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BMC Pregnancy and Childbirth

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Open Access 01-12-2018 | Research article

Exploring antenatal education content for couples in Blantyre, Malawi

Authors: Maria Chifuniro Chikalipo, Ellen Mbweza Chirwa, Adamson Sinjani Muula

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

Abstract

Background

Despite advocating for male involvement in antenatal education, there is unmet need for antenatal education information for expectant couples. The objective of this study was to gain a deeper understanding of the education content for couples during antenatal education sessions in Malawi. This is needed for the development of a tailor-made curriculum for couple antenatal education in the country, later to be tested for acceptability, feasibility and effectiveness.

Methods

An exploratory cross sectional descriptive study using a qualitative approach was conducted in semi-urban areas of Blantyre District in Malawi from February to August 2016. We conducted four focus group discussions (FGDs) among men and women independently. We also conducted one focus group discussion with nurses/ midwives, 13 key informant interviews whose participants were drawn from both health-related and non-health related institutions; 10 in-depth interviews with couples and 10 separate in-depth interviews with men who had attended antenatal clinics before with their spouses. All the interviews were audiotaped, transcribed verbatim and translated from Chichewa, the local language, into English. We managed data with NVivo 10.0 and used the thematic content approach as a guide for analysis.

Results

We identified one overarching theme: couple antenatal education information needs. The theme had three subthemes which were identified based on the three domains of the maternity cycle which are pregnancy, labour and delivery and postpartum period. Preferred topics were; description of pregnancy, care of pregnant women, role of men during perinatal period, family life birth preparedness and complication readiness plan, coitus during pregnancy and after delivery, childbirth and baby care.

Conclusion

Antenatal education is a potential platform to disseminate information and discuss with male partners the childbearing period and early parenting. Hence, if both men and women were to participate in antenatal education, their information needs should be prioritized. Men and women had similar choices of topics to be taught during couple antenatal education, with some minor variations.

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Serçekuş P, Mete S. Effects of antenatal education on maternal prenatal and postpartum adaptation. J Adv Nurs. 2010;66(5):999–1010. https://doi.org/10.1111/j.1365-2648.2009.05253. CrossRefPubMed

Taiwo R, Salami F. Discourse acts in antenatal clinic literacy classroom in South-Western Nigeria. Linguistik online. 2013;31(2). https://bop.unibe.ch/linguistik-online/article/view/544/916

Ho I, Holroyd E. Chinese women's perceptions of the effectiveness of antenatal education in the preparation for motherhood. J Adv Nurs. 2002;38. https://doi.org/10.1046/j.1365-2648.2002.02148.

Geçkil E, Şahin T, Ege E. Traditional postpartum practices of women and infants and the factors influencing such practices in south eastern Turkey. Midwifery. 2009;25(1):62–71. https://doi.org/10.1016/j.midw.2006.12.007.CrossRefPubMed

Liu N, Mao L, Sun X, Liu L, Yao P, Chen B. The effect of health and nutrition education intervention on women's postpartum beliefs and practices: a randomized controlled trial. BMC Public Health. 2009;9(1):45. https://doi.org/10.1186/1471-2458-9-45.CrossRefPubMedPubMedCentral

White G. You cope by breaking down in private: fathers and PTSD following childbirth. Br J Midwifery 2007;15(1). DOI: https://doi.org/10.12968/bjom.2007.15.1.22679

McElligott M. Antenatal information wanted by first-time fathers. Br J Midwifery. 2001;9(9):556–8. https://doi.org/10.12968/bjom.2001.9.9.12706.CrossRef

Andersson E, Norman Å, Kanlinder C, Plantin L. What do expectant fathers expect of antenatal care in Sweden? A cross-sectional study. Sex Reprod Healthc. 2016;9:27–34. https://doi.org/10.1016/j.srhc.2016.06.003.CrossRefPubMed

Leverett S. Men and antenatal pedagogy: discourse, subject positions and affect: Cardiff University; 2013. URI: http://orca.cf.ac.uk/id/eprint/56523

10.

