Understanding male involvement in antenatal care in the Kilimanjaro region of Tanzania: Barriers, facilitators, and opportunities for engagement

Sao, Saumya S.; Kisigo, Godfrey A.; Osaki, Haika; Coleman, Jessica N.; Renju, Jenny; Mwamba, Rimel N.; Ngocho, James S.; Mmbaga, Blandina T.; Watt, Melissa H.

doi:10.1016/j.srhc.2023.100931

Cited by 4 publications

(3 citation statements)

References 34 publications

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“…We found that the desire to acquire pregnancy-related knowledge directly from expert providers was the greatest motivation for male ANC attendance. Contrary to other studies 45,54 , we found little evidence on companionship or couple HIV testing as motivating factors for male ANC attendance. In the Cameroonian context, most male respondents perceived ANC attendance as a platform to reinforce their power through direct access to knowledge from medical experts.…”

Section: Fast-track Services Forcontrasting

confidence: 99%

“…Based on our study, the construction of male role and perceived involvement in pregnancy care in Bamenda, Cameroon is at the intersection of gender and socio-cultural norms on masculinity. This nding corroborates previous evidence across sub-Saharan Africa that re ect the traditional dichotomy of ANC attendance as the preserve of women while nancial provision for antenatal care is the responsibility of men [45][46][47][48] . A novel nding that emerged in our study was male perceptions that men participate indirectly in antenatal care through the nances they generate to send women for ANC and these nances in turn act as their representatives in antenatal clinics.…”

Section: Fast-track Services Forsupporting

confidence: 89%

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‘I am a father but not pregnant’—a qualitative analysis of the perspectives of pregnant couples on male partner role during pregnancy care in Bamenda, Cameroon

Foglabenchi,

Stöckl,

Marchant

2024

Preprint

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Background The reduction of maternal mortality has stagnated globally. Estimates project a rise to 140.9 deaths per 100,000 live births by 2030, which is double the Sustainable Development Goal target. Male involvement in pregnancy care has been proposed as an intervention to improve maternal and child health outcomes. However, there is limited understanding of how communities view the role of men beyond the instrumentalist approach that only targets men as accompanying partners without altering the underlying gender and socio-cultural determinants that shape their involvement in pregnancy care. This study broadens existing research by exploring and and contextualising the role of male partners during pregnancy in Bamenda, Cameroon. Methods This study employed a qualitative design underpinned by symbolic interactionism. We conducted 68 semi-structured interviews (SSIs) and three focus group discussions (FGDs) with purposively selected pregnant women(n= 38 SSIs; n=6, FGD) and male partners (n= 30 SSIs; n=6, FGD) in an urban hospital in the North West Regional capital—Bamenda. Nvivo was used for data management and subsequently, we performed thematic analysis using a critical discourse lens to generate manifest and latent interpretations of study findings. Results The role of male partners reflected hegemonic masculinity and was broadly conceptualised in three categories: breadwinner, protector/comforter, and ‘sender’ for antenatal care. Perceptions of men’s role differed between male and female participants. While women sought male involvement for pragmatic reasons like joint attendance of antenatal care, psychosocial support (affirmation) and assistance with domestic chores, men limited their involvement to roles that matched gendered preconceptions of masculinity like financial support for antenatal fees, maternal nutrition and birth supplies. Nonetheless, the perceived benefits for antenatal attendance was expressed by some men in terms of the direct access it gives them to pregnancy-related education from experts, paternal bonding and the appeal of fast-track services for couples. Conclusion Male involvement in maternal and child health in Bamenda Health District is an extension and reflection of how patriarchal norms on masculinity are constructed and adapted in this setting. To address gaps in male involvement, intervention designers and implementers will need to take into account prevailing culture-specific norms while deconstructing and leveraging masculine ideals to situate male involvement in the prenatal context.

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Section: Fast-track Services Forcontrasting

confidence: 99%

Section: Fast-track Services Forsupporting

confidence: 89%

‘I am a father but not pregnant’—a qualitative analysis of the perspectives of pregnant couples on male partner role during pregnancy care in Bamenda, Cameroon

Foglabenchi,

Stöckl,

Marchant

2024

Preprint

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“…These findings align with the results of a recent study conducted in Tanzania, which found that despite naming the ANC as the responsibility of the woman, ANC space as a female-dominated area, and long waiting services, pregnant women perceived their husband's participation in ANC as beneficial for a pregnant woman and unborn baby. [50] Healthcare providers can implement education campaigns to stress the importance of male involvement in pregnancy and childbirth in order to encourage more husbands to accompany their wives to ANC appointments. In addition, creating a welcoming and inclusive environment in healthcare facilities can increase men's participation in ANC visits.…”

Section: Discussionmentioning

confidence: 99%

Exploring Perceptions about Enablers of Women’s Attendance and Adherence to the Recommended Antenatal Care Visits in Rwanda: A Qualitative Study

