scholarly journals Men perspectives on attending antenatal care visits with their pregnant partners in Misungwi district, rural Tanzania: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maendeleo Boniphace ◽  
Dismas Matovelo ◽  
Rose Laisser ◽  
Hadija Swai ◽  
Victoria Yohani ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Workers ◽  
Cultural Norms ◽  
Health Providers ◽  
Group Discussions ◽  
Individual Interviews ◽  
Men 2 ◽  
Rural Tanzania ◽  
Expectant Fathers ◽  
And Gender

Abstract Background Mens’attendance with their pregnant partners at facility-based antenatal care (ANC) visits is important for maternal and child health and gender equality yet remains uncommon in parts of rural Tanzania. This study examined men’s perspectives on attending ANC with their pregnant partners in Misungwi District, Tanzania. Methods Twelve individual interviews and five focus group discussions were conducted using semi-structured questionnaires with fathers, expectant fathers, and in-depth interviews were done to health providers, volunteer community health workers, and village leaders. Interviews were recorded and transcribed in Swahili and later translated to English. The research team conducted thematic analysis to identify common themes among interviews. Results We identified two broad themes on the barriers to male attendance at facility-based ANC visits: (1) Perceived exclusion during ANC visits among men (2) Traditional gender norms resulting to low attendance among men. Conclusion Attendance at health facility for ANC visits by men with their pregnant partners in the study areas were challenged by structural and local cultural norms. At the facility men were uncomfortable to sit with women due to lack of specific waiting area for men and that they perceived to be neglected. Local cultural norms demanded women to have secrecy in pregnancy while men perceived not to have a role of being with their partners during ANC visits.

scholarly journals Men perspectives on attending antenatal care visits together with their pregnant partners in Misungwi district, rural Tanzania: a qualitative study

2020 ◽  
Author(s):  
Maendeleo Boniphace ◽  
Dismas Matovelo ◽  
Rose Laisser ◽  
Hadija Swai ◽  
Victoria Yohana ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Workers ◽  
Cultural Norms ◽  
Health Providers ◽  
Group Discussions ◽  
Individual Interviews ◽  
Men 2 ◽  
Rural Tanzania ◽  
Expectant Fathers ◽  
And Gender

Abstract Background: Mens’attendance with their pregnant partners at facility-based antenatal care (ANC) visits is important for maternal and child health and gender equality yet remains uncommon in parts of rural Tanzania. This study examined men’s perspectives on attending ANC with their pregnant partners in Misungwi District, Tanzania.Methods: Twelve individual interviews and five focus group discussions were conducted using semi-structured questionnaires with fathers, expectant fathers, and in-depth interviews were done to health providers, volunteer community health workers, and village leaders. Interviews were recorded and transcribed in Swahili and later translated to English. The research team conducted thematic analysis to identify common themes among interviews. Results: We identified two broad themes on the barriers to male attendance at facility-based ANC visits: (1) Perceived exclusion during ANC visits among men (2) Traditional gender norms resulting to low attendance among men.Conclusion: Attendance at health facility for ANC visits by men with their pregnant partners in the study areas were challenged by structural and local cultural norms. At the facility men were uncomfortable to sit with women due to lack of specific waiting area for men and that they perceived to be neglected. Local cultural norms demanded women to have secrecy in pregnancy while men perceived not to have a role of being with their partners during ANC visits.

scholarly journals Men perspectives on attending antenatal care visits together with their pregnant partners in Misungwi district, rural Tanzania: a qualitative study

2021 ◽  
Author(s):  
Maendeleo Boniphace ◽  
Dismas Matovelo ◽  
Rose Laisser ◽  
Hadija Swai ◽  
Victoria Yohana ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Workers ◽  
Cultural Norms ◽  
Health Providers ◽  
Group Discussions ◽  
Individual Interviews ◽  
Men 2 ◽  
Rural Tanzania ◽  
Expectant Fathers ◽  
And Gender