Tweheyo R, Konde-Lule J, Tumwesigye NM, Sekandi JN. Male partner attendance of skilled antenatal care in peri-urban Gulu district, northern Uganda. BMC Pregnancy Childbirth. 2010;10(1):1–9. https://doi.org/10.1186/1471-2393-10-53.CrossRef

11.

Smyth S, Spence D, Murray K. Does antenatal education prepare fathers for their role as birth partners and for parenthood? Br J Midwifery. 2015;23(5). https://doi.org/10.12968/bjom.2015.23.5.336.

12.

Singh D, Lample M, Earnest J. The involvement of men in maternal health care: cross-sectional, pilot case studies from Maligita and Kibibi. Uganda Reprod Health. 2014;11(1):68. https://doi.org/10.1186/1742-4755-11-68.CrossRefPubMed

13.

Yende N, Van Rie A, West NS, Bassett J, Schwartz SR. Acceptability and Preferences among Men and Women for Male Involvement in Antenatal Care. J Pregnancy. 2017;2017. DOI: https://doi.org/10.1155/2017/4758017.

14.

May C, Fletcher R. Preparing fathers for the transition to parenthood: recommendations for the content of antenatal education. Midwifery. 2013;29(5):474–8. https://doi.org/10.1016/j.midw.2012.03.005.CrossRefPubMed

15.

Nigenda G, Langer A, Kuchaisit C, Romero M, Rojas G, Al-Osimy M, et al. Womens' opinions on antenatal care in developing countries: results of a study in Cuba, Thailand, Saudi Arabia and Argentina. BMC Public Health. 2003;3(1):17. https://doi.org/10.1186/1471-2458-3-17.CrossRefPubMedPubMedCentral

16.

Malata A, Chirwa E. Childbirth information needs for first time Malawian mothers who attended antenatal clinics. Malawi Med J. 2011;23(2):43–6. https://doi.org/10.4314/mmj.v23i2.70747.CrossRefPubMedPubMedCentral

17.

Otaiby TA, Jradi H, Bawazir A. Antenatal education: Assessment of pregnant women knowledge and preferance in Saudi Arabia. J Women’s Health Care. 2:139. https://doi.org/10.4172/2167-0420.1000139.

18.

Singh D, Newburn M, Smith N, Wiggins M. The information needs of first-time pregnant mothers. Br J Midwifery. 2002;10(1):54–8. https://doi.org/10.12968/bjom.2002.10.1.10054.CrossRef

19.

Deave T, Johnson D, Ingram J. Transition to parenthood: the needs of parents in pregnancy and early parenthood. BMC Pregnancy Childbirth. 2008;8(1):30. https://doi.org/10.1186/1471-2393-8-3020. CrossRefPubMedPubMedCentral

20.

Axelsen SF, Brixval CS, Due P, Koushede V. Integrating couple relationship education in antenatal education–a study of perceived relevance among expectant Danish parents. Sex Reprod Healthc. 2014;5(4):174–5. https://doi.org/10.1016/j.srhc.2014.06.006.CrossRefPubMed

21.

Widarsson M, Kerstis B, Sundquist K, Engström G, Sarkadi A. Support needs of expectant mothers and fathers: a qualitative study. J Perinat Educ. 2012;21(1):36–44. https://doi.org/10.1891/1058-1243.21.1.3622.CrossRefPubMedPubMedCentral

22.

Andersson E, Small R. Fathers’ satisfaction with two different models of antenatal care in Sweden–findings from a quasi-experimental study. Midwifery. 2017;50:201–7. https://doi.org/10.1016/j.midw.2017.04.014.CrossRefPubMed

23.

Andersson E, Christensson K, Hildingsson I. Parents' experiences and perceptions of group-based antenatal care in four clinics in Sweden. Midwifery. 2012;28(4):502–8. https://doi.org/10.1016/j.midw.2011.07.006.CrossRefPubMed

24.

Pålsson P, Persson EK, Ekelin M, Hallström IK, Kvist LJ. First-time fathers experiences of their prenatal preparation in relation to challenges met in the early parenthood period: implications for early parenthood preparation. Midwifery. 2017;50:86–92. https://doi.org/10.1016/j.midw.2017.03.021.CrossRefPubMed

25.

