Male Partner Involvement in Promoting Antenatal Care and Skilled Delivery Attendance in Bumula Sub-County, Kenya

Globally, male partner involvement in antenatal care and skilled delivery services remains a challenge to effective management of maternal health. Maternal morbidities and mortalities have been increasing due to the underutilization of antenatal care and skilled delivery attendance at a global level. However, developed countries have had a different story on male partner involvement in antenatal care and skilled delivery attendance – most male partners are involved in the process. But sub-Saharan Africa in the global south records the highest percentage of male partners who are never active in accompanying their female counterparts to visit antenatal care and skilled delivery. In Kenya male involvement in maternal services remains low despite it being recognized as one of the pillars of safe motherhood. Therefore, this study was conducted to investigate male partner involvement in promoting antenatal care and skilled delivery attendance in Bumula Sub-County of Bungoma County in Kenya. It focused on the level of male partners involvement in maternal health. The study adopted a cross-sectional design. The target populations were married men and community health volunteers. The study had a sample size of 427 persons. Data was collected using a pre-tested semi-structured questionnaire, key in-depth interview guides, focused group discussion guides and observation checklist. Data were analysed using descriptive statistics with the aid of the Statistical Package for Social Scientist version 25. Data were presented using tables, figures, narratives and direct quotes. The study found a low level of male involvement (18%) in promoting antenatal care and skilled delivery attendance. Most of the male partners (83.1%) did not plan with their partners for ANC and skilled delivery services, however, (54.1%) accompanied their partners to the clinics. The study concluded There was a low level of male partner involvement in ANC and skilled delivery attendance. About 18% of male partners were involvement in ANC and skilled delivery attendance. There was an improvement of male partner involvement in accompaniment and provision of support. The study recommended that the two levels of government through the Ministry of Health should create awareness campaigns and public education with a targeted massage on negative cultural practices/mindset that hinder male partner involvement in maternal health services in the Bumula sub-county.

Nurses' and midwives' views on male partner involvement in maternity care in Imo, Nigeria

Background/Aims In 2015, the World Health Organization recommended male partner involvement in maternal and child health as an effective strategy to combat maternal and child health in pregnancy. Healthcare practitioners' acceptance of male partners in maternal and child healthcare is likely to improve provider and patient satisfaction. The main objective of the study was to assess nurses' and midwives' perceptions of male partner involvement in maternity care, and their willingness and constraints to performing it in selected hospitals in Imo, Nigeria. Methods A mixed-method approach was used to gather data from nurses and midwives in the antenatal care, labour and postnatal care wards of selected hospitals. A semi-structured questionnaire and interview guide were used to collect data assessing the participants' perceptions of male partner involvement in maternity care and of the barriers to it. Quantitative data were analysed through bivariate analysis, using the Chi squared test, and key quotes were extracted from qualitative data to illustrate relevant points. Results The majority (57%) of the respondent had a good perception of the concept of male partner involvement. The ward that a participant worked in significantly affected their perception (P=0.01). Respondents were willing to accept male partners in maternity care through education and providing more male-friendly services. However, sociocultural, hospital policy and structural factors restricted acceptance of men in the wards. Conclusions Nurses and midwives in all wards should be educated on the importance of male partner involvement in maternity care. Nurses and midwives need to engage in community health education programmes that will modify cultural constraints to male partner involvement and facilities should modify their structure and policies to be more male-friendly.

Fathers’ involvement in perinatal healthcare in Australia: experiences and reflections of Ethiopian-Australian men and women

Background Family-centred maternity care models include the expectation that fathers prepare for and attend the birth. In Australia over 20% of the population is from a culturally and linguistically diverse background. Public policies espouse culturally competent healthcare. Little is known about the experiences of perinatal health care of men from culturally and linguistically diverse (CALD) communities living in high income countries. The aim was to understand the experiences, attitudes and beliefs about father’s inclusion in perinatal healthcare, from the growing, and recently settled community of Ethiopian families living in Australia. Methods A qualitative study using semi-structured individual interviews with Ethiopian-Australian men and women who had experienced Australian maternity care and were sampled for diversity of time since migration, and parity. Interviews were in English, audio-recorded, transcribed and then analysed thematically. Results Participants were seven women and six men all born in Ethiopia, including two couples. Key themes included: the loss of extended family through migration, new roles for both parents and the need to establish ‘family-like’ relationships with friendship groups in Australia. There was a willingness to involve male partners in the Ethiopian community in Australia, although it was recognised as a cultural change. Experiences of male partner involvement were mixed among healthcare types, with men attending Maternal and Child Health (MCH) appointments less frequently than antenatal (ANC) appointments. Conclusions Results suggests men may be missing out on the education provided during antenatal appointments and may benefit from an alternative. There were not universally high levels of cultural competency among healthcare professionals, with further training still required. Commitment to paid employment remains a barrier to men’s involvement, suggesting that flexible working conditions and increased paternity leave would support their involvement. Alternatively services could utilise flexible delivery methods such as phone and zoom to include fathers.

