The impact of including husbands in antenatal health education services on maternal health practices in urban Nepal: results from a randomized controlled trial

Abstract

Observational studies suggest that including men in reproductive health interventions can enhance positive health outcomes. A randomized controlled trial was designed to test the impact of involving male partners in antenatal health education on maternal health care utilization and birth preparedness in urban Nepal. In total, 442 women seeking antenatal services during second trimester of pregnancy were randomized into three groups: women who received education with their husbands, women who received education alone and women who received no education. The education intervention consisted of two 35-min health education sessions. Women were followed until after delivery. Women who received education with husbands were more likely to attend a post-partum visit than women who received education alone [RR = 1.25, 95% CI = (1.01, 1.54)] or no education [RR = 1.29, 95% CI = (1.04, 1.60)]. Women who received education with their husbands were also nearly twice as likely as control group women to report making >3 birth preparations [RR = 1.99, 95% CI = (1.10, 3.59)]. Study groups were similar with respect to attending the recommended number of antenatal care checkups, delivering in a health institution or having a skilled provider at birth. These data provide evidence that educating pregnant women and their male partners yields a greater net impact on maternal health behaviors compared with educating women alone.

Perceptions about the cultural practices of male partners during postpartum care in rural Tanzania: a qualitative study

“…Health professionals do not expect them to come, do not encourage them and may have negative perceptions of men’s involvement [13,25]. Numerous studies have also indicated the barriers that men face in accessing health services for themselves and becoming engaged with services during pregnancy and childbirth [1,26,34,38]. Policies and programs should take into consideration these societal barriers if they want to enhance men’s engagement during this period.…”

“…Men play an important role in women’s and children’s health [1–3]. Studies have primarily focused on the negative impact of men’s behavior on women’s health, e.g.…”

“…violence, unwanted pregnancy and human immunodeficiency virus (HIV) infection [4–7]. However, men can also play a positive role, and men’s involvement in pregnancy and childbirth has been shown to benefit the health of mothers and newborns [1,8–13]. Men’s involvement in reproductive health can also enhance gender equality and empower individual women to make their own decisions [14,15].…”

“…Despite the potential that men’s involvement in maternal healthcare has in terms of improving the health of the men, women and children, men’s actual involvement remains low in most African countries [1,17–20]. To understand why, it is necessary to consider gender relations [20].…”

Understanding gendered influences on women's reproductive health in Pakistan: Moving beyond the autonomy paradigm

“…Men and the socio-cultural construction of masculinities are now recognised to have important implications for women's reproductive health outcomes (Mullany, Becker and Hindin, 2007), however, research based within the autonomy paradigm seems unlikely to produce a full understanding of these complex influences.…”