Adeniran AS, Aboyeji AP, Fawole AA, Balogun OR, Adesina KT, Adeniran PI. Male Partner’s role during pregnancy, labour and delivery: expectations of pregnant women in Nigeria. Int J Health Sci. 2015;9(3):305 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4633194/.

26.

Svensson J, Barclay L, Cooke M. Effective antenatal education: strategies recommended by expectant and new parents. J Perinat Educ. 2008;17(4):33–42. https://doi.org/10.1624/105812408X364152.CrossRefPubMedPubMedCentral

27.

Premberg A, Lundgren I. Fathers' experiences of childbirth education. J Perinat Educ 2006. 2006;15(2):21–28. DOI: https://doi.org/10.1624/105812406X107780.

28.

Malawi Government Participants' manual for intergrated in service training for maternal and neonatal care, Malawi. 2014.

29.

Polit DF, Beck CT. Essentials of nursing research: appraising evidence for nursing practice: Lippincott Williams & Wilkins; 2013.

30.

Polit DF, Beck CT. Essentials of nursing research: methods appraisal and utilization. Philadelphia: Lippincott Williams and Wilkins; 2010.

31.

Boyce C, Neale P. Conducting in-depth interviews: a guide for designing and conducting in-depth interviews for evaluation input: pathfinder international Watertown, MA; 2006. http://www2.pathfinder.org/site/DocServer/m_e_tool_series_indepth_interviews.pdf

32.

Marshall B, Cardon P, Poddar A, Fontenot R. Does sample size matter in qualitative research?: a review of qualitative interviews in IS research. J Comput Inf Syst. 2013;54(1):11–22. https://doi.org/10.1080/08874417.2013.11645667.CrossRef

33.

Morse JM. Critical analysis of strategies for determining rigor in qualitative inquiry. Qualitative health research. Qual Health Res 2015;25(9):1212–1222. DOI: https://doi.org/10.1177/1049732315588501.

34.

Morse JM. Determining sample size. Thousand Oaks, CA: Sage Publications Sage CA; 2000.

35.

Burnard P, Gill P, Stewart K, Treasure E, Chadwick B. Analysing and presenting qualitative data. Br Dent J. 2008;204(8):429–32 https://www.nature.com/articles/sj.bdj.2008.292.CrossRef

36.

Grove SK, Burns N, Gray JR. Understanding nursing research: building an evidence-based practice: Elsevier Health Sciences; 2014.

37.

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101. https://doi.org/10.1191/1478088706qp063oa.CrossRef

38.

Erlandsson K, Häggström-Nordin E. Prenatal parental education from the perspective of fathers with experience as primary caregiver immediately following birth: a phenomenographic study. The J J Perinat Educ. 2010;19(1):19–28. https://doi.org/10.1624/105812410X481537.CrossRef

39.

Malata A. Development of childbirth education for Malawian women 2004.

40.

Yidana A, Ziblim S-D, Yamusah B. Male partner involvement in birth preparedness and utilization of antenatal care services: a study in the West Mamprusi municipality of northern Ghana. World J Public Health. 2018;3(3):69. https://doi.org/10.11648/j.wjph.20180303.11.CrossRef

41.

August F, Pembe AB, Mpembeni R, Axemo P, Darj E. Men’s knowledge of obstetric danger signs, birth preparedness and complication readiness in rural Tanzania. PLoS One. 2015;10(5):e0125978. https://doi.org/10.1371/journal.pone.0125978.CrossRefPubMedPubMedCentral

42.

Lori JR, Dahlem CHY, Ackah JV, Adanu RMK. Examining antenatal health literacy in Ghana. Journal of nursing Scholaship. J Nurs Scholarsh. 2014;46(6):432–40. https://doi.org/10.1111/jnu.CrossRefPubMedPubMedCentral

43.

Weldearegay HG. Determinant factors of male involvement in birth preparedness and complication readiness at Mekelle town; a community based study. Sci J Public Health. 2015;3(2):175–80. https://doi.org/10.11648/j.sjph.20150302.14.CrossRef

44.

Tadesse M, Boltena AT, Asamoah BO. Husbands' participation in birth preparedness and complication readiness and associated factors in Wolaita Sodo town, southern Ethiopia. Afr j prim health care fam med. 2018;10(1):1–8. https://doi.org/10.4102/phcfm.v10i1.1471.CrossRef

45.

Tobin EA, Ofili AN, Enebeli N, Enueze O. Assessment of birth preparedness and complication readiness among pregnant women attending primary health care Centres in Edo state, Nigeria. Ann Niger Med. 2014;8(2):76. https://doi.org/10.4103/0331-3131.153358.CrossRef

46.

Kaye DK, Kakaire O, Nakimuli A, Osinde MO, Mbalinda SN, Kakande N. Male involvement during pregnancy and childbirth: men's perceptions, practices and experiences during the care for women who developed childbirth complications in Mulago hospital, Uganda. BMC Pregnancy Childbirth. 2014;14:54. https://doi.org/10.1186/1471-2393-14-54.CrossRefPubMedPubMedCentral

47.

Davis J, Vyankandondera J, Luchters S, Simon D, Holmes W. Male involvement in reproductive, maternal and child health: a qualitative study of policymaker and practitioner perspectives in the Pacific. Reprod Health. 2016;13(1):81. https://doi.org/10.1186/s12978-016-0184-2.CrossRefPubMedPubMedCentral

48.

Brown A, Davies R. Fathers' experiences of supporting breastfeeding: challenges for breastfeeding promotion and education. Matern Child Nutr. 2014;10(4):510–26.CrossRef

49.

Duggan R, Adejumo O. Adolescent clients’ perceptions of maternity care in KwaZulu-Natal, South Africa. Women Birth. 2012;25(4):e62–e7. https://doi.org/10.1016/j.wombi.2011.10.004.CrossRefPubMed

50.

Opondo C, Redshaw M, Savage-McGlynn E, Quigley MA. Father involvement in early child-rearing and behavioural outcomes in their pre-adolescent children: evidence from the ALSPAC UK birth cohort. BMJ Open. 2016;6(11):e012034. https://doi.org/10.1136/bmjopen-2016-012034.CrossRefPubMedPubMedCentral

51.

Mohlahla BKF, Gregson S, Boily MC. Barriers to involvement of men in ANC and VCT in Khayelitsha, South Africa. AIDS care. 2012;24:972–7. https://doi.org/10.1080/09540121.2012.668166.CrossRef

52.

Mphonda SM, Rosenberg NE, Kamanga E, Mofolo I, Mwale G, Boa E, et al. Assessment of peer-based and structural strategies for increasing male participation in an antenatal setting in Lilongwe. Malawi Afr J Reprod Health. 2014;18(2):97–104 https://www.ajol.info/index.php/ajrh/article/view/104429.PubMed

53.

Nyondo AL, Chimwaza AF, Muula AS. Exploring the relevance of male involvement in the prevention of mother to child transmission of HIV services in Blantyre. Malawi BMC Int Health Hum Rights. 2014;14(30). https://doi.org/10.1186/s12914-014-0030-y.

54.

Pauleta JR, Pereira NM, Graça LM. Sexuality during pregnancy. Sex Med. 2010;7:136–42. https://doi.org/10.1111/j.1743-6109.2009.01538.CrossRef

55.

Polomeno V. Marriage in the transition to parenthood: how can perinatal education help? Or can it? Int J Childbirth Edu. 2007;22(2). https://www.thefreelibrary.com.

56.

Polomeno V. The teaching of conjugal vulnerability during the transition to parenthood. Int J Childbirth Educ. 2014;29(1). https://www.thefreelibrary.com.

57.

Nyondo AL, Chimwaza AF, Muula AS. Stakeholders’ perceptions on factors influencing male involvement in prevention of mother to child transmission of HIV services in Blantyre. Malawi BMC Public Health. 2014;14(1):691. https://doi.org/10.1186/1471-2458-14-691.CrossRefPubMed

58.

Larsson EC, Thorson A, Nsabagasani X, Namusoko S, Popenoe R, Ekström AM. Mistrust in marriage-reasons why men do not accept couple HIV testing during antenatal care-a qualitative study in eastern Uganda. BMC Public Health. 2010;10(1):769. https://doi.org/10.1186/1471-2458-10-769.CrossRefPubMedPubMedCentral

59.

Olawole-Isaac A, Oni G, Oladosun M, Muyiwa A. Gender-based violence and pregnancy outcomes among couples and cohabiting Partners in Nigeria. 2016. URI: http://eprints.covenantuniversity.edu.ng/id/eprint/6636

60.

Turan JM, Nalbant H, Bulut A, Sahip Y. Including expectant fathers in antenatal education programmes in Istanbul, Turkey. Reprod Health Matters. 2001;9(18):114–25. https://doi.org/10.1016/S0968-8080(01)90098-9.CrossRefPubMed

61.

Svensson J, Barclay L, Cooke M. The concerns and interests of expectant and new parents: assessing learning needs. J Perinat Educ. 2006;15(4):18–27. https://doi.org/10.1624/105812406X151385.CrossRefPubMedPubMedCentral

62.

Bäckström C, Hertfelt Wahn E. Support during labour: first-time fathers’ descriptions of requested and received support during the birth of their child. Midwifery. 2011;27(1):67–73. https://doi.org/10.1016/j.midw.2009.07.001.CrossRefPubMed

63.

Kululanga LI, Malata A, Chirwa E, Sundby J. Malawian fathers' views and experiences of attending the birth of their children: a qualitative study. BMC Pregnancy Childbirth. 2012;12:141. https://doi.org/10.1186/1471-2393-12-141.CrossRefPubMedPubMedCentral

64.

Naim M, Bhutto E. Sexuality during pregnancy in Pakistani women. J Pak Med Assoc. 2000;50(1):38–43 http://www.jpma.org.pk/PdfDownload/2898.pdf.PubMed

65.

Williamson M, McVeigh C, Baafi M. An Australian perspective of fatherhood and sexuality. Midwifery. 2008;24(1):99–107. https://doi.org/10.1016/j.midw.2006.07.010.CrossRefPubMed

66.

Malawi Government. Sexual Reproductive Health and Right Policy. Lilongwe, Malawi 2011.

67.

Redshaw M, Henderson J. Fathers’ engagement in pregnancy and childbirth: evidence from a national survey. BMC Pregnancy Childbirth. 2013;13(1):70. https://doi.org/10.1186/1471-2393-13-70.CrossRefPubMedPubMedCentral

68.

Simbar M, Nahidi F, Tehrani R, Akbarzadeh A. Educational needs assessment for men's participation in perinatal care. East Mediterr Health J. 2011;17:689–96.CrossRef

69.

Soliman M. Impact of antenatal counselling on couples' knowledge and practice of contraception in Mansoura, Egypt. 1999. http://www.who.int/iris/handle/10665/118791

70.

Kabagenyi A, Jennings L, Reid A, Nalwadda G, Ntozi J, Atuyambe L. Barriers to male involvement in contraceptive uptake and reproductive health services: a qualitative study of men and women’s perceptions in two rural districts in Uganda. Reprod Health. 2014;11(1):21. https://doi.org/10.1186/1742-4755-11-21.CrossRefPubMedPubMedCentral

71.

Noronha JA, Bhaduri A, Bhat HV, Kamath A. Interventional study to strengthen the health promoting behaviours of pregnant women to prevent anaemia in southern India. Midwifery. 2013;29(7):e35–41. https://doi.org/10.1016/j.midw.2012.07.014.CrossRefPubMed

Title: Exploring antenatal education content for couples in Blantyre, Malawi
Authors: Maria Chifuniro Chikalipo
Ellen Mbweza Chirwa
Adamson Sinjani Muula
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-018-2137-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Exploring antenatal education content for couples in Blantyre, Malawi

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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