The fear of social stigma experienced by men: A barrier to male involvement in maternal services in Misungwi District, rural Tanzania

Abstract

Background: Evidence have 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, participation remains low; one barrier that impacts men’s participation is the fear and experience of social stigma. This study, built on previous findings about men’s perspectives in attending antenatal care appointments in Misungwi district in Tanzania, more closely examines the fear of social stigma among men attending maternal health services. Methods: A secondary analysis was conducted on data collected for a broader research study on male involvement in maternal services. We conducted twelve focus group discussions with males of reproductive age, and six in depth interviews with health care 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. Financial and material insecurity. Conclusion: Respondent’s experiences reveal that fear of social stigma is a major barrier to attend maternal 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 maternal services and require community engagement of community health workers (CHWs), government officials and other stakeholders who understand the local context.