Leaving no one behind: using action research to promote male involvement in maternal and child health in Iringa region, Tanzania

Abstract

IntroductionMale involvement has been reported to improve maternal and child health (MCH) outcomes. However, most studies in low-income and middle-income countries have reported low participation of men in MCH-related programmes. While there is a growing interest in the involvement of men in MCH, little is known on how male involvement can be effectively promoted in settings where entrenched unequal gender roles, norms and relations constrain women from effectively inviting men to participate in MCH.Methods and analysisThis paper reports participatory action research (PAR) aimed to promote male participation in pregnancy and childbirth in Iringa Region, Tanzania. As part of the Innovating for Maternal and Child Health in Africa project, PAR was conducted in 20 villages in two rural districts in Tanzania. Men and women were engaged separately to identify barriers to male involvement in antenatal care and during delivery; and then they were facilitated to design strategies to promote male participation in their communities. Along with the PAR intervention, researchers undertook a series of research activities. A thematic analysis was used to analyse the data. The common strategies designed were: engaging health facility committees; using male champions and male gatekeepers; and using female champions to sensitise and provide health education to women. These strategies were validated during stakeholders’ meetings, which were convened in each community.DiscussionThe use of participatory approach not only empowers communities to diagnose barriers to male involvement and develop culturally acceptable strategies but also increases sustainability of the interventions beyond the life span of the project. More lessons will be identified during the implementation of these strategies.

Participatory approaches in primary health care related implementation research in low-and middle-income countries: A narrative review

“…Description of studies: All the articles were published between 2002 and 2021. Two studies were RCTs [ 17 , 18 ], five were qualitative in design [ [19] , [20] , [21] , [22] , [23] ], three were quasi-experimental [ [24] , [25] , [26] ] two were cross-sectional studies [ 27 , 28 ], and one was program implementation [ 29 ]. Almost all the studies were in the African region (four studies in South Africa, two in Ghana, and one study in Sudan, Nigeria, Malawi, Tanzania, and Burkina Faso, and DRC each) and, only two were from South Asia (Bangladesh, Pakistan).…”

“…Level of post intervention maternal depression CHW home visit increases level of uptake, coverage of health care and changed behavior of community. Maluka et al, 2020 [ 26 ] Tanzania Maternal and child health Community based maternal and child health education to male participants 1. The participatory approach to male involvement can help the treatments last longer than the project's lifespan.…”

The influence of community factors in the implementation of community-based interventions to improve antenatal care: a qualitative study based on the IMCHA programme in Tanzania

“…In Phase IV, the implementers of interventions evaluated the effectiveness and sustainability of the implemented strategies. Details of the PAR process have been reported elsewhere [ 37 ].…”

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“…In each Village, women chosen to represent their community were given the opportunity to define the problems, strategize locally and culturally contextualized solutions and then implement their plans. The specific interventions which were implemented were: engaging women groups in providing health education; working with community and religious leaders to sensitize community members on maternal and child health matters; strengthening the capacity of health committees to improve the quality of health care services and sensitizing health care workers to provide friendly and timely care to children and pregnant women (Maluka et al, 2020). Against this background, this study examined the contribution of male engagement interventions in promoting women's autonomy in decision making within households and societies.…”