Extent of male involvement and associated factors in antenatal care service utilization in Bench Sheko zone, Southwest Ethiopia: A community-based cross-sectional study

Coping and experience post an adverse birth outcome for fathers: a population-based perspective from India

INTRODUCTION

We report on the experience and coping mechanism of the fathers post adverse birth outcome from a population-based representative sample in the Indian state of Bihar.

METHODS

A state-representative sample of fathers of stillborn babies and babies who died within neonatal period (newborn deaths) born between July 2020 and June 2021 were interviewed. They reported on socio-demography, supportive experience and coping mechanism post birth/death of their baby, and their opinion on if their baby could have been saved. The prevalence of supportive experience, and type and prevalence of coping mechanisms by select socio-demographic characteristics is reported for them, and the prevalence of seeing, holding, and naming of the baby for the fathers of stillborn.

RESULTS

A total of 241 (71.5% participation) and 347 (71.2% participation) fathers of stillborn and of newborn deaths participated, respectively. Being able to talk to someone about their baby was reported by 174 (72.5%; 95% CI: 66.5-77.8) and 264 (77.0%; 95% CI: 72.2-81.1); and having received support to cope with loss by 194 (80.8%; 95% CI: 75.3-85.3) and 264 (77.0%; 95% CI: 72.2-81.1) fathers with stillborn and newborn death, respectively. Majority reported crying as a coping mechanism (70.8%; 95% CI: 64.7-76.3 for stillborn and 75.5%; 95% CI: 70.6-79.8 for newborn deaths), and aggression was the most common negative coping mechanism (29.6%; 95% CI: 24.1-35.7 for stillborn and 28.3%; 95% CI: 23.7-33.3 for newborn death). Majority were of the opinion their baby could have been saved had they gone to a higher-level health facility for delivery or medical attention (63.0% for stillborn and 67.7% for newborn death). Naming, seeing and holding of the stillborn was reported by 5.8%, 83.4% and 55% fathers who were present at the time of delivery, respectively.

CONCLUSION

This study highlights the need for perinatal bereavement strategies to be inclusive of the fathers along with the mothers and offer insights on formulation of those strategic programs.

TRIAL REGISTRATION

Not applicable.

Involvement of Husband During Antenatal Care Follow up of Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis

Background

Involving husbands in pregnancy, childbirth, and postpartum care improves the outcomes for mothers and babies. In most developing countries involvement of husbands towards antenatal care follow up is influenced by different socio-cultural and traditional factors. In Ethiopia, the degree of husband involvement as indicated by several research varied greatly.

Objective

The aim of this study is to measure the overall prevalence of husband involvement during antenatal care follow up of pregnant women in Ethiopia.

Methods

Five databases including PubMed, Scopus, EMBASE, SAGE and Google Scholar were reviewed for relevant articles retrieved from 2011 to 2023. Literature search used keywords, including "male partner involvement," "husband involvement," "spouse involvement" "antenatal care," and "perinatal care" and "Ethiopia". The Joanna Briggs Institute guidelines were used for appraisal review of journals. Thirteen articles were included in the final systematic review and meta-analysis and random effect model was used to analyze. The presence of statistical heterogeneity was tested using I2, and publication bias was examined by various factors.

Result

Thirteen studies were finally identified and included in this systematic review and meta-analysis. The pooled estimated proportion of husband involvement during antenatal care follow up in Ethiopia was found to be 39.3[95%-CI (38.2, 40.4)]. Cochran Q test indicates that there is heterogeneity since I2 is 98.6%. Egger's and Begg's tests were conducted to check possible publication bias and p-value = 0.679 and 0.807 respectively, which indicates that there is no possible publication bias.

Conclusion

It was discovered that the total pooled proportion of Ethiopian husbands' involvement towards antenatal care follow up was low. This demands that the nation take action to evaluate the health care policy in order to encourage husbands to participate in antenatal care and yield positive outcomes for the health of mothers and children.

Fathers' involvement in pregnancy and childbirth in Africa: an integrative systematic review

BACKGROUND

As notions of masculinity evolve globally, it is important to understand their dimensions within geographic regions and life contexts. African men's involvement in their partners'pregnancy and childbirth has been explored to a limited extent in the peer-reviewed literature. This analysis provides a comprehensive examination of the existing literature on the diverse experiences of fathers across the African continent.

