94) and being formally employed (cOR = 1.90 (95% CI 1.4, 3.1)) were associated with CS. Being formally employed (AOR = 1.78, p = 0.030) was independently associated with a mother undergoing CS compared to mothers who were not formally employed, while mothers whose babies had a normal birth weight, ≥ 2.5kg (AOR = 0.40, p = 0.040) were less likely to undergo CS as compared to mothers whose babies had a low birth weight.Conclusionemployment status and birth weight were associated with CS in urban Kenyan mothers.

What do You Need to Get Male Partners of Pregnant Women Tested for HIV in Resource Limited Settings? The Baby Shower Cluster Randomized Trial

Male partner involvement has the potential to increase uptake of interventions to prevent mother-to-child transmission of HIV (PMTCT). Finding cultural appropriate strategies to promote male partner involvement in PMTCT programs remains an abiding public health challenge. We assessed whether a congregation-based intervention, the Healthy Beginning Initiative (HBI), would lead to increased uptake of HIV testing among male partners of pregnant women during pregnancy. A cluster-randomized controlled trial of forty churches in Southeastern Nigeria randomly assigned to either the HBI (intervention group; IG) or standard of care referral to a health facility (control group; CG) was conducted. Participants in the IG received education and were offered onsite HIV testing. Overall, 2498 male partners enrolled and participated, a participation rate of 88.9%. Results showed that male partners in the IG were 12 times more likely to have had an HIV test compared to male partners of pregnant women in the CG (CG = 37.71% vs. IG = 84.00%; adjusted odds ratio = 11.9; p < .01). Culturally appropriate and community-based interventions can be effective in increasing HIV testing and counseling among male partners of pregnant women.

Strategies to improve male involvement in PMTCT Option B+ in four African countries: a qualitative rapid appraisal

BackgroundThe World Health Organization recommends that antiretroviral therapy be started as soon as possible, irrespective of stage of HIV infection. This ‘test and treat’ approach highlights the need to ensure that men are involved in prevention of mother-to-child HIV transmission (PMTCT). This article presents findings from a rapid appraisal of strategies to increase male partner involvement in PMTCT services in Uganda, Democratic Republic of Congo, Malawi, and Côte d'Ivoire in the context of scale-up of Option B+ protocol.DesignData were collected through qualitative rapid appraisal using focus groups and individual interviews during field visits to the four countries. Interviews were conducted in the capital city with Ministry of Health staff and implementing partners (IPs) and at district level with district management teams, facility-based health workers and community health cadres in each country.ResultsCommon strategies were adopted across the countries to effect social change and engender greater participation of men in maternal, child and women's health, and PMTCT services. Community-based strategies included engagement of community leaders through dialogue and social mobilization, involving community health workers and the creation and strengthening of male peer cadres. Facility-based strategies included provision of incentives such as shorter waiting time, facilitating access for men by altering clinic hours, and creation of family support groups.ConclusionsThe approaches implemented at both community and facility levels were tailored to the local context, taking into account cultural norms and geographic regional variations. Although intentions behind such strategies aim to have positive impacts on families, unintended negative consequences do occur, and these need to be addressed and strategies adapted.A consistent definition of ‘male involvement’ in PMTCT services and a framework of indicators would be helpful to capture the impact of strategies on cultural and behavioral shifts. National policies around male involvement would be beneficial to streamline approaches across IPs and ensure wide-scale implementation, to achieve significant improvements in family health outcomes.

Male Partners’ Involvement in Abortion Care: A Mixed‐Methods Systematic Review

Although some women may desire the involvement of their partners when obtaining abortion care, male partners are not routinely included in the abortion process. A review of the literature on how male involvement relates to women's abortion experiences may help guide facilities that are considering incorporating male partners in abortion care. PubMed, PsycINFO (Ovid), the Cumulative Index to Nursing and Allied Health Literature, the Latin American and Caribbean Health Sciences Literature database, and the Cochrane Library were systematically searched without restrictions through September 23, 2015, to identify qualitative and quantitative primary studies investigating male partner accompaniment during the abortion process in noncoercive situations. Analysis focused on identifying different types of male involvement and their associations with women's abortion experiences. Some 1,316 unique articles were reviewed; 15 were analyzed. These studies were conducted in six countries and published between 1985 and 2012, primarily with observational designs. Four types of male partner involvement emerged: presence in the medical facility, participation in preabortion counseling, presence in the room during the surgical abortion procedure or while the woman is experiencing the effects of abortifacient medications, and participation in postabortion care. Studies explored relationships between type of involvement and women's access to abortion care and their emotional and physical well-being. Most findings suggested that male involvement was positively associated with women's well-being and their assessment of the experience; no negative associations were found. In noncoercive circumstances, women who include their male partners in the abortion process may find this involvement beneficial.

