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.

reterm birth is defined as delivery of a live born infant before 37 weeks of completed gestation. 1 Worldwide, about 15 million babies (more than 10% of all births) are born preterm. 1 There are three commonly used or established categories of preterm birth based on gestational age: very early (<32 weeks), early (32 0/7 -33 6/7 weeks), and late preterm (LP; 34 0/7 -36 6/7 weeks). "Late preterm" was introduced to replace the "near term" descriptor to differentiate this group as more similar to preterm infants and more vulnerable compared to term infants. 2 The increase in preterm birth rates in recent years can be largely attributed to increases in LP births. 3 The Canadian preterm birth rate was approximately 8.1% in 2006 to 2007 and almost three quarters (74.0%) of these births were late preterm. 4 Indeed, LPs are the largest and fastest growing subgroup of preterm births, a trend that constitutes a growing public health concern given its increased risk of morbidity compared to longer gestations. 5 Despite assumptions that LP infants are similar to term infants, LPs are physiologically and metabolically immature. 5 LP infants are more likely to be diagnosed with temperature instability, hypoglycemia, respiratory distress, apnea, jaundice, and feeding difficulties during birth and in the first month of life. 5 Although less is known about long-term outcomes for LPs and their families, recent reports suggest that there are subtle developmental delays that present as poor school outcomes, 6 cognitive impairments, and behavioural and emotional problems. 7 In addition, mothers of LPs tend to report both short-term and long lasting distress, including breastfeeding difficulties, anxiety and depression, and post-traumatic stress. 5,[8][9][10][11][12] Given the large population attributable risk associated with the LP gestation category, such findings may have major implications for health and education services.Although the benefits associated with breastfeeding for infants and mothers are well documented, 13 the rates of exclusive breastfeeding at 4 to 6 months are far from optimal in many countries, 14 including Canada, 15 which fail to meet WHO's recommendation of exclusive breastfeeding for the first six months of life. 16 In Canada, the rate of breastfeeding initiation is promising at 90.3%, however only 14.4% of mothers surveyed reported exclusively breastfeeding at 6 months. 15 Preterm birth is a risk factor for early discontinuation of breastfeeding, along with other known factors such as maternal age,

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BackgroundThe Ugandan health system now supports integrated community case management (iCCM) by community health workers (CHWs) to treat young children ill with fever, presumed pneumonia, and diarrhea. During an iCCM pilot intervention study in southwest Uganda, two CHWs were selected from existing village teams of two to seven CHWs, to be trained in iCCM. Therefore, some villages had both ‘basic CHWs’ who were trained in standard health promotion and ‘iCCM CHWs’ who were trained in the iCCM intervention. A qualitative study was conducted to investigate how providing training, materials, and support for iCCM to some CHWs and not others in a CHW team impacts team functioning and CHW motivation.MethodsIn 2012, iCCM was implemented in Kyabugimbi sub-county of Bushenyi District in Uganda. Following seven months of iCCM intervention, focus group discussions and key informant interviews were conducted alongside other end line tools as part of a post-iCCM intervention study. Study participants were community leaders, caregivers of young children, and the CHWs themselves (‘basic’ and ‘iCCM’). Qualitative content analysis was used to identify prominent themes from the transcribed data.ResultsThe five main themes observed were: motivation and self-esteem; selection, training, and tools; community perceptions and rumours; social status and equity; and cooperation and team dynamics. ‘Basic CHWs’ reported feeling hurt and overshadowed by ‘iCCM CHWs’ and reported reduced self-esteem and motivation. iCCM training and tools were perceived to be a significant advantage, which fueled feelings of segregation. CHW cooperation and team dynamics varied from area to area, although there was an overall discord amongst CHWs regarding inequity in iCCM participation. Despite this discord, reasonable personal and working relationships within teams were retained.ConclusionsTraining and supporting only some CHWs within village teams unexpectedly and negatively impacted CHW motivation for ‘basic CHWs’, but not necessarily team functioning. A potential consequence might be reduced CHW productivity and increased attrition. CHW programmers should consider minimizing segregation when introducing new program opportunities through providing equal opportunities to participate and receive incentives, while seeking means to improve communication, CHW solidarity, and motivation.

Background Evidence has shown that male involvement is associated with improved maternal health outcomes. In rural Tanzania, men are the main decision makers and may determine women’s access to health services and ultimately their health outcomes. Despite efforts geared towards enhancing male participation in maternal health care, their involvement in antenatal care (ANC) remains low. One barrier that impacts men’s participation is the fear and experience of social stigma. This study, builds on previous findings about men’s perspectives in attending antenatal care appointments in Misungwi district in Tanzania, examining more closely the fear of social stigma amongst men attending ANC together with their partners. Methods Twelve individual interviews and five focus group discussions were conducted using semi-structured questionnaires with fathers and expectant fathers. In-depth interviews were conducted with health providers, volunteer community health workers and village leaders. Interviews were audiotaped, and transcripts were transcribed and translated to English. Transcripts were organized in NVivo V.12 then analyzed using thematic approach. Results Three main themes were found to create fear of social stigma for men: 1. Fear of HIV testing; 2. Traditional Gender Norms and 3. Insecurity about family social and economic status. Conclusion Respondent’s experiences reveal that fear of social stigma is a major barrier to attend ANC services with their partners. Attention must be given to the complex sociocultural norms and social context that underly this issue at the community level. Strategies to address fear of social stigma require an understanding of the real reasons some men do not attend ANC and require community engagement of community health workers (CHWs), government officials and other stakeholders who understand the local context.