Effect of male partner involvement on maternity waiting home utilization in Hadiya Zone, Southern Ethiopia: a cluster-randomized controlled trial protocol

BackgroundThe primary cause of adverse maternal health outcomes has been identified to be the delay in reaching care at health facility. This is often attributed to the long distances’ women need to travel to gain access to health facilities. Literature show that maternity waiting homes (MWHs) contribute significantly to the reduction of maternal death and stillbirth among users. Despite its importance in improving maternal & neonatal health outcomes, the utilization of MWHs is very low in Ethiopia. So, it is important to investigate what strategies could be effective in improving MWH utilization in Ethiopia. The aim of this study is to assess if male partner involvement could be used as a solution to improve MWH utilization in Ethiopia.Methods/designThis study will evaluate the effect of male partner involvement on MWH utilization in Hadiya Zone, Southern Ethiopia. A behavioral intervention will be performed using a cluster-randomized controlled trial design. The intervention will have two arms, i.e., experimental and control arms. The study participants will be pregnant women in their second trimesters with their male partners. The total trial sample size will be 388. That means 194 study participants in each arm. Randomization will be conducted at cluster level. Study participants and assessors will be masked. Data analysis will be performed by STATA version 14.0 using an Intention-To-Treat Approach.DiscussionThe content of the intervention will be group health education, home visits, and phone counseling. Health education will be delivered to "husband-expectant wife" pairs at the baseline. Then home visits will be conducted at the beginning of every month, and phone counseling will be conducted in the third week of every month for consecutive six months. The anticipated trial commencement time is November 2021.Trial RegistrationClinicalTrials.gov Identifier: NCT05015023. Registered August 20, 2021. https://clinicaltrials.gov/ct2/show/NCT05015023

Couple oriented counselling improves male partner involvement in sexual and reproductive health of a couple: Evidence from the ANRS PRENAHTEST randomized trial

Background Male partner involvement (MPI) has been recognized as a priority area to be strengthened in Prevention of Mother to Child Transmission (PMTCT) of HIV. We explored the impact of Couple Oriented Counselling (COC) in MPI in sexual and reproductive health and associated factors. Method From February 2009 to October 2011, pregnant women were enrolled at their first antenatal care visit (ANC-1) and followed up until 6 months after delivery in the Mother and Child Center of the Chantal Biya Foundation within the randomized prenahtest multicentric trial. The MPI index was defined using sexual and reproductive health behaviour variables by using multiple correspondence analysis followed by mixed classification. Men were considered as highly involved if they had shared their HIV test results with their partner, had discussed on HIV or condom used, had contributed financially to ANC, had accompanied their wife to ANC or had practiced safe sex. Factors associated to MPI were investigated by the logistic model with GEE estimation approach. Results A total of 484 pregnant women were enrolled. The median age of the women was 27 years (IQR: 23–31) and 55.23% had a gestational age greater than 16 weeks at ANC-1. Among them, HIV prevalence was 11.9% (95% CI: 9.0–15.4). The median duration of the women’s relationship with their partner was 84 months (IQR: 48–120). MPI index at 6 months after delivery was significantly greater in the COC group than the classical counselling group (14.8% vs 8,82%; p = 0,043; Fig 1). The partners of the women who participated in the COC were more likely to be involved during follow up than others (aOR = 1.45; 95% CI = 1.00–2.10). Partners with no incoming activity (aOR = 2.90; 95% CI = 1.96–4.29), who did not used violence within the couple (aOR = 1.70; 95% CI = 1.07–2.68), and whose partner came early for ANC-1 (aOR = 1.37; 95% CI = 1.00–1.89) were more likely to be involved than others. Conclusion MPI remains low in stable couples and COC improves partner involvement. Our findings also support the need of strengthening outreach towards "stable" couples and addressing barriers. This could go a long way to improve PMTCT outcomes in Cameroon. Trial registration PRENAHTEST, NCT01494961. Registered 15 December 2011—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT01494961.

Knowledge of male partner involvement in Maternity care among Nurses/midwives in tertiary hospitals in Owerri, Imo State Nigeria

Male partner involvement has been recommended as an effective strategy to combat maternal and child death in pregnancy and childbirth and to promote effective child care. This study assessed nurses'/midwives perception Knowledge on male involvement in midwifery care. A total of 84 nurses/midwives were purposively selected from the facility for the study. The study employed a quantitative approach in which a questionnaire was used to collect data. Data were analyzed using SPSS Version 25. Respondents’ were aware of the importance of male involvement in maternity care and 60.7% of the respondents had a good level of knowledge on male involvement in maternity care. Respondents’ number of years in practice (X2 =13.76, p=0.001)and rank (X2 =14.75, p=0.012) were significantly associated with their level of knowledge. If facilities can improve the knowledge of nurses/midwives and other health care providers on the concept of male involvement and in maternity care, there will be the implementation of a more ‘Male-friendly’ care approach in maternity care.

Male Partner Involvement and Development of HIV-exposed Infants in Rural South Africa

Male partner involvement (MPI) during the prenatal and postnatal periods has been proven to have a beneficial effect on infant development. Infants born to HIV seropositive mothers with lacking or no prenatal and postnatal male partner support may be at a higher risk for adverse developmental outcomes. This study examined the effect of MPI on cognitive, communicative, fine, and gross motor development in 160 infants born to HIV seropositive mothers attending Prevention of Mother-to-Child Transmission of HIV (PMTCT) services in rural South Africa. Results of the bivariate logistic regression showed that both prenatal (OR 1.13; 95% CI 1.01, 1.26; p < 0.05) and postnatal MPI (at 12 months) (1.19; 1.07, 1.31; p < 0.005) were associated with risk for delayed gross motor development in HIV exposed infants. Decreased postnatal MPI (0.85; 0.75, 0.98; p < 0.05) was significantly associated with risk for delayed cognitive development. Not living together with a male partner (2.01; 1.06, 3.80; p < 0.05) was significantly associated with risk for delayed cognitive development. In the multivariate logistic regression analysis, decreased postnatal MPI (0.85; 0.75, 0.98; p < 0.05) was significantly associated with risk for delayed cognitive development. On the other hand, postnatal MPI (1.30; 1.12, 1.50; p < 0.005) was associated with risk for delayed gross motor development among HIV exposed infants. Increased MPI can have beneficial effects on infants’ cognitive development. Interventions in PMTCT programs should promote increased prenatal and postnatal MPI to improve cognitive development in HIV exposed infants.

Az együttszülés feltételeinek megteremtése a hazai szülészeti osztályokon a COVID–19-járvány idején

Összefoglaló. Bevezetés: Az Egészségügyi Világszervezet adatai alapján 2020 őszére a világ minden régióját elérte az új koronavírus (SARS-CoV-2) okozta fertőzés. Magyarországon 2020 márciusában az első esetek – több más betegjogi kérdés mellett – ráirányították a figyelmet a betegtájékoztatás kiemelt fontosságára, annak jogszabály szerinti betartására, valamint az alkalmazás során fellépő nehézségekre. Tekintve, hogy az együttszülés lehetősége az utóbbi évtizedekben egyre népszerűbb a családtervezés és a közös életkezdés folyamatában, az apák felkészítése a szülésre – a járványhelyzet miatt megváltozott tájékoztatási szigorítások összehangolásával – a szülészeti osztályok jelentős feladata lett. A betegtájékoztatás teljes körű alkalmazása során számos szempontot kellett figyelembe venni ahhoz, hogy a szülés az anya és az apa számára pozitív emlék maradjon, még olyan helyzetben is, mint a COVID–19-járvány. Célkitűzés: Elemezni kívántuk, hogy a magyarországi szülészeti osztályokon hogyan lehetett a világjárvány idején is betartani a hatályos jogszabályokat és eljárásrendeket, milyen intézkedések váltak szükségessé az együttszülés gyakorlatának fenntartásához, és egyidejűleg biztosítani, hogy a szülőnőnek és férfi partnerének a tájékoztatáshoz való jogai ne sérüljenek. Módszer: Online 14 feleletválogatós kérdőívet küldtünk valamennyi magyarországi, állami fenntartású kórház és klinika szülészeti osztálya vezetőjének. A beérkezett kérdőívek adatait összevetettük az intézmények honlapján az együttszüléssel kapcsolatos információkkal is. Eredmények: A 2020. március 20. és szeptember 20. közötti fél évben a várandós párok tájékoztatása során a szolgáltatók minden esetben a hatályos eljárásrendeket követték, ez azonban több esetben többlet anyagi ráfordítást és szervezést jelentett számukra. Következtetés: Adataink rámutatnak arra, hogy az együttszüléssel kapcsolatosan a szülésre érkezők igyekeznek a lehető legjobban tájékozódni, és ugyanolyan elvárásaik vannak a szülés körülményeit illetően, mint a járványmentes időszakban. Amennyiben a tájékoztatás kielégítő és részletes számukra, az esetleges hátrányos változtatásokat is jobban tolerálják. A járványra tekintettel valamennyi osztályon megmaradt az együttszülés lehetősége, a megfelelő járványügyi intézkedések megtartása mellett. Orv Hetil. 2021; 162(21): 824–829. Summary. Introduction: According to data collected by the World Health Organization, by the autumn of 2020, all regions of the world were affected by SARS-CoV-2 viral infection. In Hungary, the first cases were detected in March 2020, and the epidemic, among several other patient rights issues, drew attention to the paramount importance of patient information, its compliance with the law, and the difficulties encountered in its application. During the last decades, the possibility of male partner involvement in birth has become increasingly popular in the process of family planning and starting a life together. Preparing fathers for childbirth and coordinating information restrictions that have changed due to the epidemic is a priority for obstetric departments. The full application of patient information requires a number of considerations to ensure that childbirth remains a positive memory for mother and father, even in a situation such as the COVID-19 pandemic. Objective: We wanted to analyze how the obstetric wards in Hungary were able to comply with the laws and procedures in force at the time of the pandemic, what measures became necessary for creating male partner involvement in births, and at the same time to ensure that the rights of the mother and the father are not violated. Method: We sent an online questionnaire to the head of the obstetrics department of all Hungarian state hospitals and clinics, using 14 multiple-choice questions. The data of the received questionnaires were also compared with the information related to male partner involvement in births published on the websites of the institutions. Results: In the period from 20 March to 20 September 2020, in terms of informing pregnant couples, the service providers always followed the procedures in force, but in several cases this meant more financial expenditure and organization for them. Conclusion: Our data showed that those who give birth insist on the best possible information about conditions of male partner involvement in births, have the same expectations about the conditions of childbirth as during the epidemic-free period. If the information is satisfactory and detailed for them, they are more tolerant of adverse changes. In view of the epidemic, the possibility of father involvement in birth remained in all departments available, while maintaining appropriate epidemiological measures. Orv Hetil. 2021; 162(21): 824–829.

Male partner participation in maternity care and social support for childbearing women: a discussion paper

Male partners/fathers are key support persons for many childbearing women and their involvement in pregnancy, childbirth and the postpartum/postnatal period has beneficial effects on a wide range of outcomes related to maternal and child health and family wellbeing. Social support is implicated in the relevant causal pathway, but has received largely tangential attention in the public health literature. This discussion paper aims to reframe men's participation in maternity care as an opportunity to enhance their readiness and ability to provide social support to women, contributing to the debate on the definition and rationale for male partner involvement, and paving the way for further empirical work. I begin by presenting a theory of change illustrating the causal pathway leading from male partner participation, through the key intermediate step of social support, to improved health and wellbeing for women and children. I proceed by arguing that many people desire male partner participation in maternity care; however, in practice, this is often limited owing to cultural, social and institutional barriers. I use examples from the intervention literature to demonstrate how participation in care can boost men's motivation to support women and enhance their ability to do so by increasing their knowledge and skills. Finally, I draw up general implications for further male partner involvement programmes, suggesting that in order to achieve meaningful and sustainable gains, attention to design is crucial in order to avoid reinforcing patriarchal gender norms. Programmes should be implemented alongside other efforts to improve quality and promote woman-centred care. This article is part of the theme issue ‘Multidisciplinary perspectives on social support and maternal–child health’.