“It is her responsibility”: partner involvement in prevention of mother to child transmission of HIV programmes, northern Tanzania

Abstract

BackgroundPartner involvement has been deemed fundamental in prevention of mother to child transmission (PMTCT) programmes, but is difficult to achieve. This study aimed to explore acceptability of the PMTCT programme components and to identify structural and cultural challenges to male involvement.MethodsThe study was conducted during 2007-2008 in rural and urban areas of Moshi in the Kilimanjaro region of Tanzania. Mixed methods were used, and included focus group discussions with fathers and mothers, in-depth interviews with fathers, mothers and health personnel, and a survey of 426 mothers bringing their four-week-old infants for immunization at five reproductive and child health clinics.ResultsRoutine testing for HIV of women at the antenatal clinic was highly acceptable and appreciated by men, while other programme components, notably partner testing, condom use and the infant feeding recommendations, were met with continued resistance. Very few men joined their wives for testing and thus missed out on PMTCT counselling. The main barriers reported were that women did not have the authority to request their husbands to test for HIV and that the arena for testing, the antenatal clinic, was defined as a typical female domain where men were out of place.ConclusionsDeep-seated ideas about gender roles and hierarchy are major obstacles to male participation in the PMTCT programme. Empowering women remains a huge challenge. Empowering men to participate by creating a space within the PMTCT programme that is male friendly should be feasible and should be highly prioritized for the PMTCT programme to achieve its potential.

Stakeholders’ perceptions on factors influencing male involvement in prevention of mother to child transmission of HIV services in Blantyre, Malawi

“…This finding remains consistent with Tanzanian and Ugandan studies where women could not ask their partners for HIV tests because they had no authority over them [39,55] and was also concluded as a limiting factor for MI in maternal health services in Mwanza, Malawi [66]. Superiority norms held by men led to men shunning of any HIV related clinics for fear of being regarded as weak [65] or less masculine [39]. Furthermore in this study, participants regarded a man who follows what his wife tells him, to have unknowingly taken a local herb called “Khuzumule” which renders him a “puppet”.…”

“…At community level, promotions that can be done include “mass campaigns” on couple HIV testing, use of key and influential people to promote MI [19,45], mass media campaigns such as television programmes [45] on MI, community mobilization [39] and involvement [26], male peers reaching to other men [46] and community based programme and support [26]. …”

Dukungan Keluarga, Dukungan Petugas Kesehatan, Dan Perilaku Ibu Hiv Dalam Pencegahan Penularan Hiv/Aids Ke Bayi

“…Demikian dapat terjadi karena responden tidak memberitahukan informasi dan aturan tersebut (Ditekemana, 2012). Sementara itu, Falnes, et al menyatakan bahwa keterlibatan suami dipengaruhi oleh komponen yang sangat penting untuk pelayanan ANC, terutama untuk meningkatkan strategi upaya pencegahan penularan HIV dari ibu ke bayi (Falnes, 2011).…”

Where are the men? Targeting male partners in preventing mother-to-child HIV transmission

“…The underlying reasons likely include HIV-associated stigma (Greig et al, 2008, Montgomery et al, 2006, the perception that clinics are not "male-friendly" (Misiri et al, 2004, Falnes et al, 2011, Theuring et al, 2009, and the fact that men are not invited to participate (Mullany, 2006). Efforts to increase rates of male voluntary HIV counseling and testing (VCT) in PMTCT programs in sub-Saharan Africa have had limited success (Msuya et al, 2008), with rates of testing mirroring those for pregnant women across the region (Kiarie et al, 2006, Kizito et al, 2008, Semrau et al, 2005, Shetty et al, 2008.…”