Abstract Background: Mens’attendance with their pregnant partners at facility-based antenatal care (ANC) visits is important for maternal and child health and gender equality yet remains uncommon in parts of rural Tanzania. This study examined men’s perspectives on attending ANC with their pregnant partners in Misungwi District, Tanzania.Methods: Twelve individual interviews and five focus group discussions were conducted using semi-structured questionnaires with fathers, expectant fathers, and in-depth interviews were done to health providers, volunteer community health workers, and village leaders. Interviews were recorded and transcribed in Swahili and later translated to English. The research team conducted thematic analysis to identify common themes among interviews. Results: We identified two broad themes on the barriers to male attendance at facility-based ANC visits: (1) Perceived exclusion during ANC visits among men (2) Traditional gender norms resulting to low attendance among men.Conclusion: Attendance at health facility for ANC visits by men with their pregnant partners in the study areas were challenged by structural and local cultural norms. At the facility men were uncomfortable to sit with women due to lack of specific waiting area for men and that they perceived to be neglected. Local cultural norms demanded women to have secrecy in pregnancy while men perceived not to have a role of being with their partners during ANC visits.

scholarly journals A Dialogue-Building Pilot Intervention Involving Traditional and Biomedical Health Providers Focusing on STIs and HIV/AIDS Care in Zambia

2008 ◽  
Vol 13 (2) ◽  
pp. 110-126 ◽  
Author(s):  
Berthollet Bwira Kaboru ◽  
Phillimon Ndubani ◽  
Torkel Falkenberg ◽  
Anastasia Pharris ◽  
Maureen Muchimba ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Health Workers ◽  
Peer Group ◽  
Intersectoral Collaboration ◽  
Health Providers ◽  
Care Providers ◽  
Group Discussions ◽  
Positive Attitudes ◽  
Stis And Hiv ◽  
Hiv Aids

Collaboration between traditional and biomedically trained health workers is regarded as key in HIV/AIDS control. However, few studies have focused on exploring ways of enhancing this collaboration. Using a pre- and postintervention questionnaire, the authors assessed changes in attitudes to and practices of collaboration among 19 biomedical and 28 traditional health care providers following a 12-month dialogue-building intervention in Ndola, Zambia. The intervention consisted of peer group discussions, interactive group discussions, training sessions, and peer-influenced networking. The results show that although both groups of providers had fairly positive attitudes toward each other before the intervention, further improvements in attitudes were observed after the intervention. Referrals between the two sectors and cross visits increased. However, some attitudes to collaboration became more negative and cautious after the intervention. Dialogue-building interventions involving traditional and biomedical providers are not only feasible but also complex. Intersectoral collaboration needs time and coordination between all relevant actors in the community.

scholarly journals “Taking Care of Your Pregnancy”: A Mixed-Methods Study of Group Antenatal Care in Kakamega County, Kenya

2020 ◽  
Author(s):  
Aleefia Somji ◽  
Kate Ramsey ◽  
Sean Dryer ◽  
Fredrick Makokha ◽  
Constance Ambasa ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Antenatal Care ◽  
Health Workers ◽  
Wait Times ◽  
Health Providers ◽  
Healthy Behaviors ◽  
Danger Signs ◽  
Intention To Treat ◽  
Experience Of Care ◽  
Time Diaries

Abstract Background: Traditional antenatal care (ANC) models often do not meet women’s needs for information, counseling, and support, resulting in gaps in quality and coverage. Group ANC (GANC) provides an alternative, person-centered approach where pregnant women of similar gestational age meet with the same health provider for facilitated discussion. There are few studies that show associations between GANC and various outcomes. Methods: We used mixed methods to evaluate a contextualized GANC model (Lea Mimba Pregnancy Clubs) and to understand implementation experiences at six health facilities in Kakamega County, Kenya. Between April 2018 and January 2019, we tracked 1,652 women who were assigned to 162 GANC cohorts to assess ANC retention. Using an intention-to-treat approach, we conducted baseline (N = 112) and endline surveys (N = 360) with women attending immunization visits to assess outcomes and used time diaries to assess wait times. At endline, we conducted 29 in-depth interviews (IDIs) and three focus group discussions with women who were currently and previously participating in GANC, and 15 IDIs with stakeholders.Results: GANC was associated with enhanced social support, with some evidence for improved knowledge, adoption of healthy behaviors, enhanced self-efficacy, and improved experience of care. Quantitatively, we found strong associations with knowledge of danger signs, women who shared their feelings with other women, knowledge and competence of health workers, respect shown by ANC providers, overall quality of care, and birth preparations. No changes were seen in knowledge of positive behaviors, empowerment, several aspects of the experience of care, ANC retention, early ANC, and other healthy behaviors. Qualitatively, women and stakeholders noted improvements in interactions between health providers and women, improved counseling, increased feelings of empowerment to ask questions and speak freely, and strengthened social networks and enhanced social cohesion among women. Both wait times and counseling times increased in GANC compared to traditional ANC.Conclusions: This is one of the few mixed-methods studies evaluating GANC and offers new measures for experience of care, empowerment, and adoption of healthy behaviors. While more research is required, GANC holds promise for enhancing women’s experiences during pregnancy. Modifications are needed for sustainability and scalability.

scholarly journals Perceived Social Influences on Women's Decisions to use Medications not Studied in Pregnancy. A Qualitative Ethical Analysis of Preexposure Prophylaxis Implementation Research in Kenya

2021 ◽  
pp. 155626462110122
Author(s):  
Kenneth Ngure ◽  
Susan B. Trinidad ◽  
Kristin Beima-Sofie ◽  
John Kinuthia ◽  
Daniel Matemo ◽  
...  
Keyword(s):  
Implementation Research ◽  
Social Influences ◽  
Safety Data ◽  
Health Providers ◽  
Male Partners ◽  
Group Discussions ◽  
Preexposure Prophylaxis ◽  
Investigational Drugs ◽  
And Gender ◽  
In Pregnancy

Implementation research ethics can be particularly challenging when pregnant women have been excluded from earlier clinical stages of research given greater uncertainty about safety and efficacy in pregnancy. The evaluation of human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP) during pregnancy offered an opportunity to understand important ethical considerations and social influences shaping women's decisions to participate in the evaluation of PrEP and investigational drugs during pregnancy. We conducted interviews with women ( n = 51), focus groups with male partners (five focus group discussions [FGDs]), interviews with health providers ( n = 45), four FGDs with pregnant/postpartum adolescents and four FGDs with young women. Data were analyzed using thematic content analysis, including ethical aspects of the data. Our study reveals that women navigate a complex network of social influences, expectations, support, and gender roles, not only with male partners, but also with clinicians, family, and friends when making decisions about PrEP or other drugs that lack complete safety data during pregnancy.

scholarly journals ‘If he sees it with his own eyes, he will understand’: how gender informed the content and delivery of a maternal nutrition intervention in Burkina Faso

2020 ◽  
Vol 35 (5) ◽  
pp. 536-545 ◽  
Author(s):  
Jasmin Isler ◽  
N Hélène Sawadogo ◽  
Guy Harling ◽  
Till Bärnighausen ◽  
Maya Adam ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Maternal Nutrition ◽  
Health Workers ◽  
Nutrition Intervention ◽  
Nutrition Interventions ◽  
Group Discussions ◽  
Intervention Delivery ◽  
Meal Preparation ◽  
And Gender ◽  
Two Stages

Abstract A growing body of literature urges policymakers, practitioners and scientists to consider gender in the design and evaluation of health interventions. We report findings from formative research to develop and refine an mHealth maternal nutrition intervention in Nouna, Burkina Faso, one of the world’s most resource-poor settings. Gender was not an initial research focus, but emerged as highly salient during data collection, and thus guided lines of inquiry as the study progressed. We collected data in two stages, first using focus group discussions (FGD; n = 8) and later using FGDs (n = 2), interviews (n = 30) and observations of intervention delivery (n = 30). Respondents included pregnant women, breastfeeding mothers and Close-to-Community (CTC) providers, who execute preventative and curative tasks at the community level. We applied Morgan et al.’s gender framework to examine intervention content (what a gender-sensitive nutrition programme should entail) and delivery (how a gender-sensitive programme should be administered). Mothers emphasized that although they are often the focus of nutrition interventions, they are not empowered to make nutrition-based decisions that incur costs. They do, however, wield some control over nutrition-related tasks such as farming and cooking. Mothers described how difficult it is to consider only one’s own children during meal preparation (which is communal), and all respondents described how nutrition-related requests can spark marital strife. Many respondents agreed that involving men in nutrition interventions is vital, despite men’s perceived disinterest. CTC providers and others described how social norms and gender roles underpin perceptions of CTC providers and dictate with whom they can speak within homes. Mothers often prefer female CTC providers, but these health workers require spousal permission to work and need to balance professional and domestic demands. We recommend involving male partners in maternal nutrition interventions and engaging and supporting a broader cadre of female CTC providers in Burkina Faso.

scholarly journals Kenya: Community sensitization must precede alternative coming-of-age rite

2002 ◽  
Author(s):  
Keyword(s):  
Gender Equity ◽  
Female Circumcision ◽  
Coming Of Age ◽  
Female Genital Cutting ◽  
Cultural Norms ◽  
Rite Of Passage ◽  
Group Discussions ◽  
And Gender ◽  
Life Education ◽  
The Impact

Female genital cutting (FGC) is practiced as a rite of passage in over half of Kenya’s districts. Kenyan nongovernmental agency Maendeleo Ya Wanawake (MYWO) has long conducted community sensitization focused on discouraging this practice. In 1996, MYWO began implementing the “alternative rite” (AR) intervention in sensitized communities. Girls participating in AR receive family life education in seclusion, followed by a public graduation ceremony recognizing them as adults. They are not cut as part of the ceremony. In 2000, the Population Council carried out an assessment of the AR program that sought to identify the impact of MYWO’s activities on knowledge and attitudes regarding FGC, reproductive health, and gender equity. Data were collected through focus group discussions, interviews, household surveys, and case studies of AR-participating families. As this brief states, where cultural support for female circumcision is weakening, communities are more likely to accept sensitization messages encouraging abandonment of the practice and to participate in an alternative coming-of-age ceremony for girls. However, such alternative ceremonies must be preceded by extensive sensitization that changes attitudes and must be tailored to fit cultural norms for rite of passage.

scholarly journals “Taking Care of Your Pregnancy”: A mixed-methods study of group antenatal care in Kakamega County, Kenya

2021 ◽  
Author(s):  
Aleefia Somji ◽  
Kate Ramsey ◽  
Sean Dryer ◽  
Fredrick Makokha ◽  
Constance Ambasa ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Antenatal Care ◽  
Health Workers ◽  
Wait Times ◽  
Health Providers ◽  
Healthy Behaviors ◽  
Danger Signs ◽  
Intention To Treat ◽  
Experience Of Care ◽  
Time Diaries

Abstract Background Traditional antenatal care (ANC) models often do not meet women’s needs for information, counseling, and support, resulting in gaps in quality and coverage. Group ANC (GANC) provides an alternative, person-centered approach where pregnant women of similar gestational age meet with the same health provider for facilitated discussion. There are few studies that show associations between GANC and various outcomes. Methods We used mixed methods to evaluate a contextualized GANC model (Lea Mimba Pregnancy Clubs) and to understand implementation experiences at six health facilities in Kakamega County, Kenya. Between April 2018 and January 2019, we tracked 1,652 women who were assigned to 162 GANC cohorts to assess ANC retention. Using an intention-to-treat approach, we conducted baseline (N = 112) and endline surveys (N = 360) with women attending immunization visits to assess outcomes and used time diaries to assess wait times. At endline, we conducted 29 in-depth interviews (IDIs) and three focus group discussions with women who were currently and previously participating in GANC, and 15 IDIs with stakeholders. Results GANC was associated with enhanced social support, with some evidence for improved knowledge, adoption of healthy behaviors, enhanced self-efficacy, and improved experience of care. Quantitatively, we found strong associations between GANC and knowledge of danger signs, women who shared their feelings with other women, knowledge and competence of health workers, respect shown by ANC providers, overall quality of care, and birth preparations; as well as an improvement in ANC retention. No changes were seen in knowledge of positive behaviors, empowerment, several aspects related to women’s experience of care, ANC retention, early initiation of ANC, and other healthy behaviors. Qualitatively, women and stakeholders noted improved interactions between health providers and women, improved counseling, increased feelings of empowerment to ask questions and speak freely, and strengthened social networks and enhanced social cohesion among women. Both wait times and counseling times increased in GANC compared to traditional ANC. Conclusions This is one of the few mixed-methods studies evaluating GANC and offers new measures for experience of care, empowerment, and adoption of healthy behaviors. While more research is required, GANC holds promise for enhancing women’s experiences during pregnancy. Modifications are needed for sustainability and scalability.

scholarly journals Living with death in a time of AIDS: A rural South African case study

2007 ◽  
Vol 35 (69_suppl) ◽  
pp. 138-146 ◽  
Author(s):  
Deborah Posel ◽  
Kathleen Kahn ◽  
Liz Walker
Keyword(s):  
Public Health Practice ◽  
Limpopo Province ◽  
Cultural Norms ◽  
Middle Aged ◽  
Group Discussions ◽  
Aged People ◽  
The Social ◽  
Cultural Taboos ◽  
And Gender ◽  
Hiv Aids

Aims: To examine how a rural community profoundly affected by escalating rates of largely AIDS-related deaths of young and middle-aged people makes sense of this phenomenon and its impact on their everyday lives. Methods: Data were collected in Agincourt subdistrict, Limpopo Province. Twelve focus groups were constituted according to age and gender and met three times (a total of 36 focus-group discussions [FGDs]). The FGDs explored sequentially people's expectations of their lives in the ``new'' South Africa, their interpretations of the acceleration of death amongst the young and middle-aged, and their understandings of HIV/AIDS. Discussions were recorded, fully transcribed, and thematically analysed. Results: Respondents acknowledged escalating death rates in their community, yet few referred directly to HIV/AIDS as the cause. Rather, respondents focused on the social and cultural causes of death, including the erosion of cultural norms and traditions such as cultural taboos on sex. There are many competing versions of what HIV/AIDS is, what causes it and how it is spread, ranging from scientific explanations to conspiracy theories. Findings highlight the relationship between AIDS and other traditional diseases with some respondents suggesting that AIDS is a new form of other longstanding illnesses. Conclusions: This study points to the centrality of cultural explanations in understanding ``bad death'' (AIDS death) in the Agincourt area. Physical illness is understood to be a symptom of ``cultural damage''. Implications of this for public health practice and research are outlined.

scholarly journals Men perspectives on attending antenatal care visits together with their pregnant partners in Misungwi district, rural Tanzania: a qualitative study

2020 ◽  
Author(s):  
Maendeleo Boniphace ◽  
Dismas Matovelo ◽  
Rose Laisser ◽  
Hadija Swai ◽  
Victoria Yohana ◽  
...  
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Community Health ◽  
Community Health Workers ◽  
Research Team ◽  
English Language ◽  
Health Workers ◽  
Cultural Beliefs ◽  
National Language ◽  
Rural Tanzania

Abstract Background: Mens’ attendance, together with their pregnant partners at facility-based antenatal care (ANC) visits is important, yet remains uncommon in parts of rural Tanzania. This study examined perspectives of men on attending with their pregnant partners in Misungwi District, Tanzania.Methods: Individual interviews (n=6) and focus group discussions (5) were conducted using semi-structured questionnaires with fathers, expectant fathers and other key informants (health providers, volunteer community health workers, Village leaders). The interviewers were researchers trained on how to conduct interviews prior field visits. The questions were asked using Tanzania National language ( Swahili).Transcripts were recorded, transcribed in Swahili Language and later on it was translated in English language. The research team conducted thematic analysis using English language by grouping related codes into themes. The main themes were obtained upon agreement with the research team. Results: Two key system/societal-level themes were identified: (1) males who attended facility-based ANC visits and experienced lack of being given ANC feedback from health care workers and partners and hence men felt excluded from visit services; and (2) traditional cultural beliefs and gender roles strongly influenced the choice not to attend visits. This resulted into men being hidden pregnancy details (secrecy) from their partners in the community. Conclusion: To maximize gender equity in maternal and health requires involvement of men at ANC visits in Misungwi. This can be achieved by addressing core traditional and systemic barriers including use of community health workers. Improved communication between partners and health care providers through provision of ANC feedback and male involvement in examination room is warranted to promote access to ANC.

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