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Published in: Reproductive Health 1/2011

Open Access 01-12-2011 | Research

Striving to promote male involvement in maternal health care in rural and urban settings in Malawi - a qualitative study

Authors: Lucy I Kululanga, Johanne Sundby, Address Malata, Ellen Chirwa

Published in: Reproductive Health | Issue 1/2011

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Abstract

Background

Understanding the strategies that health care providers employ in order to invite men to participate in maternal health care is very vital especially in today's dynamic cultural environment. Effective utilization of such strategies is dependent on uncovering the salient issues that facilitate male participation in maternal health care. This paper examines and describes the strategies that were used by different health care facilities to invite husbands to participate in maternal health care in rural and urban settings of southern Malawi.

Methods

The data was collected through in-depth interviews from sixteen of the twenty health care providers from five different health facilities in rural and urban settings of Malawi. The health facilities comprised two health centres, one district hospital, one mission hospital, one private hospital and one central hospital. A semi-structured interview guide was used to collect data from health care providers with the aim of understanding strategies they used to invite men to participate in maternal health care.

Results

Four main strategies were used to invite men to participate in maternal health care. The strategies were; health care provider initiative, partner notification, couple initiative and community mobilization. The health care provider initiative and partner notification were at health facility level, while the couple initiative was at family level and community mobilization was at village (community) level. The community mobilization had three sub-themes namely; male peer initiative, use of incentives and community sensitization. The sustainability of each strategy to significantly influence behaviour change for male participation in maternal health care is discussed.

