“What Will I Be Doing There Among So Many Women?”: Perceptions on Male Support in Prevention of Mother to Child Services in Lilongwe, Malawi

Nkhoma, Nicola; Nyondo-Mipando, Alinane Linda; Makanjee, Chandra Rekha; Myburgh, Nellie; Nyasulu, Peter

doi:10.1177/2333794x19865442

Cited by 3 publications

(5 citation statements)

References 37 publications

(78 reference statements)

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“…The fear of marital dissolution as stated in this study is in line with the results from a previous study that reported that fear of stigma and relationship dissolution also influenced non-disclosure among couples [28]. Notably, women often associate disclosure of their HIV infected status with the dissolution of their relationship [31,45]. This may explain why one woman in our study reported that she planned to hide her HIV status and her ARV from the partner as she thought that disclosing would lead to the automatic dissolution of her relationship and accusations of promiscuity.…”

Section: Discussionsupporting

confidence: 91%

To disclose or not: experiences of HIV infected pregnant women in disclosing their HIV status to their male sexual partners in Blantyre, Malawi

2022

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Background HIV status disclosure is one of the pillars of success of the elimination of Mother to Child Transmission of HIV (eMTCT) program. However, there are challenges associated with it that limit full disclosure. Literature shows that for pregnant women in developing countries, who have been diagnosed with HIV, 16% to 86% disclose their status to their sexual partners. This study explored the experiences of newly diagnosed HIV-infected antenatal women in disclosing their HIV status to their male sexual partners in Blantyre, Malawi. Methods This was a qualitative explanatory multiple case study that was conducted from 2018 to 2019 using in-depth interviews and diaries as data collection tools. We recruited seven newly diagnosed HIV pregnant women who had not disclosed their status to their male sexual partners and were initiated on Option B + strategy of the eMTCT of HIV at Limbe Health Centre. The investigator had 3 contacts with each participant from which data was gathered except for one participant who got lost to follow-up. This study employed content analysis and used a within-case and across-case analysis. Results Women either use facilitated mutual disclosure process or disclosed directly to their male sexual partners. Women were motivated to disclose because they wanted an HIV-free baby, to know the partners' status, and to resolve the gap on how they got infected with HIV. The disclosure process faced challenges such as uncertainty about a partner’s reaction after disclosure, fear of relationship dissolution, and the soberness of the partner. Privacy was an important consideration during the process of disclosure. Following disclosure, male sexual partners either accepted the status immediately after disclosure or initially denied but later accepted. Conclusion This study has shown that newly diagnosed HIV pregnant women accessing eMTCT services have a plan of either to disclose or conceal their HIV status from their male sexual partner and this decision is affected by the nature of relationship that exist between them and their partner. Factors relating to the unborn baby, the relationship as well as to know partners status motivate women to either disclose or conceal.

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Section: Discussionsupporting

confidence: 91%

To disclose or not: experiences of HIV infected pregnant women in disclosing their HIV status to their male sexual partners in Blantyre, Malawi

2022

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“…Healthcare worker hostility was cited as the most common reason for male partners’ absence at delivery for pregnant women in North-Central Nigeria [ 87 ]. Strategies to accommodate male partners are important for their engagement and positive impact in maternal-child health [ 47 , 65 , 66 ]. These include making space and time for men’s health services and male peer support [ 47 , 88 ].…”

Section: Discussionmentioning

confidence: 99%

“…facilitate, but are not to participate in maternal-child healthcare, and women are to comply with measures found acceptable by male partners and/or the family/community to ensure the birth of a healthy baby [21, [64][65][66][67]. As a result, women who would otherwise access care may be unable to do so if their male partner is in disagreement, and men who desire to actively participate in maternal-child healthcare may be derided and stigmatized as non-masculine.…”