Impact of approaches in improving male partner involvement in the prevention of mother-to-child transmission (PMTCT) of HIV on the uptake of PMTCT services in sub-Saharan Africa: a protocol of a systematic review and meta-analysis

IntroductionSeveral studies have reported approaches used in improving the delivery of prevention of mother-to-child transmission (PMTCT) of HIV services through the involvement of male partners, but evidence from a systematic...

Male partners' views of involvement in maternal healthcare services at Makhado Municipality clinics, Limpopo Province, South Africa.

BackgroundMale partners have a strong influence on pregnant partners’ health and their access to care. Their involvement is critical in the delivery and uptake of maternal healthcare services and improving maternal and child health outcomes.AimThe study sought to determine male partners’ views on their involvement in maternal healthcare services.SettingThe Makhado Municipality’s Kutama, Madombidzha and Vleifontein clinics.MethodsA qualitative study design, which is exploratory, descriptive and contextual in nature, was used. The population comprised 15 men whose partners had been pregnant within the last 2 years. A non-probability, purposive sampling procedure was used. Data were collected via in-depth individual interviews using a voice recorder and an interview schedule guide. Tesch’s open coding method was used to analyse data.ResultsThe findings revealed one major theme, namely that maternal health issues are viewed as a woman’sdomain; and three sub-themes: culture and participation in childbirth, male partners’ employment status, and male partners’ unwillingness to participate in maternal health issues.ConclusionsThe involvement of male partners in maternal healthcare services, and further research in promoting this activity, should be proposedto policymakers.

Factors associated with male involvement in the prevention of mother to child transmission of HIV, Midlands Province, Zimbabwe, 2015 - a case control study.

BackgroundUptake of and adherence to the prevention of mother to child transmission of HIV (PMTCT) interventions are a challenge to most women if there is no male partner involvement. Organizations which include the National AIDS Council and the Zimbabwe AIDS Prevention Project- University of Zimbabwe have been working towards mobilizing men for couple HIV testing and counseling (HTC) in antenatal care (ANC). In 2013, Midlands province had 19 % males who were tested together with their partners in ANC, an increase by 9 % from 2011. However, this improvement was still far below the national target, hence this study was conducted to determine the associated factors.MethodsA1:1 unmatched case control study was conducted. A case was a man who did not receive HIV testing and counseling together with his pregnant wife in ANC in Midlands province from January to June 2015. A control was a man who received HIV testing and counseling together with his pregnant wife in ANC in Midlands province from January to June 2015. Simple random sampling was used to select 112 cases and 112 controls. Epi Info statistical software was used to analyze data. Written informed consent was obtained from each study participant.ResultsIndependent factors that predicted male involvement in PMTCT were: having been previously tested as a couple (aOR) 0.22, 95 % CI = 0.12, 0.41) and having time to visit the clinic (aOR) 0.41, 95 % CI = 0.21, 0.80). Being afraid of knowing one’s HIV status (aOR 2.22, 95 % CI = 1.04, 4.76) was independently associated with low male involvement in PMTCT.ConclusionMultiple factors were found to be associated with male involvement in PMTCT. Routine PMTCT educational campaigns in places where men gather, community based couple HTC and accommodating the working class during weekends are essential in fostering male involvement in PMTCT thereby reducing HIV transmission to the baby.

Postpartum family planning: current evidence on successful interventions.

We reviewed existing evidence of the efficacy of postpartum family planning interventions targeting women in the 12 months postpartum period in low- and middle-income countries. We searched for studies from January 1, 2004 to September 19, 2015, using the US Preventive Services Task Force recommendations to assess evidence quality. Our search resulted in 26 studies: 11 based in sub-Saharan Africa, six in the Middle East and North Africa, and nine in Asia. Twenty of the included studies assessed health facility-based interventions. Three were focused on community interventions, two had community and facility components, and one was a workplace program. Overall quality of the evidence was moderate, including evidence for counseling interventions. Male partner involvement, integration with other service delivery platforms, such as prevention of mother-to-child transmission of HIV and immunization, and innovative product delivery programs may increase knowledge and use during the postpartum period. Community-based and workplace strategies need a much stronger base of evidence to prompt recommendations.

