scholarly journals “I came to escort someone”: Men’s experiences of antenatal care services in urban Ghana—a qualitative study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Gloria Abena Ampim ◽  
Astrid Blystad ◽  
Albert Kpoor ◽  
Haldis Haukanes
Keyword(s):  
Antenatal Care ◽  
Health Workers ◽  
Group Discussion ◽  
Male Involvement ◽  
Active Role ◽  
Maternal Health Services ◽  
Positive Health ◽  
And Gender ◽  
Maternity Clinic ◽  
Female Space

Abstract Background Male involvement in maternal healthcare has been widely recognized as essential for positive health outcomes for expectant mothers and their unborn babies. However, few studies have explored men’s experiences of maternal health services. The purpose of this paper is to explore men’s involvement in antenatal care in urban Ghana and to discuss how men navigate their roles in a space that has been constructed as feminine. The study draws upon theories of space, place, and gender. Methods A qualitative exploratory study using semistructured interviews, focus group discussion, and observation was conducted in Accra, Ghana. Expectant fathers and health workers were interviewed, and observation was conducted at a selected public hospital in Accra. Results The findings suggest that the few men who attend antenatal care with their expecting partners become involved to a limited extent in the clinic’s activities. Beyond a few who take an active role, most men stay on the outskirts of the hospital grounds and rarely participate in consultations with their partner and midwife. Men still view their presence as necessary to acquire knowledge and as sources of emotional, financial, and physical support for their partners. On the health workers’ side, the study found no clear agenda for engaging men at the clinic, and nurses/midwives felt there was a lack of staff who could engage more directly with the men. Conclusion The study indicates that most expecting fathers feel too shy and uncomfortable to locate themselves in the female space that makes up antenatal care/maternity wards. Health workers do not feel they have the necessary resources to involve men fruitfully. Thus, men do not engage in the activity as hoped but rather remain on the outskirts of the maternity clinic. However, if men continue to negotiate their involvement at the clinic and become more assertive in their roles, the maternity clinic as a female space could, with time, be transformed into a space in which both expecting mothers and fathers can actively participate and be engaged to the benefit of all.

scholarly journals “I came to escort someone”: Men’s experiences of antenatal care services in Urban Ghana. A qualitative study

2020 ◽  
Author(s):  
Gloria Abena Ampim ◽  
Astrid Blystad ◽  
Albert Kpoor ◽  
Haldis Haukanes
Keyword(s):  
Antenatal Care ◽  
Health Workers ◽  
Group Discussion ◽  
Male Involvement ◽  
Active Role ◽  
Maternal Health Services ◽  
Structured Interviews ◽  
Positive Health ◽  
Maternity Clinic ◽  
Female Space

Abstract BackgroundMale involvement in maternal healthcare has been widely recognized as important for positive health outcomes for expectant mothers and their unborn babies, but few studies have explored men’s experiences of maternal health services. The purpose of this paper is to explore men’s involvement in antenatal care in urban Ghana and to discuss how men navigate their roles in a space that has been constructed as feminine. The study draws upon theories of gender, place and space.MethodsA qualitative exploratory study using semi-structured interviews, focus group discussion and observation was conducted in Accra, Ghana. Expectant fathers and health workers were interviewed and observation was conducted at a selected public hospital in Accra. ResultsThe findings suggest that the few men who attend antenatal care with their expecting partners get involved to a limited extent in activities at the clinic. Beyond a few who take an active role, most men stay on the outskirts of the hospital grounds, and rarely participate in the consultation with their partner and nurse-midwife. Men still view their presence as important, both to acquire knowledge, and as a source of emotional, financial and physical support for their partners. On the health workers’ side, the study found that there was no clear agenda for engaging men at the clinic, and nurses / midwives felt the lack of staff who could engage more directly with the men. ConclusionThe study indicates that most expecting fathers feel too shy and uncomfortable to locate themselves in the female space that makes up antenatal care / maternity wards. Health workers do not feel they have the necessary resources to involve men in a fruitful way. Thus, men do not engage in the activity as hoped but remain on the outskirts of the maternity clinic. However, if men continue to negotiate their involvement at the clinic and become more assertive in their roles, the maternity clinic as a female space could, with time, be transformed into a space where both expecting mothers and fathers can be active and engaged to the benefit of all.

