Stakeholder's experiences, expectations and decision making on reproductive care: An ethnographic study of three districts in northern Ghana

Ayanore, Martin Amogre; Pavlova, Milena; Biesma, Regien; Groot, Wim

doi:10.1371/journal.pone.0186908

Cited by 3 publications

(1 citation statement)

References 48 publications

(40 reference statements)

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“…This has implications for maternal health and evidence suggests that involving men in pregnancy, delivery and the post-delivery period can help reduce maternal and neonatal mortality [2]. Other positive benefits include increasing access to and use of maternal services and contraceptives, discouraging unhealthy maternal health practices and encouraging more equitable couple communication and decision making [2][3][4][5]. Male involvement in health care also benefits men themselves: they are healthier, more connected socially and have improved relationships with their partners [6].…”

Section: Introductionmentioning

confidence: 99%

Involving men in pregnancy: a cross-sectional analysis of the role of self-efficacy, gender-equitable attitudes, relationship dynamics and knowledge among men in Kinshasa

Wood,

Gage,

Mafuta

et al. 2024

BMC Pregnancy Childbirth

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Background Although male participation in maternal health has gained increasing recognition and support over the years, little is known about male involvement during pregnancy in the Democratic Republic of the Congo. This paper identified male involvement patterns during pregnancy and evaluated their associations with pregnancy and birth preparedness knowledge, gender-equitable attitudes, self-efficacy, and co-parental relationship factors. Lastly, it explored the moderating effect of gender-equitable attitudes and intimate partner violence on the association between relationship satisfaction and male involvement. Methods Data from the 2018 Momentum baseline study were analyzed to determine the predictors of involvement. Factor analysis was used to create male involvement indices for antenatal carebirth preparedness and shared decision making. The sample consisted of 1,674 male partners of nulliparous pregnant women who were 6 months pregnant at baseline. Results Male involvement in individual pregnancy-related activities was low, ranging from 11% (finding a blood donor) to 49% (saving money during emergencies). Knowledge of the number of antenatal care visits, birth preparedness steps, and newborn danger signs were positively associated with involvement in antenatal care/birth preparedness activities while knowledge of antenatal care benefits was positively associated with involvement in shared decisions. Increasing relationship satisfaction and self-efficacy were associated with antenatal care/birth preparedness involvement and for shared decisions, a positive association with gender-equitable attitude and a negative association with self-efficacy were observed. Moderation effects were also detected. Conclusions The findings suggest that male involvement is multifaceted and factors influencing involvement vary depending on the type of involvement. Addressing these factors can improve male participation in maternal health.

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Section: Introductionmentioning

confidence: 99%

Involving men in pregnancy: a cross-sectional analysis of the role of self-efficacy, gender-equitable attitudes, relationship dynamics and knowledge among men in Kinshasa

Wood,

Gage,

Mafuta

et al. 2024

BMC Pregnancy Childbirth

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“Our girls need to see a path to the future” --perspectives on sexual and reproductive health information among adolescent girls, guardians, and initiation counselors in Mulanje district, Malawi

et al. 2019

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BackgroundMalawi has one of the highest adolescent pregnancy rates worldwide; at 141 births/1000 girls it is 3-fold higher than the global average. Adolescent pregnancy contributes to poor maternal and neonatal outcomes, school dropout, and poverty. In preparation for an information, education, and communication (IEC) intervention to reduce unintended pregnancy among adolescent girls, formative research was conducted to understand how and what sexual and reproductive health (SRH) information is shared with girls in southern, rural Malawi, and perceptions of such information among key informants.MethodsForty semi-structured interviews were conducted with three participant groups: adolescent girls (n = 18), mothers/female guardians (M/FGs) of adolescent girls (n = 12), and leaders of initiation rites (n = 10). Interviews were conducted in 15 villages. Data were analyzed and coded using Dedoose 7.5.ResultsParticipants widely acknowledged both the health risks and the general social unacceptability of early childbearing, yet adolescent pregnancy is common in the region. Respondents also acknowledged the importance of female school completion and the norm that pregnancy usually marks the end of a girl’s education. Unprotected transactional sex was reported to be common and driven by poverty. Initiation rites were described as prevalent and often encourage girls to practice sex at puberty. Contraceptives, and even condoms, were reportedly discouraged for adolescents due to concerns about inappropriateness for nulliparous and young girls and misconceptions about side effects. Adolescent respondents also noted barriers to accessing condoms and contraceptives. M/FGs were described as gatekeepers to SRH information and services, and many parents reported delaying SRH discussions until after sexual debut due to concerns about encouraging sexual activity. Adolescent and M/FG participants expressed a desire for role models or “outside experts” to provide SRH education and to promote an alternate vision to adolescent motherhood.ConclusionTo improve SRH outcomes for adolescent girls, it is critical to engage key stakeholders and create an enabling environment so that girls can effectively act on the IEC they receive. Initiation counselors remain entrenched information sources; efforts to provide them with training on accurate SRH messaging could leverage an existing channel. Engaging parents, especially mothers, is crucial to encourage earlier SRH education and to gain their acceptance of adolescent access to SRH services. Also important is mobilizing the broader community of influencers in support of girls’ SRH and vision for a healthier future. Sensitization messages focusing on the health, educational and economic benefits of preventing early pregnancy may overcome misconceptions about and barriers to contraceptive use. Finally, fostering girls’ aspirations for school completion and jobs and other income generating opportunities via role models can encourage an alternative to adolescent motherhood. Ultimately, poverty and gen...

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Barriers to the use of facility-based birthing services in rural northern Ghana: A qualitative study

Nyefene

Ayanore

Adatara

et al. 2018

African Journal of Midwifery and Women's Health

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Background: Use of facility-based birthing can reduce maternal mortality rates; however, service uptake is still poor in rural Ghana. Aims: To analyse key stakeholders' views on barriers to facility-based birthing in the Bongo district of rural northern Ghana. Methods: The study used a qualitative design. A purposive sampling technique was used to recruit 45 women from three communities for the study, plus four health professionals and two policy-makers. Data were collected through in-depth interviews and focus group discussions. Findings: This study revealed major barriers to the use of facility-based birthing services, including an inability to pay for transport and items for childbirth, poor quality of services, impolite staff, long distance, and the influence of significant others. Health professionals and policy-makers identified staff/facility inadequacy and general logistic constraints as major barriers. Conclusions: Women should be empowered through education campaigns, a review of the health insurance scheme and realignment of the facility protocols.

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Stakeholder's experiences, expectations and decision making on reproductive care: An ethnographic study of three districts in northern Ghana

Cited by 3 publications

References 48 publications

Involving men in pregnancy: a cross-sectional analysis of the role of self-efficacy, gender-equitable attitudes, relationship dynamics and knowledge among men in Kinshasa

Involving men in pregnancy: a cross-sectional analysis of the role of self-efficacy, gender-equitable attitudes, relationship dynamics and knowledge among men in Kinshasa

“Our girls need to see a path to the future” --perspectives on sexual and reproductive health information among adolescent girls, guardians, and initiation counselors in Mulanje district, Malawi

Barriers to the use of facility-based birthing services in rural northern Ghana: A qualitative study

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