Conclusion

Strategies to invite men to participate in maternal health care were at health facility, family and community levels. The couple strategy was most appropriate but was mostly used by educated and city residents. The male peer strategy was effective and sustainable at community level. There is need for creation of awareness in men so that they sustain their participation in maternal health care activities of their female partners even in the absence of incentives, coercion or invitation.
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Literature
1.
go back to reference Kinanee JB, Ezekiel-Hart J: Men as partners in maternal health: Implications for reproductive health counselling in Rivers State, Nigeria. Journal of Psychology and Counseling. 2009, 1: 039-044. Kinanee JB, Ezekiel-Hart J: Men as partners in maternal health: Implications for reproductive health counselling in Rivers State, Nigeria. Journal of Psychology and Counseling. 2009, 1: 039-044.
2.
go back to reference Iliyasu Z, Abubakar IS, Galadanci HS, Aliyu MH: Birth Preparedness, Complication Readiness and Fathers' Participation in Maternity Care in a Northern Nigerian Community. African Journal of Reproductive Health. 2010, 14: 21-32.PubMed Iliyasu Z, Abubakar IS, Galadanci HS, Aliyu MH: Birth Preparedness, Complication Readiness and Fathers' Participation in Maternity Care in a Northern Nigerian Community. African Journal of Reproductive Health. 2010, 14: 21-32.PubMed
3.
go back to reference Mumtaz Z, Salway S: Understanding gendered influences on women's reproductive health in Pakistan: moving beyond the autonomy paradigm. Soc Sci Med. 2009, 68: 1349-1356. 10.1016/j.socscimed.2009.01.025.CrossRefPubMed Mumtaz Z, Salway S: Understanding gendered influences on women's reproductive health in Pakistan: moving beyond the autonomy paradigm. Soc Sci Med. 2009, 68: 1349-1356. 10.1016/j.socscimed.2009.01.025.CrossRefPubMed
4.
go back to reference Dudgeon MR, Inhorn MC: Men's influences on women's reproductive health: medical anthropological perspectives. Soc Sci Med. 2004, 59: 1379-1395. 10.1016/j.socscimed.2003.11.035.CrossRefPubMed Dudgeon MR, Inhorn MC: Men's influences on women's reproductive health: medical anthropological perspectives. Soc Sci Med. 2004, 59: 1379-1395. 10.1016/j.socscimed.2003.11.035.CrossRefPubMed
5.
go back to reference Speizer IS, Whittle L, Carter M: Gender relations and reproductive decision making in Honduras. Int Fam Plan Perspect. 2005, 31: 131-139. 10.1363/3113105.CrossRefPubMed Speizer IS, Whittle L, Carter M: Gender relations and reproductive decision making in Honduras. Int Fam Plan Perspect. 2005, 31: 131-139. 10.1363/3113105.CrossRefPubMed
6.
go back to reference Bloom SS, Tsui AO, Plotkin M, Bassett S: What husbands in Northern India know about reproductive health: Correlates of knowledge about pregnancy and maternal and sexual health. Journal of Biosocial Science. 2000, 32: 237-251. 10.1017/S0021932000002376.CrossRefPubMed Bloom SS, Tsui AO, Plotkin M, Bassett S: What husbands in Northern India know about reproductive health: Correlates of knowledge about pregnancy and maternal and sexual health. Journal of Biosocial Science. 2000, 32: 237-251. 10.1017/S0021932000002376.CrossRefPubMed
7.
go back to reference Carter M: Husbands and maternal health matters in rural Guatemala: Wives' reports on their spouses' involvement in pregnancy and birth. Social Science and Medicine. 2002, 55: 437-450. 10.1016/S0277-9536(01)00175-7.CrossRefPubMed Carter M: Husbands and maternal health matters in rural Guatemala: Wives' reports on their spouses' involvement in pregnancy and birth. Social Science and Medicine. 2002, 55: 437-450. 10.1016/S0277-9536(01)00175-7.CrossRefPubMed
8.
go back to reference Roth DM, Mbizvo MT: Promoting safe motherhood in the community: the case for strategies that include men. African Journal of Reproductive Health. 2001, 5: 10-21. 10.2307/3583426.CrossRefPubMed Roth DM, Mbizvo MT: Promoting safe motherhood in the community: the case for strategies that include men. African Journal of Reproductive Health. 2001, 5: 10-21. 10.2307/3583426.CrossRefPubMed
9.
go back to reference Kunene B, Beksinska M, Zondi S, Mthembu N, Mullick S, Ottolenghi E: Involving Men in Maternity Care: South Africa. 2004, Durban, South Africa, Reproductive Health Research Unit in Durban, Department of Obstetrics and Gynecology, University of the Witwatersrand Kunene B, Beksinska M, Zondi S, Mthembu N, Mullick S, Ottolenghi E: Involving Men in Maternity Care: South Africa. 2004, Durban, South Africa, Reproductive Health Research Unit in Durban, Department of Obstetrics and Gynecology, University of the Witwatersrand
10.
go back to reference Mullany BC, Lakhey B, Shrestha D, Hindin MJ, Becker S: Impact of husbands' participation in antenatal health education services on maternal health knowledge. J Nepal Med Assoc. 2009, 48: 28-34. Mullany BC, Lakhey B, Shrestha D, Hindin MJ, Becker S: Impact of husbands' participation in antenatal health education services on maternal health knowledge. J Nepal Med Assoc. 2009, 48: 28-34.