Tengera,

Meharry,

Nkurunziza

et al. 2024

Rwanda J Med Health Sci

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BackgroundAntenatal care (ANC) helps ensure the best health conditions of the mother and foetus during pregnancy. However, achieving optimal ANC attendance and adherence to the World Health Organization (WHO) recommendations remains a global challenge, with significant disparities in attendance rates. A qualitative study was conducted exploring pregnant women's perspectives of various enablers to their attendance and adherence to recommended ANC visits in Rwanda. MethodsThis exploratory qualitative study involved 22 pregnant women attending ANC in four public health centres in the Eastern province, of Rwanda. An interview guide with semi-structured questions was used to gather information about the moderators of ANC attendance and adherence among pregnant women. Data were audio-recorded and transcribed verbatim, and thematic analysis was used to categorize themes under the five-level Social Ecological Model (SEM).ResultsEarly recognition of pregnancy, financial stability, and female participation in decision-making were identified as intrapersonal enabling factors of ANC attendance and adherence; spousal support was identified as an interpersonal enabling factor; community health workers, and community relationships as community enabling factors; availability and cost of ANC services as institutional enabling factors; and media campaign, community outreach as public policy enabling factors contributing to the pregnant women's attendance and adherence to ANC visits.ConclusionEnablers at multiple levels affect women’s attendance and adherence to ANC visits. It is essential to consider each level when implementing effective strategies to maximize ANC attendance and adherence to the WHO recommendations in order to improve maternal- foetal well-being in Rwanda.Rwanda J Med Health Sci. 2024;7(1):101-115

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Female genital schistosomiasis is a women’s issue, but men should not be left out: involving men in promoting care for female genital schistosomiasis in mainland Tanzania

Lambert,

Samson,

Matungwa

et al. 2024

Front. Trop. Dis

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ObjectivesFemale Genital Schistosomiasis (FGS) causes gynecologic symptoms among women and girls living in sub-Saharan Africa. Despite continued efforts to raise awareness in communities about schistosomiasis, FGS remains poorly recognized. This study aimed to understand men’s knowledge and perceptions of FGS in northwestern Tanzania, and how this affects or can promote women’s uptake of FGS services.Design and methodsWe conducted a qualitative, formative survey called “Broad Brush Survey” (BBS) using 30 focus group discussions (FGDs) and 29 key informant interviews in five (5) districts across three regions in northwestern Tanzania. Participants were purposively selected in collaboration with village leaders and provided a written consent and/or assent to participate and be voice recorded. They included adolescent girls and boys (15-20 years), adult women and men (21-45 years), older women and men (≥46 years), village leaders (village chairpersons and executive officers), community health workers (CHWs), traditional healers, retail drug sellers, religious leaders, and opinion leaders (influential women and men). This analysis focuses and draws on 18 FGDs and 19 KIIs in which participants discussed or explained the importance and potential role of men in promoting FGS care.ResultsMost participants were not aware of FGS. Despite having adequate knowledge about urogenital schistosomiasis, they perceived FGS to be a sexually transmitted infection (STI). Three main themes emerged during analysis. First, most men reported perceiving women suffering from FGS as “promiscuous” or “unfaithful” due to misperceiving FGS as an STI. Such misperception could result in men ending a relationship. Second, participants reported that their engagement in FGS interventions would be critical to the interventions’ effectiveness because men often regulate women’s access to healthcare. Third, participants argued that men could be empowered through education to promote women’s uptake of FGS services. Finally, they argued that if men are educated about FGS like women, they can both work together in seeking care for FGSConclusionEngaging men to address FGS holds potential to transform their negative perceptions of FGS. Further, participants described men’s potential to support and even advocate for women’s healthcare seeking when women experience symptoms that could be consistent with FGS. Including men more explicitly in FGS community education efforts could facilitate the provision of high-quality sexual and reproductive health care for women living in many communities where FGS is endemic but access to care is limited. We propose that public health interventions in such communities, which are often highly patriarchal, should leverage men’s positions within society by engaging them in promoting women’s health interventions. While we only interviewed participants from five (5) districts across three (3) regions, we are confident that their perceptions are reflective of many similar communities in Tanzania and beyond.

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Understanding male involvement in antenatal care in the Kilimanjaro region of Tanzania: Barriers, facilitators, and opportunities for engagement

Cited by 4 publications

References 34 publications

‘I am a father but not pregnant’—a qualitative analysis of the perspectives of pregnant couples on male partner role during pregnancy care in Bamenda, Cameroon

‘I am a father but not pregnant’—a qualitative analysis of the perspectives of pregnant couples on male partner role during pregnancy care in Bamenda, Cameroon

Exploring Perceptions about Enablers of Women’s Attendance and Adherence to the Recommended Antenatal Care Visits in Rwanda: A Qualitative Study

Female genital schistosomiasis is a women’s issue, but men should not be left out: involving men in promoting care for female genital schistosomiasis in mainland Tanzania

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