Knowledge, Perception and Level of Male Partner Involvement in Choice of Delivery Site among Couples at Coast Level Five Hospital, Mombasa County, Kenya.

Involvement of males in reproductive health is an important step in reducing maternal and newborn deaths. A number of pregnant women attending Coast Level Five Hospital report waiting for their male partner to discuss and choose the delivery site. Although some do this when already in labour , there are no records on how many practice this and the influence of the couple knowledge and perception on male partner involvement in choice of delivery site. This descriptive cross-sectional study aimed at establishing the level of male partner involvement and influence of couple knowledge and perception on male involvement in choice of delivery site among women who delivered at this facility. Systematic sampling was used to select the participants. A semi-structured questionnaire and focus group discussion guide were used to collect data. Chi-square and binary logistic regression were used for statistical analysis. 40.6% of male partners were involved in choice of delivery site, women knowledge (χ2-19.256; df-1; p<0.001), women (χ2-11.347; df-1; p=0.001) and male partners' perception (χ2-10.909; df-1; p=0.001) influenced male partner involvement. However, women knowledge was the only predictor of male involvement (OR-3.843; 95% CI, 2.082-7.092; P<0.001). Male partner involvement was low, empowering women and encouraging positive perception among women and male partners will enhance male partner involvement in choice of delivery site. The health workers in Mombasa should come up with health education and communication strategies to improve public knowledge and perception towards male involvement and ultimately improve the level of male partner involvement in choice of delivery site.

Barriers to Males Involvement in Family Planning Services in Arba Minch Town, Southern Ethiopia: Qualitative Case Study

Effective utilization of family planning services are major contributors of improved maternal health. This, in turn, needs adequate involvement of male partners through direct uptake the services and approval of the spouses’ usage. Yet the family planning method utilization as well as male involvement is indicated to be low in Ethiopia. Qualitative case study was conducted in August 2015 in Arba Minch town to identify barriers to male involvement in uptake of family planning services. Open ended, semi-structured questionnaire was used to interview the participants. Four men and four women are purposively selected. Interviews were conducted in audibly private location after verbal consent was obtained from the recruited individuals. All interviews were recorded and transcribed verbatim. The narratives were then translated to English and the responses are aggregated in to nine concepts. The final aggregated data were analyzed using OpenCode 3.4 software based on thematic framework analysis. Total of eight participants (four men and four women) were interviewed where seven are married and one is single. Participants identified that, Perception (or opinion) towards family planning as women’s issue, Sex preference for inheritance and considering children as measure of blessing of and Fear of partner sexual promiscuity and to reduce women’s attractiveness were barriers for male involvement in modern family planning method. Future interventions aimed at improving family planning services and methods utilization in Arba Minch town and similar settings need to consider these bottlenecks for male involvement.

Barriers to Males Involvement in Family Planning Services in Arba Minch Town, Southern Ethiopia: Qualitative Case Study

Effective utilization of family planning services are major contributors of improved maternal health. This, in turn, needs adequate involvement of male partners through direct uptake the services and approval of the spouses’ usage. Yet the family planning method utilization as well as male involvement is indicated to be low in Ethiopia. Qualitative case study was conducted in August 2015 in Arba Minch town to identify barriers to male involvement in uptake of family planning services. Open ended, semi-structured questionnaire was used to interview the participants. Four men and four women are purposively selected. Interviews were conducted in audibly private location after verbal consent was obtained from the recruited individuals. All interviews were recorded and transcribed verbatim. The narratives were then translated to English and the responses are aggregated in to nine concepts. The final aggregated data were analyzed using OpenCode 3.4 software based on thematic framework analysis. Total of eight participants (four men and four women) were interviewed where seven are married and one is single. Participants identified that, Perception (or opinion) towards family planning as women’s issue, Sex preference for inheritance and considering children as measure of blessing of and Fear of partner sexual promiscuity and to reduce women’s attractiveness were barriers for male involvement in modern family planning method. Future interventions aimed at improving family planning services and methods utilization in Arba Minch town and similar settings need to consider these bottlenecks for male involvement.

