Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2018

Open Access 01-12-2018 | Research article

A qualitative analysis of men’s involvement in maternal and child health as a policy intervention in rural Central Malawi

Authors: Elizabeth Mkandawire, Sheryl L. Hendriks

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

Login to get access

Abstract

Background

Men’s involvement in maternal and child health presents an opportunity for the advancement of maternal and child nutrition as men often play a key role in decision-making particularly regarding women’s reproductive health. While most research on men’s involvement in maternal and child health has focused on men’s participation in antenatal care, this study focuses specifically on men’s involvement in maternal and child nutrition. The purpose of the study is to explore how men’s involvement is conceptualised in rural Central Malawi, highlighting the key factors influencing men’s involvement in maternal and child health.

Methods

Focus group discussions and in-depth interviews were conducted with 26 informants and 44 community members. Critical policy was used as the theoretical framework to inform the analysis of research findings.

Results

In this study, we identified several factors that facilitate men’s involvement in maternal and child health, but we also identified several barriers. Facilitators of men’s involvement included: recognition by men of the impact of their involvement, pride, advocacy, incentives and disincentives and male champions. Barriers included socio-cultural beliefs, stigmatisation and opportunity costs. The study also found that there were several limitations that had unintended consequences on desired programme outcomes. These included: discriminating against women, marginalisation of married women and reinforcing men’s decision-making roles.

Conclusion

The study findings highlight the importance of involving men in maternal and child health for improved nutrition outcomes. We emphasise the need for nutrition policy-makers to be aware that gender dynamics are changing. It is no longer just women who are involved in nutrition activities, therefore policy-makers need to revise their approach to ensure that they consider men’s role in nutrition.
Footnotes
1
In rural communities in Malawi, it is common for people to be superstitious about certain behaviours that appear uncommon. As such, people often make the assumption that when a man is engaging in work that is typically considered women’s responsibility, he has either been bewitched or has been given some potion to change his behaviour.
 
