Maternal near‐miss morbidity: is this evidence of maternal health quality in sub‐Saharan Africa?

Abstract Background Increasing male involvement during pregnancy is considered an important, but often overlooked intervention for improving maternal health in sub-Saharan Africa. This study explores the attitudes and beliefs of health policymakers, health care providers and local communities regarding men's involvement in maternal health in southern Mozambique. Methods Ten key informant interviews with stakeholders were carried out to assess their attitudes and perspectives regarding male involvement in maternal health, followed by 10 days of semi structured observations in health care centers. Subsequently 16 focus group discussions were conducted in the community and at provider level, followed by three in depth couple interviews. Analysis was done by applying a socio-ecological systems theory in thematic analysis. Results Results show a lack of strategy at policy level to stimulate male involvement in maternal health. Invitation cards for men are used as an isolated intervention in health facilities but these have not lead to the expected success. Providers have a rather passive attitude towards male involvement initiatives and women accompanied by a husband are often put in a submissive position. In the community however, male attendance at ANC is considered important and men are willing to take a more participating role. Main barriers are the association of male attendance at ANC with being HIV infected and strong social norms and gender roles. On the one hand men are seen as caretakers of the family by providing money and making the decisions. On the other hand, men supporting their wife by showing interest in their health or sharing household tasks are seen as weak or as a manifestation of HIV seropositivity. Conclusions A clear strategy at policy level and a multi-level approach is needed. Gender-equitable relationships between men and women should be encouraged in all maternal health interventions and health programs should step away from linking male involvement to HIV prevention. Key messages Linking the promotion of gender equality to male involvement is the key for success. Step away from linking HIV prevention to male involvement in maternal health.

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Participatory and intersectionality approaches for gender equity and maternal health promotion in sub-Saharan Africa

Handbook of Communication and Development ◽

10.4337/9781789906356.00025 ◽

2021 ◽

pp. 285-301

Author(s):

Emrakeb A. Woldearegay ◽

Elinam Amevor ◽

H. Leslie Steeves

Keyword(s):

Health Promotion ◽

Maternal Health ◽

Gender Equity ◽

Sub Saharan Africa ◽

Sub Saharan

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MATERNAL HEALTH-SEEKING BEHAVIOUR AND UNDER-FIVE MORTALITY IN ZIMBABWE

Journal of Biosocial Science ◽

10.1017/s0021932016000298 ◽

2016 ◽

Vol 49 (3) ◽

pp. 408-421 ◽

Cited By ~ 1

Author(s):

Nyasha Chadoka-Mutanda ◽

Clifford O. Odimegwu

Keyword(s):

Public Health ◽

Maternal Health ◽

Reproductive Age ◽

Sub Saharan Africa ◽

Health Seeking Behaviour ◽

Health Seeking ◽

Cross Sectional ◽

Under Five ◽

Sub Saharan ◽

Cox Proportional Hazard Regression

SummaryUnder-five mortality remains a major public health challenge in sub-Saharan Africa. Zimbabwe is one of the countries in the region that failed to achieve Millennium Developmental Goal 4 in 2015. The objective of this study was to examine the extent to which maternal health-seeking behaviour prior to and during pregnancy and post-delivery influences the likelihood of under-five mortality among Zimbabwean children. The study was cross-sectional and data were extracted from the 2010/11 Zimbabwe Demographic and Health Survey (ZDHS). The study sample comprised 5155 children who were born five years preceding the 2010/11 ZDHS to a sample of 4128 women of reproductive age (15–49 years). Cox Proportional Hazard regression modelling was used to examine the relationship between maternal health-seeking behaviour and under-five mortality. The results showed that maternal health-seeking behaviour factors are associated with the risk of dying during childhood. Children born to mothers who had ever used contraceptives (HR: 0.38, CI 0.28–0.51) had a lower risk of dying during childhood compared with children born to mothers who had never used any contraceptive method. The risk of under-five mortality among children who had a postnatal check-up within two months after birth (HR: 0.36, CI 0.23–0.56) was lower than that of children who did not receive postnatal care. Small birth size (HR: 1.70, CI 1.20–2.41) and higher birth order (2+) increased the risk of under-five mortality. Good maternal health-seeking behaviour practices at the three critical stages around childbirth have the potential to reduce under-five mortality. Therefore, public health programmes should focus on influencing health-seeking behaviour among women and removing obstacles to effective maternal health-seeking behaviour in Zimbabwe.

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