scholarly journals Determinants of antenatal care visits and their impact on the choice of birthplace among mothers in Uganda: a systematic review

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Shallon Atuhaire ◽  
John Francis Mugisha
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
Rural Areas ◽  
Health Workers ◽  
Cochrane Review ◽  
Maternal Health Services ◽  
Economic Factors ◽  
Sustainable Livelihood ◽  
Intrinsic Factors ◽  
Socio Economic Factors

Objective: The utilization of Antenatal Care (ANC) services to the recommended time by WHO is still low in developing countries. In Uganda, about 990,000 women become pregnant annually, 90 to 94% of whom attend at least the first ANC visit while 65% and 58% of them attend four or more times in urban and rural areas respectively with eventual health facility birth at about 62%, homebirth and TBA together at about 38%. The study determined antenatal care attendance and the mother’s choice of birthplace in Uganda. Materials and methods: Using electronic databases mainly Google Scholar, Science Direct, PubMed and African Journals Online, and journal articles of international Website, 70,195 articles were identified but only 19 met the Cochrane review inclusion criteria hence were reviewed. Results: Reviewed studies attribute a decline in antenatal care visits and subsequent choice of birthplace to institutional, demographic and socio-economic factors. The demographic factors are maternal age (mothers less than eighteen years are less likely to utilize maternal health services than those above), marital status, occupation, residency, distance from home to the health facility, and parity. The socio-economic factors are mothers’ and partners’ levels of education (less educated women and their partners are less likely to utilize ANC), household income which affects transportation and medical bills, cultural norms and taboos, patriarchy society, enrollment on ANC in the third trimester, and intrinsic factors of attending ANC such as obtaining ANC card to present in case of emergency. Institutional factors include quality of medical care, availability of logistics and supplies, and health workers’ influence in terms of attitude, referral, competences, and staffing. Conclusion: Pregnant women who attend ANC are more likely to deliver in the health facility than those who do not at all. To enable them to attend ANC to full term and have a health facility delivery, their empowerment for increased self-efficacy through education, sustainable livelihood training and provision of subsidized capital alongside partner involvement. The facilitation of health facilities would also attract them.

scholarly journals How involved are husbands in antenatal care? The perspective of women availing antenatal services at a maternity hospital in rural South Karnataka-India

2019 ◽  
Vol 8 (10) ◽  
pp. 3879
Author(s):  
Nancy A. Gnanaselvam ◽  
Apoorva Dore ◽  
Sadhana Beaty ◽  
Jacqueline V. Y. ◽  
Tresa Rose A. ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Male Involvement ◽  
Maternity Hospital ◽  
Clinical Findings ◽  
Vital Role ◽  
Positive Health ◽  
Nuclear Families ◽  
Care Workers ◽  
Positive Health Outcomes ◽  
Antenatal Services

Background: Male involvement in maternal health is associated with significant positive health outcomes in the mother. We aimed to assess the antenatal womens’ perception of their husbands’ involvement in antenatal care in a maternity hospital in rural Karnataka, India.Methods: 200 pregnant women in a maternity hospital in Karnataka were interviewed using a semi-structured pilot tested questionnaire on their perception about their husbands’ participation in antenatal care.Results: The mean score of women’s perception of husband’s awareness of antenatal care was 10.1±2.2 out of a maximum of 12, while that of husband’s attitude to antenatal care was 7.7±1.4 out of a maximum of 9 and of husband’s participation was 21.7±5.4 out of a maximum of 30. The score of perception of husband’s awareness was significantly higher among multigravidae and among women who had a planned pregnancy. The score of perception of husband’s attitude was significantly higher among women from nuclear families, multigravidae, those with a living child and those with no complications in the current pregnancy. The score of perception of husband’s participation was significantly higher among women with no complications in the current pregnancy.Conclusions: Husbands play a vital role in the antenatal care of their wives. This should be harnessed by health care workers by providing health education to them, encouraging husbands to accompany their wives to antenatal checkups and labour and promptly communicating clinical findings to them.

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

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036211
Author(s):  
Clara C Natai ◽  
Neema Gervas ◽  
Frybert M Sikira ◽  
Beatrice J Leyaro ◽  
Juma Mfanga ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Antenatal Care ◽  
Male Involvement ◽  
Maternal Health Services ◽  
Cross Sectional Study ◽  
Growth Monitoring ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mwanza City

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 most maternal deaths occur. In Sub-Sahara, men are chief decision makers and highly influence maternal health. In Tanzania information is limited regarding influence of male involvement during ANC on utilisation of maternal health services.ObjectivesTo determine the effect of male involvement during ANC on use of maternal health services in Mwanza, Tanzania.DesignA cross-sectional study conducted from June to July 2019.SettingThis study was conducted at seven randomly selected health facilities providing reproductive, maternal and child health (RCH) services in Mwanza City.ParticipantsIncluded 430 postpartum women who delivered 1 year prior to the study and attending for RCH services (growth monitoring, vaccination, postpartum care).Outcome measures4 or more ANC visits, skilled birth attendant (SBA) use during childbirth and postnatal care (PNC) utilisation 48 hours after delivery.MethodsInterviews and observation of the women’s ANC card were used to collect data. Data was entered, cleaned and analysed by SPSS.ResultsThe mean age of participants was 25.7 years. Of 430 women, 54.4% reported their partners attended ANC at least once, 69.7% reported they attended for four or more ANC visits during last pregnancy, 95% used SBAs during childbirth and 9.2% attended PNC within 48 hours after delivery. Male involvement during ANC was significantly associated with four or more ANC visits (Crude Odds Ratio (COR): 1.90; 95% CI: 1.08–3.35) but not with SBA use or PNC utilisation.ConclusionMale involvement in ANC is still low in Mwanza, as 46% of the partners had not attended with partners at ANC. Alternative strategies are needed to improve participation. Studies among men are required to explore the barriers of participation in overall RCH services.

scholarly journals Married Men Perceptions and Barriers to Participation in the Prevention of Mother-to-Child HIV Transmission Care in Osogbo, Nigeria

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Ademola L. Adelekan ◽  
Elizabeth R. Edoni ◽  
Oladipupo S. Olaleye
Keyword(s):  
Antenatal Care ◽  
Hiv Transmission ◽  
Demographic Data ◽  
Group Discussion ◽  
Male Involvement ◽  
Cultural Barriers ◽  
Societal Norms ◽  
Analysis Technique ◽  
Married Men ◽  
Mother To Child

Men’s role in HIV prevention is pivotal to changing the course of the epidemic. Men’s barriers toward participation in Prevention of Mother-to-Child Transmission (PMTCT) have not been adequately documented. This study is therefore designed to determine men’s level of awareness and barriers to their participation in PMTCT programmes in Osogbo, Nigeria. This study was a descriptive qualitative one that utilized Focus Group Discussion (FGD). One-hundred and sixty married men were selected by convenience sampling and interviewed. Data collected were analysed using content analysis technique. Demographic data were analysed using SPSS 15.0 software to generate frequency tables. Participants mean age was 31.9 ± 5.9 years. Many of the participants had heard about PMTCT and the majority agreed that it is good to accompany their wife to Antenatal Care (ANC) but only few had ever done so. Societal norms and cultural barriers were the leading identified barriers for male involvement in PMTCT programmes. The majority of the participant perceived it was a good idea to accompany their wife to antenatal care but putting this into practice was a problem due to societal norms and cultural barriers. Community sensitization programmes such as health education aimed at breaking cultural barriers should be instituted by government and nongovernmental agencies.

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 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

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 Health workers’ perspectives on informed consent for caesarean section in Southern Malawi

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Wouter Bakker ◽  
Siem Zethof ◽  
Felix Nansongole ◽  
Kelvin Kilowe ◽  
Jos van Roosmalen ◽  
...  
Keyword(s):  
Informed Consent ◽  
Caesarean Section ◽  
Health Workers ◽  
Group Discussion ◽  
Legal Protection ◽  
Analytical Framework ◽  
Structured Interviews ◽  
Middle Income ◽  
Partial Disclosure ◽  
Labour Pains

Abstract Objective Informed consent is a prerequisite for caesarean section, the commonest surgical procedure in low- and middle-income settings, but not always acquired to an appropriate extent. Exploring perceptions of health care workers may aid in improving clinical practice around informed consent. We aim to explore health workers’ beliefs and experiences related to principles and practice of informed consent. Methods Qualitative study conducted between January and June 2018 in a rural 150-bed mission hospital in Southern Malawi. Clinical observations, semi-structured interviews and a focus group discussion were used to collect data. Participants were 22 clinical officers, nurse-midwives and midwifery students involved in maternity care. Data were analysed to identify themes and construct an analytical framework. Results Definition and purpose of informed consent revolved around providing information, respecting women’s autonomy and achieving legal protection. Due to fear of blame and litigation, health workers preferred written consent. Written consent requires active participation by the consenting individual and was perceived to transfer liability to that person. A woman’s refusal to provide written informed consent may pose a dilemma for the health worker between doing good and respecting autonomy. To prevent such refusal, health workers said to only partially disclose surgical risks in order to minimize women's anxiety. Commonly perceived barriers to obtain a fully informed consent were labour pains, language barriers, women’s lack of education and their dependency on others to make decisions. Conclusions Health workers are familiar with the principles around informed consent and aware of its advantages, but fear of blame and litigation, partial disclosure of risks and barriers to communication hamper the process of obtaining informed consent. Findings can be used to develop interventions to improve the informed consent process.

scholarly journals Realities and challenges of breastfeeding policy in the context of HIV: a qualitative study on community perspectives on facilitators and barriers related to breastfeeding among HIV positive mothers in Baringo County, Kenya

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Betty Mogesi Samburu ◽  
Judith Kimiywe ◽  
Sera Lewise Young ◽  
Frederick Murunga Wekesah ◽  
Milka Njeri Wanjohi ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Cultural Practices ◽  
Health Workers ◽  
Male Involvement ◽  
Holistic Approach ◽  
Antiretroviral Drugs ◽  
Hiv Positive ◽  
Community Perspectives ◽  
Hiv Positive Mothers ◽  
Facilitators And Barriers

Abstract Background Although recent policies have sought to increase the rates of exclusive breastfeeding (EBF) and continued breastfeeding for HIV exposed infants, few programs have considered the multiple social and cultural barriers to the practice. Therefore, to generate evidence for exclusive and continued breastfeeding policies in Kenya, we examined community perspectives on the facilitators and barriers in adherence to EBF for the HIV positive mothers. Methods Qualitative research was conducted in Koibatek, a sub-County in Baringo County Kenya, in August 2014 among 205 respondents. A total of 14 focus group discussions (n = 177), 14 In-depth Interviews and 16 key informant interviews were conducted. Transcribed data was analyzed thematically. NVivo version 10.0 computer qualitative software program was used to manage and facilitate the analysis. Results Facilitators to exclusive breastfeeding were perceived to include counselling at the health facility, desire to have a healthy baby, use of antiretroviral drugs and health benefits associated with breastmilk. Barriers to EBF included poor dissemination of policies, knowledge gap, misinterpretation of EBF, inadequate counselling, attitude of mother and health workers due to fear of vertical HIV transmission, stigma related to misconception and misinformation that EBF is only compulsory for HIV positive mothers, stigma related to HIV and disclosure, social pressure, lack of male involvement, cultural practices and traditions, employment, food insecurity. Conclusions There are multiple facilitators and barriers of optimal breastfeeding that needs a holistic approach to interventions aimed at achieving elimination of mother to child transmission. Extension of infant feeding support in the context of HIV to the community while building on existing interventions such as the Baby Friendly Community Initiative is key to providing confidential support services for the additional needs faced by HIV positive mothers.

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