Section: Plos Onementioning

confidence: 99%

Access to maternal-child health and HIV services for women in North-Central Nigeria: A qualitative exploration of the male partner perspective

et al. 2020

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Background In much of sub-Saharan Africa, male partners play influential roles in women's access to maternal-child healthcare, including prevention of mother-to-child transmission of HIV services. We explored male partner perspectives on women’s access to maternal-child healthcare in North-Central Nigeria. Methods Three focus groups were conducted with 30 men, purposefully-selected on the basis of being married, and rural or urban residence. Major themes explored were men’s maternal-child health knowledge, gender power dynamics in women’s access to healthcare, and peer support for pregnant and postpartum women. Data were manually analyzed using Grounded Theory, which involves constructing theories out of data collected, rather than applying pre-formed theories. Results Mean participant age was 48.3 years, with 36.7% aged <40 years, 46.7% between 41 and 60 years, and 16.6% over 60 years old. Religious affiliation was self-reported; 60% of participants were Muslim and 40% were Christian. There was consensus on the acceptability of maternal-child health services and their importance for optimal maternal-infant outcomes. Citing underlying patriarchal norms, participants acknowledged that men had more influence in family health decision-making than women. However, positive interpersonal couple relationships were thought to facilitate equitable decision-making among couples. Financial constraints, male-unfriendly clinics and poor healthcare worker attitudes were major barriers to women’s access and male partner involvement. The provision of psychosocial and maternal peer support from trained women was deemed highly acceptable for both HIV-positive and HIV-negative women. Conclusions Strategic engagement of community leaders, including traditional and religious leaders, is needed to address harmful norms and practices underlying gender inequity in health decision-making. Gender mainstreaming, where the needs and concerns of both men and women are considered, should be applied in maternal-child healthcare education and delivery. Clinic fee reductions or elimination can facilitate service access. Finally, professional organizations can do more to reinforce respectful maternity care among healthcare workers.

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“…The area has several industrial companies such as tobacco, seed, plastic, and pharmaceutical companies. 16 …”

Section: Methodsmentioning

confidence: 99%

“…The area has several industrial companies such as tobacco, seed, plastic, and pharmaceutical companies. 16 Sampling A total of 30 participants were included in the study comprising 9 key informants and 21 clients. They were identified using a purposive sampling approach with maximum variation in mind to achieve a greater understanding of participants' experience (Table 1).…”

Section: Methodsmentioning

confidence: 99%

“There Are Just Too Many Rooms Here!” Perception of Clients and Health Care Workers on the Implementation of Test and Treat Strategy at Area 25 Health Center in Lilongwe, Malawi

Chigona

Mipando

2023

J Int Assoc Provid AIDS Care

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Background: Malawi adopted World Health Organisation test-and-treat policy in 2016. The policy initiates early antiretroviral treatment to all clients diagnosed with HIV, irrespective of their CD4 count. However, some facilities record low linkage following the strategy. Perceptions of clients and health care workers on the implementation of test-and-treat strategy were explored in Malawi. Methods: A descriptive qualitative approach was conducted in which 21 in-depth interviews, 9 key informant interviews, and 15 non-participatory observations were conducted. Data were analyzed following thematic approach. Results: Most participants had positive perceptions of the test-and-treat strategy. However, negative perceptions stemmed from the fragmented structure of the facility with multiple rooms in which the client navigates through as well as limited privacy. Conclusion: Optimal implementation of the test-and-treat strategy will need to strengthen privacy and minimize unintended disclosure that is inherent in the organization of services.

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“What Will I Be Doing There Among So Many Women?”: Perceptions on Male Support in Prevention of Mother to Child Services in Lilongwe, Malawi

Cited by 3 publications

References 37 publications

To disclose or not: experiences of HIV infected pregnant women in disclosing their HIV status to their male sexual partners in Blantyre, Malawi

To disclose or not: experiences of HIV infected pregnant women in disclosing their HIV status to their male sexual partners in Blantyre, Malawi

Access to maternal-child health and HIV services for women in North-Central Nigeria: A qualitative exploration of the male partner perspective

“There Are Just Too Many Rooms Here!” Perception of Clients and Health Care Workers on the Implementation of Test and Treat Strategy at Area 25 Health Center in Lilongwe, Malawi

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