2
Tameki is the brand name of a rat poison in Malawi
 
Literature
3.
go back to reference Yeboah T, Serbeh R, Ommission BP. Of men from gender-development theory and praxis: a pathway for addressing the plights of women? J Soc Sci. 2015;11:7–19. Yeboah T, Serbeh R, Ommission BP. Of men from gender-development theory and praxis: a pathway for addressing the plights of women? J Soc Sci. 2015;11:7–19.
4.
go back to reference Ganle JK, Dery I. ‘What men don’t know can hurt women’s health’: a qualitative study of the barriers to and opportunities for men’s involvement in maternal healthcare in Ghana. BMC Reprod Health. 2015;12:93.CrossRef Ganle JK, Dery I. ‘What men don’t know can hurt women’s health’: a qualitative study of the barriers to and opportunities for men’s involvement in maternal healthcare in Ghana. BMC Reprod Health. 2015;12:93.CrossRef
5.
go back to reference Yargawa J, Leonard-Bee J. Male involvement and maternal health outcomes: systematic review and meta-analysis. J of Epidemiology and Community Health. 2015;0:1–9. Yargawa J, Leonard-Bee J. Male involvement and maternal health outcomes: systematic review and meta-analysis. J of Epidemiology and Community Health. 2015;0:1–9.
6.
go back to reference UN. Beijing Declaration and Platform for Action. New York: United Nations. p. 1995. UN. Beijing Declaration and Platform for Action. New York: United Nations. p. 1995.
7.
go back to reference FAO, WHO. Rome declaration on nutrition. Rome: Food and Agriculture Organisation; 2014. FAO, WHO. Rome declaration on nutrition. Rome: Food and Agriculture Organisation; 2014.
8.
go back to reference Greene EM, Mehta M, Pulerwitz J, Wulf D, Bankole A, Singh S. Involving men in reproductive health: contributions to development. Washington: UN Millennium Project; 2006. Greene EM, Mehta M, Pulerwitz J, Wulf D, Bankole A, Singh S. Involving men in reproductive health: contributions to development. Washington: UN Millennium Project; 2006.
9.
go back to reference Kululanga LI, Sundby J, Malata M, Chirwa E. Striving to promote male involvement in maternal health care in rural and urban settings in Malawi – a qualitative study. BMC Reprod Health. 2011;8:1–12.CrossRef Kululanga LI, Sundby J, Malata M, Chirwa E. Striving to promote male involvement in maternal health care in rural and urban settings in Malawi – a qualitative study. BMC Reprod Health. 2011;8:1–12.CrossRef
10.
go back to reference Aarnio P, Olsson P, Chimbiri A, Kulmala T. Male involvement in antenatal HIV counseling and testing: exploring men’s perceptions in rural Malawi. AIDS Care. 2009;21:1537–46.CrossRefPubMed Aarnio P, Olsson P, Chimbiri A, Kulmala T. Male involvement in antenatal HIV counseling and testing: exploring men’s perceptions in rural Malawi. AIDS Care. 2009;21:1537–46.CrossRefPubMed
11.
go back to reference Singh D, Lample M, Earnst J. The involvement of men in maternal health care: cross-sectional, pilot case studies from Maligita and Kibbi, Uganda. Reprod Health. 2014;11:1–8.CrossRef Singh D, Lample M, Earnst J. The involvement of men in maternal health care: cross-sectional, pilot case studies from Maligita and Kibbi, Uganda. Reprod Health. 2014;11:1–8.CrossRef
12.
go back to reference Ditekemena J, Koole O, Engmann C, Matendo R, Tsehfu A, Ryder R, Colebunders R. Determinants of male involvement in maternal and child health services in sub-Saharan Africa: a review. BMC Reprod Health. 2012;9:1–8.CrossRef Ditekemena J, Koole O, Engmann C, Matendo R, Tsehfu A, Ryder R, Colebunders R. Determinants of male involvement in maternal and child health services in sub-Saharan Africa: a review. BMC Reprod Health. 2012;9:1–8.CrossRef
13.
go back to reference Alio AP, Lewis CA, Scarborough K, Harris K, Fiscella K. A community perspective on the role of fathers during pregnancy: a qualitative study. BMC Pregnancy and Childbirth. 2013;13:1–11.CrossRef Alio AP, Lewis CA, Scarborough K, Harris K, Fiscella K. A community perspective on the role of fathers during pregnancy: a qualitative study. BMC Pregnancy and Childbirth. 2013;13:1–11.CrossRef
14.
go back to reference Mangeni JN, Mwangi A, Mbuga S, Mukthar V. Male involvement in maternal health care as a determinant of utilisation of skilled birth attendants in Kenya. East Afric Med J. 2012;89:1–12. Mangeni JN, Mwangi A, Mbuga S, Mukthar V. Male involvement in maternal health care as a determinant of utilisation of skilled birth attendants in Kenya. East Afric Med J. 2012;89:1–12.
15.
go back to reference Kalembo FW, Zgambo M, Mulaga A, Yukai D, Ahmed NI. Association between male partner involvement and the uptake of prevention of mother-to-child transmission of HIV (PMTCT) interventions in Mwanza District, Malawi: a retrospective cohort study. PLoS One. 2013:e66517. https://doi.org/10.1371/journal.pone.0066517. Kalembo FW, Zgambo M, Mulaga A, Yukai D, Ahmed NI. Association between male partner involvement and the uptake of prevention of mother-to-child transmission of HIV (PMTCT) interventions in Mwanza District, Malawi: a retrospective cohort study. PLoS One. 2013:e66517. https://​doi.​org/​10.​1371/​journal.​pone.​0066517.
