Determinants of male involvement in maternal healthcare services in southwest Nigeria

Abstract

Background/Aims In Nigeria, women's partners are often excluded from taking part in maternal healthcare, as a result of sociocultural norms. However, the involvement of male partners in maternal healthcare services has the potential to improve maternal health outcomes. This study examined factors associated with male involvement in maternal healthcare services in Ife Central, Osun State, Nigeria. Methods A cross-sectional study was conducted, involving 265 men living in Ife Central who were married with at least one child, selected by multistage sampling. A structured questionnaire was used to assess men's knowledge of their expected roles in maternal healthcare, their perception of male involvement, and their current level of involvement in their spouse's healthcare. Descriptive and inferential statistical analyses were carried out to identify predictors of active male involvement in maternal healthcare, at a significance of P<0.05. Results Approximately half (55.6%) of the respondents had good knowledge of the expected role of men in maternal healthcare services and 76.6% had a positive perception of this role. Overall, less than half (47.6%) of the participants were actively involved in maternal healthcare services. The participants most frequently reported that men's involvement was influenced by their degree of knowledge (92.4%), job schedule (92.0%), and clinic waiting time (86.4%), among others. Age (odds ratio=2.33, P=0.038), educational status (odds ratio=2.42, P=0.004) religion (odds ratio=2.34, P=0.012), occupation (odds ratio=2.81, P<0.001) and level of knowledge (odds ratio=2.34, P=0.001) were found to be significantly associated with men's level of involvement in maternal healthcare services. However, only good level of knowledge (adjusted odds ratio=2.32, P=0.004) emerged as an independent predictor of men's level of involvement in maternal healthcare services. Conclusions The study concluded that men's involvement in maternal healthcare services was low, despite their positive perception towards it. Less than half of the participants had good knowledge regarding men's role in maternal healthcare, and this factor was identified as a significant predictor of level of involvement. Programmes and policies should aim to enhance men's knowledge of their role in maternal healthcare, and it may be necessary to restructure the healthcare delivery system to be more male friendly.

Prevalence and predictors of men's involvement in pregnancy care in Modakeke, Southwest Nigeria

“…Generally, married men and those within monogamous family arrangements demonstrated elevated levels of involvement in contrast to single fathers and those from polygamous family setups. Similar findings have been widely documented in the past studies where stable and monogamous unions have been linked with increased level of male partner's involvement (14,23,33,34). Men in stable and monogamous unions may experience a more conducive environment for shared responsibilities leading to greater participation in pregnancy care.…”

“…Also, it may signify an alignment with progressive societal values that recognize and encourage men's active roles in reproductive health, thereby fostering a culture of inclusive and collaborative pregnancy care practices. Although this study found that most of the study participants expressed positive attitudes towards supportive behaviors, perceived challenges to active involvement included traditional gender norms, social stigma, ridicule, unconducive health facility environment and exclusion of men from maternity care activities in agreement with evidence from earlier investigations ( 5 , 11 , 20 , 31 , 33 , 34 , 39 – 42 ).…”

“…The study found a substantial yet statistically insignificant age difference in men's participation in pregnancy care with younger respondents exhibiting greater involvement compared to their older counterparts. This finding aligns with outcomes reported in investigations done in Ife Central, Southwest Nigeria (33), Benin-City, Southsouth Nigeria (8), Ungogo, Northern Nigeria (23), and Asmara, Eritrea (22) but contradicts evidence from studies conducted in Bench Sheko zone, Southwest Ethiopia (10) where being older was associated increased tendency of being involved in maternity care. The observed age disparity may be ascribed to distinctions in socioeconomic attributes among the age cohorts.…”

“…Education is the most consistent social determinant health of a society as it informs knowledge, attitude and practice that promotes positive health behaviors and outcomes ( 35 ). This is evidenced by numerous studies addressing various public health issues including pregnancy-related care ( 7 , 23 , 25 , 30 , 33 , 35 , 36 ). Education substitutes traditional gender norms with liberal attitudes of shared responsibility, provides access to resources and equips individuals with relevant knowledge across various life domains, including reproductive health, thus, fostering increased male partner's engagement during pregnancy ( 12 , 37 ).…”

“…Results from the bivariate and multivariate analyses consistently indicate that a positive perception regarding the act of accompanying a spouse to antenatal care and providing general pregnancy-related care have significant positive influence on men's actual involvement in pregnancy care. A few research has shown that men with positive attitudes towards supportive behaviors are more inclined to participate in pregnancy care activities ( 13 , 19 , 22 , 33 ). Positive male perceptions may correlate with a greater sense of responsibility and commitment towards the well-being of the spouse and unborn child.…”