Determinants of Male Partner Involvement in Antenatal Care in Wakiso District, Uganda

Determinants of Male Partner Involvement in Antenatal Care in Wakiso District, Uganda

An assessment of strategies used to encourage male involvement in antenatal care and women's uptake of PMTCT services in Cameroon

Background/Aims: In Sub-Saharan Africa, antenatal clinics that include prevention of mother-to-child HIV transmission (PMTCT) services remain the primary entry point where women are screened for HIV infection and receive antiretroviral therapy. Male partner involvement has been a strongly promoted strategy to increase women's uptake of PMTCT services. Although a programme for men has been in place for almost 10 years at Mbingo Baptist Hospital, the proportion of men accompanying their partner to PMTCT care visits has never exceeded 20%. This outcome exhibited the need to evaluate present strategies so as to increase male participation in PMTCT care. Methods: A survey was administered to women (n=80) attending the antenatal clinic to obtain their opinions of the strategies being used to encourage male involvement in PMTCT care. Results: Women expressed their support of male participation in PMTCT care but also identified cultural and gender barriers to male involvement. They indicated that invitation letters to men should continue to be provided but that a direct appeal to men would improve their response. All women requested that free HIV testing be continued. The majority did not think that providing rewards or incentives encouraged male participation. Conclusions: Male involvement in PMTCT care is dependent on multiple cultural, social and economic factors. Health care providers and other stakeholders need to make conscious efforts to tailor programmes that will reach out to the community with complete information about PMTCT care options.

A systematic review of interventions to improve prevention of mother-to-child HIV transmission service delivery and promote retention.

IntroductionThe success of prevention of mother-to-child transmission of HIV (PMTCT) is dependent upon high retention of mother-infant pairs within these programmes. This is a systematic review to evaluate the effectiveness of interventions that aim to improve PMTCT service delivery and promote retention throughout the PMTCT steps.MethodsSelected databases were searched for studies published in English (up to September 2015). Outcomes of interest included antiretroviral (ARV) drugs or antiretroviral therapy (ART) initiation among HIV-positive pregnant and/or breastfeeding women and their infants, retention into PMTCT programs, the uptake of early infant diagnosis (EID) of HIV and infant HIV status. Risk ratios and random-effect meta-analysis were used in the analysis.ResultsInterventions assessed in the 34 identified studies included male partner involvement in PMTCT, peer mentoring, the use of community health workers (CHWs), mobile phone-based reminders, conditional cash transfer, training of midwives, integration of PMTCT services and enhanced referral. Five studies (two randomized) that evaluated mobile phone-based interventions showed a statistically significant increase (pooled RR 1.18; 95% CI 1.05 to 1.32, I2=83%) in uptake of EID of HIV at around six weeks postpartum. Male partner involvement in PMTCT was associated with reductions in infant HIV transmission (pooled RR 0.61; 95% CI 0.39 to 0.94, I2=0%) in four studies (one randomized). Four studies (three randomized) that were grounded on psychological interventions reported non-significant results (pooled RR 1.01; 95% CI 0.93 to 1.09, I2=69%) in increasing ARV/ART uptake among HIV-positive pregnant and/or breastfeeding women and infant HIV testing (pooled RR 1.00; 95% CI 0.94 to 1.07, I2=45%). The effect of the other interventions on the effectiveness of improving PMTCT uptake was unclear. Heterogeneity of interventions limits these findings.ConclusionsOur findings indicate that mobile phone-based reminders may increase the uptake of EID of HIV. Studies on male partner involvement in PMTCT reported reductions in infant HIV transmission. Stronger evidence is needed and future studies should determine the long-term effects of these interventions in improving retention throughout the PMTCT steps.

Birth preparedness, complication readiness and male partner involvement for obstetric emergencies in rural Rwanda.