16.
go back to reference Susin LRO, Giugliani ERJ. Inclusion of fathers in an intervention to promote breastfeeding: impact on breastfeeding rates. J Hum Lact. 2008;24:386–92.CrossRefPubMed Susin LRO, Giugliani ERJ. Inclusion of fathers in an intervention to promote breastfeeding: impact on breastfeeding rates. J Hum Lact. 2008;24:386–92.CrossRefPubMed
18.
go back to reference Osman JR, Unkels R, Aliyu U, Musa HA, A and E, ADPA, FWACN, Matthew, OK. Barriers to male involvement in uptake of prevention of mother-to-child-transmission (PMTCT) of HIV in Sub-Saharan Africa. J of Nursing and Health Services. 2015;3:1. Osman JR, Unkels R, Aliyu U, Musa HA, A and E, ADPA, FWACN, Matthew, OK. Barriers to male involvement in uptake of prevention of mother-to-child-transmission (PMTCT) of HIV in Sub-Saharan Africa. J of Nursing and Health Services. 2015;3:1.
19.
go back to reference Audet CM, Chire YM, Vas LME, Bechtel R, Carlson Bremer D, Wester W, Amico KR, Gonzalez-Calvo L. Barriers to male involvement in antenatal care in rural Mozambique. Qual Health Res. 2015:1–11. Audet CM, Chire YM, Vas LME, Bechtel R, Carlson Bremer D, Wester W, Amico KR, Gonzalez-Calvo L. Barriers to male involvement in antenatal care in rural Mozambique. Qual Health Res. 2015:1–11.
20.
go back to reference BKF M, Gregson S, Barriers BM. To men’s involvement in ANC and VCT in Khayelitsha South Africa. AIDS Care. 2012;2:927–77. BKF M, Gregson S, Barriers BM. To men’s involvement in ANC and VCT in Khayelitsha South Africa. AIDS Care. 2012;2:927–77.
21.
go back to reference NSO, ICF Macro. Malawi demographic and health survey 2010. Zomba, Malawi: national statistics office; Calverton: ICF Macro. p. 2010. NSO, ICF Macro. Malawi demographic and health survey 2010. Zomba, Malawi: national statistics office; Calverton: ICF Macro. p. 2010.
22.
go back to reference Mseu D, Nyasulu BM, Muheriwa SR. Evaluation of a safe motherhood project in Ntcheu district, Malawi. Int J of Women’s Health. 2014;6:1045–55.CrossRef Mseu D, Nyasulu BM, Muheriwa SR. Evaluation of a safe motherhood project in Ntcheu district, Malawi. Int J of Women’s Health. 2014;6:1045–55.CrossRef
25.
go back to reference NSO, Macro. Malawi Demographic and Health Survey 2016. Zomba, Malawi: national statistics office; Calverton: ICF Macro; 2016. NSO, Macro. Malawi Demographic and Health Survey 2016. Zomba, Malawi: national statistics office; Calverton: ICF Macro; 2016.
26.
go back to reference Chirwa WC. A review by Afrimap and the open society for southern Africa. Johannesburg: Open Society Initiative; 2014. Chirwa WC. A review by Afrimap and the open society for southern Africa. Johannesburg: Open Society Initiative; 2014.
29.
go back to reference GoM. Malawi’s third integrated household survey. Lilongwe: Government of Malawi; 2012. GoM. Malawi’s third integrated household survey. Lilongwe: Government of Malawi; 2012.
30.
go back to reference Ewing VL, Lalloo DG, Phiri KS, Roca-Feltrer A, Mangham LJ, Sanjoaquin NA. Seasonal and geographical differences in treatment-seeking and household costs of febrile illness among children in Malawi. Malaria J. 2011;10:1–8.CrossRef Ewing VL, Lalloo DG, Phiri KS, Roca-Feltrer A, Mangham LJ, Sanjoaquin NA. Seasonal and geographical differences in treatment-seeking and household costs of febrile illness among children in Malawi. Malaria J. 2011;10:1–8.CrossRef
32.
go back to reference Liamputtong P. Focus group methodology: principle and practice. London: Sage Publicationsn Ltd; 2011.CrossRef Liamputtong P. Focus group methodology: principle and practice. London: Sage Publicationsn Ltd; 2011.CrossRef
33.
34.
go back to reference August F, Pembe AB, Mpembeni R, Axemo P, Darj E. Community health workers can improve male involvement in maternal and child health: evidence from rural Tanzania. Glob Health Action. 2016;9 August F, Pembe AB, Mpembeni R, Axemo P, Darj E. Community health workers can improve male involvement in maternal and child health: evidence from rural Tanzania. Glob Health Action. 2016;9
35.
go back to reference GoM. Constitution of the Republic of Malawi. Lilongwe, Malawi: Government of Malawi; 1994. GoM. Constitution of the Republic of Malawi. Lilongwe, Malawi: Government of Malawi; 1994.
Metadata
Title
A qualitative analysis of men’s involvement in maternal and child health as a policy intervention in rural Central Malawi
Authors
Elizabeth Mkandawire
Sheryl L. Hendriks
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/s12884-018-1669-5

Other articles of this Issue 1/2018

BMC Pregnancy and Childbirth 1/2018 Go to the issue