11.
go back to reference Toubia N: Doing more with less: The Marie Stopes clinics in Sierra leone. 1995, New York, Population Council, Quality/calidad/Qualite No. 7 Toubia N: Doing more with less: The Marie Stopes clinics in Sierra leone. 1995, New York, Population Council, Quality/calidad/Qualite No. 7
12.
go back to reference Varkey LC, Mishra A, Das A, Ottelenghi E, Huntington D, Adamchak S: Involving men in maternity care in India. 2004, Washington, DC, Population Council Varkey LC, Mishra A, Das A, Ottelenghi E, Huntington D, Adamchak S: Involving men in maternity care in India. 2004, Washington, DC, Population Council
13.
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: Psychological and Socio-medical Aspects of AIDS/HIV. 2009, 21: 1537-1546.CrossRef 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: Psychological and Socio-medical Aspects of AIDS/HIV. 2009, 21: 1537-1546.CrossRef
14.
go back to reference Farquhar C, Kiarie JN, Richardson BA, Kabura MN, John FN, Nduati RW: Antenatal Couple Counseling Increases Uptake of Interventions to Prevent HIV-1 Transmission. Journal of Acquired Immune Deficiency Syndromes. 2004, 37 (5): 1620-1626. 10.1097/00126334-200412150-00016.CrossRefPubMedPubMedCentral Farquhar C, Kiarie JN, Richardson BA, Kabura MN, John FN, Nduati RW: Antenatal Couple Counseling Increases Uptake of Interventions to Prevent HIV-1 Transmission. Journal of Acquired Immune Deficiency Syndromes. 2004, 37 (5): 1620-1626. 10.1097/00126334-200412150-00016.CrossRefPubMedPubMedCentral
15.
go back to reference Semrau K, Kuhn L, Vwalika C, Kasonde P, Sinkala M, Kankasa C: Women in couples antenatal HIV counseling and testing are not more likely to report adverse social events. AIDS. 2005, 19: 603-609. 10.1097/01.aids.0000163937.07026.a0.CrossRefPubMedPubMedCentral Semrau K, Kuhn L, Vwalika C, Kasonde P, Sinkala M, Kankasa C: Women in couples antenatal HIV counseling and testing are not more likely to report adverse social events. AIDS. 2005, 19: 603-609. 10.1097/01.aids.0000163937.07026.a0.CrossRefPubMedPubMedCentral
16.
go back to reference Dahlgren L, Emmelin M, Winkvist A: Qualitative Methodology for International Public Health. 2004, Umeå: Umeå University Publication Dahlgren L, Emmelin M, Winkvist A: Qualitative Methodology for International Public Health. 2004, Umeå: Umeå University Publication
17.
go back to reference Ministry of Health: National Sexual and Reproductive Health and Rights Policy. 2009, Lilongwe, Malawi, Ministry of Health, Reproductive Health Unit, 1-42. Ministry of Health: National Sexual and Reproductive Health and Rights Policy. 2009, Lilongwe, Malawi, Ministry of Health, Reproductive Health Unit, 1-42.
18.
go back to reference Bowen GA: Naturalistic inquiry and the saturation concept: a research note. Qualitative Research. 2008, 8: 137-152. 10.1177/1468794107085301.CrossRef Bowen GA: Naturalistic inquiry and the saturation concept: a research note. Qualitative Research. 2008, 8: 137-152. 10.1177/1468794107085301.CrossRef
19.
go back to reference Graneheim UH, Lundman B: Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse education today. 2004, 24 (2): 105-112. 10.1016/j.nedt.2003.10.001.CrossRefPubMed Graneheim UH, Lundman B: Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse education today. 2004, 24 (2): 105-112. 10.1016/j.nedt.2003.10.001.CrossRefPubMed
20.
go back to reference Kabeer N: Gender Equality and Women's Empowerment: A Critical Analysis of the Third Millennium Development Goal. Gender and Development. 2005, 13: 13-24. 10.1080/13552070512331332273.CrossRef Kabeer N: Gender Equality and Women's Empowerment: A Critical Analysis of the Third Millennium Development Goal. Gender and Development. 2005, 13: 13-24. 10.1080/13552070512331332273.CrossRef
21.
go back to reference Seljeskog L, Sundby J, Chimango J: Factors Influencing Women's Choice of Place of Delivery in Rural Malawi - An explorative study. African Journal of Reproductive Health. 2006, 10: 66-75. 10.2307/30032472.CrossRefPubMed Seljeskog L, Sundby J, Chimango J: Factors Influencing Women's Choice of Place of Delivery in Rural Malawi - An explorative study. African Journal of Reproductive Health. 2006, 10: 66-75. 10.2307/30032472.CrossRefPubMed
22.
go back to reference Theuring S, Mbezi P, Luvanda H, Jordan-Harder B, Kunz A, Harms G: Male Involvement in PMTCT Services in Mbeya Region, Tanzania. AIDS and Behavior. 2009, 13: 92-102. 10.1007/s10461-009-9543-0.CrossRefPubMed Theuring S, Mbezi P, Luvanda H, Jordan-Harder B, Kunz A, Harms G: Male Involvement in PMTCT Services in Mbeya Region, Tanzania. AIDS and Behavior. 2009, 13: 92-102. 10.1007/s10461-009-9543-0.CrossRefPubMed
23.
go back to reference Taulo F: Centre for Reproductive Health, 2nd Reproductive Health Conference, Lilongwe, Malawi. Malawi Medical Journal. 2010, 22: 2-4.PubMedPubMedCentral Taulo F: Centre for Reproductive Health, 2nd Reproductive Health Conference, Lilongwe, Malawi. Malawi Medical Journal. 2010, 22: 2-4.PubMedPubMedCentral
24.
go back to reference Moyo W, Chirenje Z, Mandel J, Schwarcz SK, Klausner JD, Rutherford G: Impact of a single session of counseling on partner referral for sexually transmitted disease treatment, Harare, Zimbabwe. AIDS and Behaviour. 2002, 6: 237-243. 10.1023/A:1019891808383.CrossRef Moyo W, Chirenje Z, Mandel J, Schwarcz SK, Klausner JD, Rutherford G: Impact of a single session of counseling on partner referral for sexually transmitted disease treatment, Harare, Zimbabwe. AIDS and Behaviour. 2002, 6: 237-243. 10.1023/A:1019891808383.CrossRef
25.
go back to reference Nuwaha F, Kambugu F, Nsubuga PS, Hojer B, Faxelid E: Efficacy of patient-delivered partner medication in the treatment of sexual partners in Uganda. Sex Transm Dis. 2001, 28: 105-110. 10.1097/00007435-200102000-00008.CrossRefPubMed Nuwaha F, Kambugu F, Nsubuga PS, Hojer B, Faxelid E: Efficacy of patient-delivered partner medication in the treatment of sexual partners in Uganda. Sex Transm Dis. 2001, 28: 105-110. 10.1097/00007435-200102000-00008.CrossRefPubMed
26.
go back to reference Homsy J, Kalamya JN, Obonyo J, Ojwang J, Mugumya R, Opio C: Routine intrapartum HIV counseling and testing for prevention of mother-to-child transmission of HIV in a rural Ugandan hospital. J Acquir Immune Defic Syndr. 2006, 42: 149-154. 10.1097/01.qai.0000225032.52766.c2.CrossRefPubMed Homsy J, Kalamya JN, Obonyo J, Ojwang J, Mugumya R, Opio C: Routine intrapartum HIV counseling and testing for prevention of mother-to-child transmission of HIV in a rural Ugandan hospital. J Acquir Immune Defic Syndr. 2006, 42: 149-154. 10.1097/01.qai.0000225032.52766.c2.CrossRefPubMed
27.
go back to reference Semrau K, Kuhn L, Vwalika C, Kasonde P, Sinkala M, Kankasa C: Women in couples antenatal HIV counseling and testing are not more likely to report adverse social events. AIDS. 2005, 19: 603-609. 10.1097/01.aids.0000163937.07026.a0.CrossRefPubMedPubMedCentral Semrau K, Kuhn L, Vwalika C, Kasonde P, Sinkala M, Kankasa C: Women in couples antenatal HIV counseling and testing are not more likely to report adverse social events. AIDS. 2005, 19: 603-609. 10.1097/01.aids.0000163937.07026.a0.CrossRefPubMedPubMedCentral
28.
go back to reference Elizabeth Glaser Pediatric AIDS Foundation: Strategies for Integrating Psychosocial Support Interventions into HIV Prevention, Care, and Treatment Services. Psychosocial Support Issue Brief. 2010, 1-8. Accessed on 28-6-2011, [http://www.pedaids.org] Elizabeth Glaser Pediatric AIDS Foundation: Strategies for Integrating Psychosocial Support Interventions into HIV Prevention, Care, and Treatment Services. Psychosocial Support Issue Brief. 2010, 1-8. Accessed on 28-6-2011, [http://​www.​pedaids.​org]
29.
go back to reference Turan JM, Nalbant H, Bulut A, Sahip Y: Including expectant fathers in antenatal education programmes in Istanbul, Turkey. Reproductive Health Matters. 2001, 9: 114-125. 10.1016/S0968-8080(01)90098-9.CrossRefPubMed Turan JM, Nalbant H, Bulut A, Sahip Y: Including expectant fathers in antenatal education programmes in Istanbul, Turkey. Reproductive Health Matters. 2001, 9: 114-125. 10.1016/S0968-8080(01)90098-9.CrossRefPubMed
30.
go back to reference Feyisetan BJ: Spousal communication and contraceptive use among the Yoruba of Nigeria. Population Research and Policy Review. 2000, 19: 29-45. 10.1023/A:1006388011947.CrossRef Feyisetan BJ: Spousal communication and contraceptive use among the Yoruba of Nigeria. Population Research and Policy Review. 2000, 19: 29-45. 10.1023/A:1006388011947.CrossRef
32.
go back to reference Onyango MA, Owoko S, Oguttu M: Factors that Influence Male Involvement in Sexual and Reproductive Health in Western Kenya: A Qualitative Study. African Journal of Reproductive Health. 2010, 14: 33-43. Onyango MA, Owoko S, Oguttu M: Factors that Influence Male Involvement in Sexual and Reproductive Health in Western Kenya: A Qualitative Study. African Journal of Reproductive Health. 2010, 14: 33-43.
35.
go back to reference Muula AS: What can Mchinji and Ntcheu districts in Malawi tell maternal health pundits globally?. Croat Med J. 2010, 51: 89-90. 10.3325/cmj.2009.51.89.CrossRefPubMedPubMedCentral Muula AS: What can Mchinji and Ntcheu districts in Malawi tell maternal health pundits globally?. Croat Med J. 2010, 51: 89-90. 10.3325/cmj.2009.51.89.CrossRefPubMedPubMedCentral
36.
go back to reference Brown WJ, Singhal A: Entertainment-Education Media Strategies for Socila Change: Promises and Problems. Mass Media Social Control and Social. 1999, Amea, Iowa: Iowa State University Press, 263-280. Ed.L edition Brown WJ, Singhal A: Entertainment-Education Media Strategies for Socila Change: Promises and Problems. Mass Media Social Control and Social. 1999, Amea, Iowa: Iowa State University Press, 263-280. Ed.L edition
Metadata
Title
Striving to promote male involvement in maternal health care in rural and urban settings in Malawi - a qualitative study
Authors
Lucy I Kululanga
Johanne Sundby
Address Malata
Ellen Chirwa
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2011
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/1742-4755-8-36

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