IntroductionBirth preparedness and complication readiness (BP/CR) promotes timely access to skilled maternal and neonatal services, active preparation and decision-making for seeking health care to prevent any adverse outcomes. The aim was to assess level of male partner (MP) involvement in the birth plan, the attitude of the women towards maternal care and factors associated with BP/CR among obstetric referrals in rural Rwanda.MethodsThis was a cross-sectional study among 350 pregnant women who were admitted as referrals at Ruhengeri hospital, between July 2015 and November 2015. Data was collected on socio-demographics, level of MP's participation in maternal health care and domestic activities, women's attitude towards involvement of men in maternal care and BP/CR. Any woman who arranged to have a birth companion, made a plan of where to deliver from, received health education on pregnancy and childbirth complications, saved money in case of pregnancy complication and had attended antenatal care (ANC) at least 4 times, was deemed as having made a birth plan.ResultsThe mean age was 27.7 years, while mean age of the spouse was 31.3 years. Majority of the women (n=193; 55.1%) and their spouse (n=208; 59.4%) had completed primary education. Men's role was found to be mainly in the area of financial support. The level of men ANC attendance was low (n=103; 29.4%), while 78 (22.3%) women were accompanied to the labor ward. However, there was a strong opposition to the physical presence of MP in the labor room (n=178; 50.9%). The main reason cited by women opposing MP presence is that it is against their culture for a man to witness the delivery of a baby. On multivariable analysis, maternal education level of secondary or higher adjusted odds ratio [AOR] 1.4 95% CI (1.8-2.6), formal occupation of spouse, AOR 2.4 95% CI (1.4-4.2) and personnel checked during ANC being community health worker AOR 2.2, 95% CI; (1.3-3.7) were associated with being well prepared.ConclusionMale involvement in pregnancy and antenatal care is low. To increase men involvement in birth plan addressing cultural barriers and refraining care-givers and health facility policies towards family delivery is paramount.

Guidelines to operationalize a model to facilitate male involvement in the reproductive health context by the registered nurses

&lt;p&gt;The purpose of this article is to describe the guidelines for operationalising a model to facilitate male partner involvement in RH. Guidelines were developed for the implementation of the model to facilitate male partner involvement in RH through the management of a partnership environment. These guidelines may be implemented in those health facilities that provide RH services, namely, clinics, health centres and hospitals. The nurses, in collaboration with significant stakeholders from the community, representatives from the line ministries and NGOs, will be able to facilitate male partner involvement in RH.&lt;/p&gt;&lt;p&gt;These guidelines and strategies were derived from the conceptual framework which was generated by means of deductive reasoning and analysis. The guidelines and strategies at each level are aimed at facilitating male partner involvement in RH through the management of the partnership environment by enabling male partners to become actively involved and participate and to eliminate those factors that impede the full participation of male partners in the RH context. The chapter will focus on these guidelines which are expressed in terms of the aims and strategies of each of the four phases in facilitating male partner involvement in RH.&lt;/p&gt;

Description of a model to facilitate male involvement in the reproductive health context by the registered nurses

&lt;p&gt;The aim of this article is to describe a model to facilitate male partner involvement in the RH context. The findings in chapter 3, step1 – concept analysis – which comprised the identification, definition and classification of concepts and the construction of an interrelationship between concepts and statements (chapter 4), formed the basis for the development of this model. This model to facilitate male partner involvement in RH is based on the theory generation of Chinn and Kramer (1991). The central concepts are defined by using the rules described by Rossouw (2000/1,) and Copi and Cohen (1996). Lastly, the model evaluation has been done in accordance with the method of Chinn and Kramer (1991).&lt;/p&gt;

Behaviour change techniques and contraceptive use in low and middle income countries: a review.

We aimed to identify effective behaviour change techniques to increase modern contraceptive use in low and middle income countries (LMICs). Literature was identified in Global Health, Web of Science, MEDLINE, PsycINFO and Popline, as well as peer reviewed journals. Articles were included if they were written in English, had an outcome evaluation of contraceptive use, modern contraceptive use, contraceptive initiation/uptake, contraceptive adherence or continuation of contraception, were a systematic review or randomised controlled trial, and were conducted in a low or middle income country. We assessed the behaviour change techniques used in each intervention and included a new category of male partner involvement. We identified six studies meeting the inclusion criteria. The most effective interventions were those that involve male partner involvement in the decision to initiate contraceptive use. The findings also suggest that providing access to contraceptives in the community promotes their use. The interventions that had positive effects on contraceptive use used a combination of behaviour change techniques. Performance techniques were not used in any of the interventions. The use of social support techniques, which are meant to improve wider social acceptability, did not appear except in two of the interventions. Our findings suggest that when information and contraceptives are provided, contraceptive use improves. Recommendations include reporting of behaviour change studies to include more details of the intervention and techniques employed. There is also a need for further research to understand which techniques are especially effective.