AIM

This study aims to provide an overview of fathers' experience of involvement in their partners' pregnancies andchildbirth in Africa.

METHODS

A systematic integrative literature review guided the process. The review comprised problem identification, literature search, data evaluation, data analysis and presentation of results. Systematic searches were conducted in the Cinahl, PubMed and Scopus databases.

RESULTS

The search identified 70 articles of which 31, relating to 11 African countries, were used. Of these, 20 were qualitative, 9 were quantitative and 2 were mixed-methods studies. Men's alienation from health services, and traditional gender norms that discourage fathers' supportive role during pregnancy were prevalent themes. Financial pressures also dominated fathers'experiences. At the same time, in 18 studies fathers expressed motivation to be involved partners and supportive fathers, despite stigma and exclusion from maternity services.

CONCLUSION

This integrative review shows that fathers' experiences of their involvement in their partners' pregnancy and childbirth across African countries are influenced by multiple factors. While unwelcoming health services, traditional gender norms, and low income are barriers to male involvement, education, younger age, and modern gender norms are associated with greater male involvement.

Male involvement in antenatal care follow-up and its determinants in Ethiopia: a systematic review and meta-analysis

OBJECTIVE

To determine the involvement of males in antenatal care (ANC) follow-up and its determinants in Ethiopia.

DESIGN

A systematic review and meta-analysis.

DATA SOURCES

A systematic search was done on PubMed, African Journals Online, HINARI, ScienceDirect, Google Scholar and direct Google up to 20 November 2023.

ELIGIBILITY CRITERIA

We included cross-sectional or case-control studies reporting male involvement in ANC service and its determinants in Ethiopia, which were published as full-length articles in English.

DATA EXTRACTION AND SYNTHESIS

The Joanna Briggs Institute checklist was used to appraise the included studies, and the I2 test was used to evaluate heterogeneity among the studies. We assessed publication bias using a funnel plot and Begg's test. The forest plot presented the combined proportion of male involvement and OR, along with a 95% CI.

RESULTS

The pooled proportion of male involvement in ANC follow-up in Ethiopia was 43.3% (95% CI 31.7% to 54.8%). Male partners with secondary education or higher (Adjusted Odds Ratio (AOR) 2.72, 95% CI 1.81 to 4.10), government employment (AOR 2.09, 95% CI 1.49 to 2.94), attendance at health education (AOR 3.02, 95% CI 1.39 to 6.54) and knowledge about ANC or pregnancy danger signs (AOR 2.36, 95% CI 1.33 to 4.19) demonstrated a significant association with increased male involvement.

CONCLUSION

Male involvement in ANC in Ethiopia is low. Recommendations include targeted education for males with no formal schooling, improved health education on ANC and pregnancy risks, and interventions for males in the private sector.

PROSPERO REGISTRATION NUMBER

CRD42021258826.

Exploring Factors Associated with Limited Male Partner Involvement in Maternal Health: A Sesotho Socio-Cultural Perspective from the Free State, South Africa

Despite efforts to promote gender-inclusive approaches to maternal health, male partner involvement (MPI) remains limited, underscoring the need for a comprehensive understanding of the factors associated with a lack of MPI. A mixed method, concurrent/parallel design was applied to explore MPI in maternal health and to identify factors associated with limited MPI. Data collection entailed a cross-sectional survey among 407 fathers together with 16 focus group discussions with men and women of reproductive age and eight community discussions with community leaders. MPI was defined in terms of communication, decision making, physical and emotional support and physical presence at ANC. Data was subjected to descriptive, multiple linear regression and thematic analysis. Three out of five participants (63.9%) scored above the mean for higher levels of MPI in maternal health. Factors significantly associated with a lower level of MPI were younger age, unemployment, men not living with the mother of their youngest child, men who had not had a male role model involved in domestic chores, and men who were not interested in attending future maternal health programmes. In addition, the qualitative analysis also identified relationship problems, family conflicts, health systems barriers and alcohol abuse as hinderances to MPI in maternal health. Health systems capacity is required for the promotion of male partner interventions that are in line with socio-cultural practices and gender norms.

Women's experiences with continuity for effective coordination during maternal and neonatal continuum in Kenya: An interpretive phenomenology

BACKGROUND

 Embracing women's experiences in decision-making is imperative for continuity in effective coordination of maternal and neonatal health (MNH); women are the end users within the care ecosystem. Through women's continuous feedback, skilled birth attendants (SBAs) and the healthcare system get to understand emerging issues based on their needs and preferences.

