FACTORS INFLUENCING MALE INVOLVEMENT IN SAFE MOTHERHOOD AMONG COMMUNITIES IN KWALE AND KILIFI IN COASTAL KENYA
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Keywords:
Safe Motherhood Practices, Male Involvement and Social Demographic FactorsSafe Motherhood Practices, Male Involvement and Social Demographic FactorsAbstract
Purpose: The main purpose of the study was to determine the factors influencing male involvement in safe motherhood among communities of Kwale and Kilifi Counties of Coastal Kenya.
Materials and methods: The study was descriptive cross sectional design. The study focused on women of child-bearing age 15 – 49 and men aged 15 – 54 from Kilifi and Kwale counties in 14 health facilities. Qualitative and quantitative methods of data collection were used. Interviewer-administered questionnaire were administered to women who were attending ANC. Data was also collected using semi-structured interviews with health service providers, community leaders and county directors. Focus group discussions were conducted using FGD guide with four women and men groups. Analysis was done using SPSS and NVivo softwares.
Results: The findings of the study revealed that Men and women interviewed in the two rural counties believed safe motherhood practices especially in pregnancy and childbirth are a preserve of women. Illiteracy, sociocultural factors, weak health systems and economic factors were found to be the major barriers to male involvement. Traditional gender roles defined the involvement of men mostly perceived to be provision of funds for transport and food.
Unique Contribution to Theory, Practice and Policy: This study recommended a defined program that target male involvement strategy. It will involve male champions/men ambassador/agents being supported to go to the Mnazi dens and educate, sensitize and support dialogues with men aged 35 years and below. A targeted alcohol abuse sensitization and education will go a long way. A friendly health system be put in place to accommodate men. Friendlier timing including weekends and late hours, space at the clinics to accommodate men and responsive health workers.
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References
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Allendorf K: Couples' reports of women's autonomy and health‐care use in Nepal. Stud Fam Plann 2007, 38(1):35–46.
Acharya DR, Bell JS, Simkhada P, van Teijlingen ER, Regmi PR: Women’s autonomy in household decision-making: a demographic study in Nepal. Reprod Health 2010, 7–15.
Adamson, P. (2001) Deaf to Screams of Women. United Kingdom. Population Council; UNICEF
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Assessing male spousal engagement with prevention of mother-to-child transmission (pMTCT) programs in western Kenya.Reece M, