Male Involvement In Antenatal Care Research Articles

Social-Cultural Determinants of Male Partner Involvement in Antenatal Care at Anti-Stock - Theft – Unit Kenya

Purpose: Male involvement in antenatal care is a problem identified by different researchers and experienced globally. It is a key component in the optimization of maternal health and universal maternal health achievement. Few men engage in care in developing countries. The current study sought to identify Social-cultural Determinants of Male Partner Involvement in Antenatal Care.Methodology: Descriptive cross-sectional research design. Simple random sampling was used to sample 334 subjects from 2582 population. Data was gathered using self- administered questionnaires, edited, coded, and organized with help of statistical Package for Social Sciences (SPSS), then analysed using descriptive and inferential statistics. Hypothesis was tested using Chi square tests of independence and information presented using tables and percentages.Results: Majority (92.8%) of subjects were affiliated to religion. On cross tabulation, (100%) of participants who accompanied the partners during the first ANC visit disagreed that religion impairs male partner participating in antenatal care unlike (100%) of those who did not. Chi squire tests of independence was (p=0.047). Majority (77.2%) of the respondents preferred traditional birth attendants for partner’s antenatal care compared to 15.6% for health care workers. On cross tabulation, (93.3%) of the participants who accompanied partners during the first ANC visit indicated that they preferred health care providers to traditional birth attendants while 81.8% of those who did not accompany the partners indicated preference for traditional birth attendants and 9.1% preferred care workers. Chi squire tests of (independence (p=0.001).Unique contribution to theory, practice and policy: Male partner involvement in maternal health is desirable at the study area and there is need of social supports such as informational, appraisal, instrumental and emotional supports to enhance physical, psychological well-being, social integration and social ties. Researcher highlights the need to address religion and traditional birth attendants’ reliance which were found significant and established as barriers of male partner participating in ANC and causes of low ANC attendances among pregnant women. Further, policy change is advocated so that the government can pass laws which oblige men to be responsible for pregnant partners by accompanying them to ANC, knowing ANC schedules, discussing interventions, supporting the ANC fees if applicable, and knowing what happens at the ANC during the current pregnancy.

Leaving no one behind: using action research to promote male involvement in maternal and child health in Iringa region, Tanzania

IntroductionMale involvement has been reported to improve maternal and child health (MCH) outcomes. However, most studies in low-income and middle-income countries have reported low participation of men in MCH-related programmes....

Improving male involvement in antenatal care in low and middle-income countries to prevent mother to child transmission of HIV: A realist review.

BackgroundChildhood Human Immunodeficiency Virus (HIV) infection occurs almost exclusively via mother to child transmission (MTCT) during pregnancy, birth, or through breastfeeding. Recent studies have shown that male involvement (MI) in antenatal care (ANC) and HIV testing, including couples voluntary counselling and testing (CVCT), increases the likelihood that women will adhere to prevention advice and comply with HIV treatment if required during their pregnancy; hence reducing the rates of MTCT of HIV. This realist review investigates how, why, when, and for whom MI in ANC works best to provide contextual advice on how MI in ANC can be best used for prevention of mother to child transmission (PMTCT) of HIV.MethodsA realist review of existing evidence was conducted. Realist review seeks to explain how and why an intervention works, or does not work, in a given context. This was completed through the five stages of realist synthesis; Eliciting the program theory, search strategy, study selection criteria, data extraction, and data analysis and synthesis. Findings are presented as context-mechanism-outcome (CMO) configurations outlining the mechanisms that work in given contexts to give an outcome.ResultsThree CMO configurations were developed. These describe that 1) Couples in monogamous relationships have higher levels of trust, commitment and security leading to increased uptake of PMTCT programs together; 2) ANC spaces that make ‘male friendly’ adaptions promote normalisation of MI in PMTCT and are more welcoming, leading to increased willingness of male partners to participate in ANC; and 3) couples and communities with higher health literacy encourage increased informed decision making, ownership, and responsibility and thus increased participation in PMTCT of HIV.ConclusionsThe CMOs developed in this review give contextual advice on how one might improve ANC services to increase MI and help reduce MTCT of HIV. We propose that MI in ANC works best where couples are monogamous and trusting, where ANC spaces actively promote being a ‘male friendly space’ and where there are high levels of community education programs around MTCT.

Association between male involvement during antenatal care and use of maternal health services in Mwanza City, Northwestern Tanzania: a cross-sectional study

BackgroundMale involvement in antenatal care (ANC) is among interventions to improve maternal health. Globally male involvement in ANC is low and varies in low-income and middle-income countries including Tanzania where...

Perception of pregnant women on barriers to male involvement in antenatal care in Sekondi, Ghana

Getting men to be actively involved in Antenatal Care (ANC) has been acknowledged by the World Health Organisation as a key indicator for better maternal health outcomes. We investigated the perception of women about barriers to male involvement in ANC in Sekondi, Ghana. Dwelling on cross-sectional design, we used a sample of 300 pregnant women (adolescents excluded) who had ever attended ANC in five fishing communities in Sekondi. The study was underpinned by a conceptual framework adapted from Doe's conceptual framework of male partner involvement in maternity care. We used questionnaire for the data collection. Both descriptive-frequencies and percentages; and inferential-binary logistic regression analyses were carried out. Seven out of ten (70%) participants indicated high male involvement in ANC. Respondents whose partners were aged 50–59 were less likely to report high male involvement in ANC compared to those whose partners were aged 20–29 years (OR = 0.47, 95% CI = [0.35–0.86], p = 0.03). Those living together with their partners were about two times more likely to report high male involvement in ANC compared to those who did not live with their partners (OR = 1.63, 95% CI = [1.18–3.19], p = 0.01). Participants who identified long waiting time at the health facility as a determinant of male involvement in ANC were less likely to report high male involvement in ANC compared to those who disagreed (OR = 0.57, 95% CI = [0.38–0.85], p = 0.01). The outcome of our study calls for male partner friendly policy driven environment at the various ANC visit points that would make men more comfortable to accompany their partners in accessing ANC services.

Sociodemographic Factors Associated with Women’s Perspectives on Male Involvement in Antenatal Care, Labour, and Childbirth

Background Evidence suggests that in patriarchal societies such as Ghana, access to and survival of maternal and child healthcare services require the active involvement of men. However, interventions to promote men's involvement in maternal and child health care are less likely to succeed if the views and concerns of women are not considered. This study provides an understanding of women's perspective on men's involvement in antenatal care, labour, and childbirth in the Northern Region of Ghana. Methods Data for this cross‐sectional study were collected from 300 pregnant women using a structured questionnaire. Logistic regression models were then used to determine the socio‐demographic factors associated with women's perspectives on men's involvement in antenatal care, labour, and childbirth. Results The mean age of the participants was 28 (SD = 5.21) years. More than four-fifths of the women in this study express the desire for male partner involment in natenatal care (ANC) services (n = 258, 86%) and as companions during labour and child birth (n = 254, 84.7%). We found that married women were 9.8 times more likely (95%CI 1.59, 60.81) to encourage male involvement in ANC compared to women who were unmarried. The probability of encouraging male involvement in ANC decreased with increased level of education among the women while support for male companionship during childbirth increased significantly with an increased level of education. After accounting for the effect of other significant covariates, there was good evidence to suggest that married women (p = 0.002), women with only primary/Junior High School education (p = 0.048) and those with two (p = 0.010), three (p = 0.008), or ≥4 (p = 0.044) previous pregnancies had a desire for male partner involvement in ANC while women who attained secondary (p = 0.004) or tertiary (p = 0.001) level education expressed the desire for male companionship in labour and childbirth in the adjusted model. Conclusion Male involvement in antenatal care, labour, and childbirth received overwhelming support from the women in this study.

Male partners' knowledge and practices of antenatal care in district Swat, Khyber Pakhtunkhwa, Pakistan: A cross-sectional study

Background & aim: Active participation of men in antenatal care and their considerable knowledge about this issue is resulted in favorable pregnancy outcomes. This study aimed to assess the knowledge and practices of male partners regarding antenatal care (ANC) and their associated factors in district Swat, Khyber Pakhtunkhwa, Pakistan (KPK). Methods: This cross-sectional study was conducted on 200 married men residing in district Swat KPK, Pakistan in 2015 who were selected by convenience sampling. The data were collected by valid and reliable self-structured questionnaire and were completed by participants. The data were analyzed with STATA (version 11) using descriptive and inferential statistics. Results: The findings of the study revealed that almost half of the participants (52%) demonstrated a good knowledge of ANC. Moreover, factors as the socio-demographic variables, men’s level of education (P < 0.01), occupation (P < 0.01), number of family members (P < 0.01), and history of wife's premature delivery (P< 0.01) were found to be significantly associated with men’s knowledge of ANC. With regard to practices of ANC, majority (84%) had good practices in terms of male involvement in ANC. Also 95/5% men allowed their wives to refer to ANC facilities and 85/5% accompanied them. Conclusion: The present study concluded that men demonstrated a reasonable practice of ANC, as compared to their knowledge. This study paved the way for further research on men’s involvement in ANC in Pakistan.

Factors Influencing Male Involvement in Antenatal Care in the Kassena Nankana Municipal in the Upper East Region, Ghana

Background: Globally, male involvement in antenatal care remains a challenge to the effective utilization of maternal health services. Male involvement is considered to be a useful tool that is capable of improving the health outcome of mothers and their children. However, matters relating to antenatal care have often been considered on a gender basis. Objective: The objective of this study was to assess the factors that influence male partner involvement in antenatal care services. Methods: A community-based crosssectional study was conducted among 420 men whose partners were pregnant or had delivered within twelve months preceding the study using multiple sampling procedures. Pearson Chi-Square and Fisher’s exact test were conducted to establish an association between dependent and independent variables after which multiple logistic regression was conducted. P-values of < 0.05 at 95% confidence interval were considered significant. Data were analyzed using STATA version 13.1. Results: The level of male involvement in antenatal care was high (67.2%). About 71.9% accompanied their partners to antenatal clinics at one point during the pregnancy period. Out of this, 45.7% of themdid so four or more times, 35.7% went two to three times, while 18.6% went only once. Factors such as staff attitude, time spent at the clinics, age, educational level, monthly income level, living with a partner during pregnancy, distance to the clinic, and community acceptability were all statistically significant to male involvement. Conclusion: The level of male involvement was high and considered above average. There is the need to develop interventions that will diffuse the existing socio-cultural perceptions and improve staff attitudes to achieve higher male involvement in antenatal care.

English

Male involvement in antenatal care helps to have safe delivery, especially in developing countries. The problem has been insufficiently studied in Ethiopia. Therefore, this study assessed male attendance and associated factors at their partners&rsquo; antenatal visits among antenatal care attendees in Bale Zone health facilities. Cross sectional study was conducted from May to June, 2017 among 609 pregnant mothers. Simple random sampling was used to select participants. Interviewer administered questionnaire was used to collect data. Data was entered into Epi-data version 3.1 and analyzed using statistical package for social sciences (SPSS version 21). Variables with p-values &lt;0.05 were considered to declare statistical significance in multivariable logistic regression analysis. Male attendance at their partners&rsquo; antenatal visits was 41.4%. Having primary level of education (AOR=2.15, CI=1.12, 4.11), age &ge; 35 years (AOR=0.3, CI=0.1, 0.87), being farmer (AOR=0.23, CI=0.11, 0.51), having previous antenatal care visit (AOR=0.49, CI=0.26, 0.92) were factors associated with male partner involvement. Male attendance at their partners&rsquo; antenatal visits was low. Hence, health providers and other stakeholders shall create awareness and implement strategies to boost male partners&rsquo; involvement in antenatal care visit. Key words:&nbsp; Antenatal visits, Bale-Zone. &nbsp

Acceptability of couple antenatal education: A qualitative study of expectant couples attending antenatal clinics in Blantyre, Malawi.

Few studies have assessed the effectiveness and acceptability of male partner involvement in antenatal education. Yet, male involvement in antenatal care including antenatal education has been proposed as a strategy to improve maternal and neonatal outcomes. We conducted this study to add to the body of knowledge on acceptability of male partner involvement in antenatal education following an intervention. This was a cross sectional qualitative study using 18 in-depth interviews with 10 couples, 5 women from the couples group and 3 nurse-midwife technicians. Participants were purposively selected and interviewed between July and November, 2017. The study setting was South Lunzu and Mpemba Health Centres and their catchment areas. All interviews were audiotaped, transcribed verbatim and translated from Chichewa into English. Data were coded in Nvivo 10.0 and analyzed thematically. We identified three themes: benefit of content received; organization of couple antenatal education appropriate for male partner involvement; and delivery of couple antenatal education incentive for male involvement and learning. However, some improvements were suggested regarding content, organization and delivery of the education sessions. Couple antenatal education was acceptable to the couples and the facilitators in terms of content received, organization and delivery. Nevertheless, adding naming the baby to the list of topics, creating a special day for couples to attend antenatal education and providing a readable leaflet are likely to make couple antenatal education more user friendly.

Influences on Exclusive Breastfeeding Among Rural HIV-Infected South African Women: A Cluster Randomized Control Trial.

South African guidelines for prevention-of-mother-to-child-transmission (PMTCT) of HIV emphasize exclusive breastfeeding (EBF). This study examined the impact of a PMTCT intervention and male involvement on EBF. In a two-phase cluster-randomized trial, rural South African community health centers were randomized to offer HIV-infected pregnant women PMTCT standard of care plus either: a behavioral PMTCT intervention, or a time-equivalent attention-control condition. Phase 1 women had non-participating male partners; Phase 2 women had participating partners. Pregnant women (n = 1398) were assessed on HIV stigma, disclosure of HIV status to partner, male involvement, and family planning knowledge. Feeding practices were assessed 6 weeks postpartum (56% retained). Reduced depressive symptomatology predicted EBF 6weeks postpartum, adjusting for attrition (AOR = 0.954, p = 0.001). Neither male involvement in antenatal care, phase, HIV stigma, disclosure, nor family planning knowledge predicted EBF. Future studies and perinatal care should address depression, which has important implications for infant health.

Men’s hopes, fears and challenges in engagement in perinatal health and the prevention of mother-to-child transmission of HIV in rural Kenya

Male involvement in antenatal care has been shown to improve health outcomes for women and infants. However, little is known about how best to encourage male partners to support essential perinatal health activities. We explored men’s perceptions of facilitators and barriers to involvement in antenatal care and HIV prevention including fears, hopes and challenges. Forty in-depth interviews were conducted with the male partners of HIV-positive and HIV-negative pregnant women in southwest Kenya. Most male partners believed engaging in pregnancy health-related activities was beneficial for keeping families healthy. However, thematic analysis revealed several obstacles that hindered participation. Poor couple relationship dynamics seemed negatively to influence male engagement. Some men were apprehensive that clinic staff might force them to test for HIV and disclose the results; if HIV-positive, men feared being labelled as ‘victimisers’ in situations of serodiscordancy, and described fears of abandonment by their wives. Some men avoided accompanying their wives, citing local culture as rationale for avoiding the ‘effeminate’ act of antenatal care attendance. Amidst these obstacles, some men chose to use their partners’ HIV status as proxy for their own. Findings suggest that improving male engagement in essential maternal and child health-related activities will require addressing both structural and interpersonal barriers.

Navigating the risks of prevention of mother to child transmission (PMTCT) of HIV services in Kibera, Kenya: Barriers to engaging and remaining in care.

Within the first year of implementation, 43% of women who tested HIV positive at their first antenatal care visit were no longer retained and being followed in the free prevention of mother to child transmission (PMTCT) of HIV program offered by the Kenyan Ministry of Health and Médecins Sans Frontières in the informal settlement of Kibera, Nairobi. This study aimed to explore barriers to enrolling and remaining engaged in PMTCT services throughout the pregnancy and postpartum periods. Qualitative data from 31 focus group discussions and 35 in-depth interviews across six stakeholder groups that included women, men, and PMTCT service providers were analyzed. Using an inductive exploratory approach, four researchers coded the data and identified key themes. Five themes emerged from the data that may influence attrition from PMTCT service in this setting: 1) HIV in the context of Kibera, 2) knowledge of HIV status, 3) knowledge of PMTCT, 4) disclosure of HIV status, and 5) male partner support for PMTCT services. A new HIV diagnosis during pregnancy immediately triggered an ongoing risk assessment of perceived hazards in the home, community, and clinic environments that could occur as a result of female participation in PMTCT services. Male partners were a major influence in this risk assessment, but were generally unaware of PMTCT services. To preserve relationships with male partners, meet community expectations of womanhood, and maintain confidentiality while following recommendations of healthcare providers, women had to continuously weigh the risks and benefits of PMTCT services and interventions. Community-based HIV testing and PMTCT education, male involvement in antenatal care, and counseling customized to assist each woman in her own unique risk assessment, may improve uptake of and retention in care and optimize the HIV prevention benefit of PMTCT interventions.

‘Unless you come with your partner you will be sent back home’: strategies used to promote male involvement in antenatal care in Southern Tanzania

ABSTRACTBackground: Male involvement in pregnancy and childbirth has been shown to improve maternal and child health. Many countries have used different strategies to promote participation of men in antenatal care services. While many strategies have been employed to promote male participation in antenatal care, few have been evaluated to provide much-needed lessons to support wider adoption.Objective: This study aimed at describing strategies that were used by health providers and the community to promote male participation in antenatal care services and challenges associated with the implementation of these interventions in Southern Tanzania.Methods: We used qualitative data and analytical methods to answer the research questions. The study relied on semi-structured interviews with health providers, men and women, village and community leaders and traditional birth attendants. Data were analysed using a thematic approach.Results: The findings of this study revealed that different strategies were employed by health providers and the community in promoting participation of men in antenatal care services. These strategies included: health providers denying services to women attending antenatal care without their partners, fast-tracking service to men attending antenatal care with their partners, and providing education and community sensitisation. The implementation of these strategies was reported to have both positive and unintended consequences.Conclusions: This study concludes that despite the importance of male involvement in pregnancy and childbirth-related services, the use and promotion of the male escort policy should not inadvertently affect access to antenatal care services by pregnant women. In addition, programmes aiming for men’s involvement should be implemented in ways that respect, promote and facilitate women’s choices and autonomy and ensure their safety. Furthermore, there is a need for sensitisation of health providers and policymakers on what works best for involving men in pregnancy and childbirth.

Acceptability and Preferences among Men and Women for Male Involvement in Antenatal Care.

Introduction. Male involvement in antenatal care (ANC) has been associated with improved prevention of mother-to-child transmission outcomes in Sub-Saharan Africa; yet it remains uncommon. We assess acceptability of male involvement from the male and female perspectives and potential incentives for men to attend ANC. Methods. Adult pregnant women and men attending primary healthcare at Witkoppen Health and Welfare Centre in Johannesburg, South Africa, from October 2013 to January 2014, were recruited using stratified random sampling to ensure equal representation across gender and HIV status. Results. 300/332 individuals (93.8%) offered participation consented. Among the 150 women, 97% had a partner; the majority (92%) preferred partner attendance at ANC, and 14% reported partner attendance during this pregnancy. The 150 men had low knowledge of services rendered at ANC outside of pregnancy monitoring, and few (19%) had previously attended ANC. Blood pressure screening, fatherhood information, and HIV testing were identified by men as incentives for attendance. Women and men expressed high willingness to, respectively, deliver (95%) and respond (97%) to ANC letter invitations. Conclusion. Invitation letters to promote male involvement in ANC are highly acceptable to pregnant women and men. Focusing invitation messages on fatherhood and primary healthcare rather than HIV testing may provide greater motivation for male involvement.

Male Involvement in Maternal Health Care at Anomabo, Central Region, Ghana.

Background Globally, male involvement in maternal health care services remains a challenge to effective maternal health care accessibility and utilization. Objective This study assessed male involvement in maternal health care services and associated factors in Anomabo in the Central Region of Ghana. Methods Random sampling procedures were employed in selecting 100 adult male respondents whose partners were pregnant or had given birth within twelve months preceding the study. Pearson Chi-Square and Fisher's exact tests were conducted to assess the association of sociodemographic and enabling/disenabling factors with male involvement in maternal health care services. Results Some 35%, 44%, and 20% of men accompanied their partners to antenatal care, delivery, and postnatal care services, respectively. Male involvement in antenatal care and delivery was influenced by sociodemographic (partner's education, type of marriage, living arrangements, and number of children) and enabling/disenabling (distance to health facility, attitude of health workers, prohibitive cultural norms, unfavourable health policies, and gender roles) factors. Conclusion The low male involvement in maternal health care services warrants interventions to improve the situation. Public health interventions should focus on designing messages to diffuse existing sociocultural perceptions and health care provider attitudes which influence male involvement in maternal health care services.

Barriers to Male Involvement in Antenatal Care in Rural Mozambique.

Low rates of antenatal care (ANC) service uptake limit the potential impact of mother-to-child HIV-prevention strategies. Zambézia province, Mozambique, has one of the lowest proportions of ANC uptake among pregnant women in the country, despite the availability of free services. We sought to identify factors influencing ANC service uptake (including HIV counseling and testing) through qualitative methods. In addition, we encouraged discussion about strategies to improve uptake of services. We conducted 14 focus groups to explore community views on these topics. Based on thematic coding of discourse, two main themes emerged: (a) gender inequality in decision making and responsibility for pregnancy and (b) community beliefs that uptake of ANC services, particularly, if supported by a male partner, reflects a woman's HIV-positive status. Interventions to promote ANC uptake must work to shift cultural norms through male partner participation. Potential strategies to promote male engagement in ANC services are discussed.

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.

Women's empowerment and male involvement in antenatal care: analyses of Demographic and Health Surveys (DHS) in selected African countries.

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.

Male involvement in antenatal care redefined: A cross-sectional survey of married men in Lang'ata district, Kenya

Although the World Health Organization (WHO) has recognised the role of male involvement in maternal and child health (MNCH), its uptake is still low ( WHO, 2001 ; Ramirez-Ferrero et al, 2012 ). Kenya's division for reproductive health has embraced male involvement to improve the local maternal mortality ratio (MMR) of 488 per 100 000 live births ( Kenya National Bureau of Statistics, 2010 ). Unfortunately, single ‘facilitative’ roles of men, such as escorting a wife to a health facility, have been mistaken for male involvement. This cross-sectional survey involving 388 married men used an index of seven proxy indicators to define male involvement in antenatal care. The index was used to find out the determinants of male involvement in the cosmopolitan Lang'ata district in Kenya. Scores of four and above out of the seven proxy indicators depicted more involvement compared to scores below four. Overall, there was 40% male involvement, and higher education (odds ratio (OR) 1.5, 95% confidence interval (CI): 1.05–2.03, p &lt;0.026), planned pregnancies (OR 0.60, 95%CI: 0.46–0.76, p &lt;0.001), high income (OR 0.51, 0.31, 95% CI: 0.30–0.72; p &lt;0.001, 0.023), joint couple counseling and formalised marriages were associated with high male involvement in antenatal care.