AIM

 The purpose of this article is to describe women's experiences of continuity for effective coordination of care through the transitions in the MNH continuum in Kenya.

SETTING

 The study was conducted in selected counties of Kenya based on birth rates per woman as follows: Wajir (7.8) Narok (6.0) Kirinyaga (2.3) and Nairobi (2.7) (1). The clients were interviewed concerning their experiences of the MNH continuum of care in English and Kiswahili.

METHODS

 An interpretive hermeneutic phenomenological approach was used to construct the experiences of women of continuity during transitions in the MNH continuum for effective care coordination. Twelve participants were interviewed between January and April 2023. Atlas ti 22 software was used for data analysis.

RESULTS

 Four women experiences were highlighted: Women unawareness of preconception care, use of prenatal care, labour, birthing and postpartum flow and the women's view on the MNH continuum.

CONCLUSION

 The women reported their segmental and transitional experience of the MNH continuum as one that did not consistently meet their needs and preferences in order for them to fully agree that the continuum enhanced continuity for effective coordination. They felt that they experienced continuity in some segments while in some they did not.Contribution: The embrace of women's experience of their needs and preferences through the MNH continuum (segments and transitional segments) through the lens of continuity for effective coordination is timely towards the improvement of maternal and neonatal care by 2030.

Men's involvement in maternal health in sub-Saharan Africa: A scoping review of enablers and barriers

BACKGROUND

Globally, there are about 800 maternal deaths every day, with low-to-middle-income countries accounting for most of these deaths. A lack of access to maternal healthcare services is one of the main causes of these deaths. In sub-Saharan Africa (SSA), one of the barriers to accessing maternal healthcare services by women is a lack of their male partners' involvement. This scoping review aimed to assess the enablers and barriers to men's involvement in maternal healthcare services.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) checklist was used as a guide for this review. We searched for peer-reviewed articles published between 2013 and 2023 in the English language from SCOPUS, ScienceDirect, PubMed, Africa Journals Online (AJOL), and Google Scholar databases. Two reviewers independently conducted the data extraction and article selection. All of the authors discussed and decided on the codes and categories for enablers and barriers after using NVivo to generate them.

RESULTS

Twenty-seven articles were used in this review. Of these, seventeen were qualitative studies, six were quantitative studies, and four were mixed-methods studies. The enablers of men's involvement in maternal healthcare were grouped into sociodemographic factors, health system factors, and policy factors, while barriers were grouped into sociodemographic, cultural, economic, and health system barriers. The lack of maternal health knowledge, insufficient economic resources, and unfriendly staff at healthcare facilities all contributed to a lack of involvement by men.

CONCLUSION

To improve men's involvement in maternal healthcare in SSA, there should be economic empowerment of both men and women, health education, and the provision of adequate infrastructure in healthcare facilities to accommodate men.

Effect of couple-based health education on male-partners knowledge and attitude towards maternity waiting homes in rural Ethiopia: a cluster-randomized trial

This cluster-randomized controlled trial examined the effect of couple-based health education on male partners' knowledge and attitude towards maternity waiting homes (MWH) in rural Ethiopia. Sixteen clusters and 320 couples were randomly assigned to intervention group (receiving group health education, home visits and print health messages alongside usual care) or control group (receiving usual care). The Chi-square test was used to estimate statistical differences, and the difference-in-differences model was used to estimate the effect of the intervention. The generalized linear regression model was used to determine the odds of outcomes between the groups. Statistical significance was set at p < 0.05, with a 95% CI. There were no significant differences in baseline characteristics between the control and intervention groups. The net effect of the intervention on improving knowledge about MWHs, and attitude towards MWHs were 35.6% and 36.2%, respectively. The participants in the intervention group were 5.5 times more likely to have good knowledge about MWH (AOR 5.55, 95% CI 3.37-9.14) and 5.6 times more likely to have a favorable attitude towards MWH (AOR 5.61, 95% CI 3.45-9.10) compared to their counterparts. Health education provided to couples significantly improved male partners' knowledge and attitude towards MWHs in rural Ethiopia.Trial registration: ClinicalTrials.gov Identifier: NCT05015023.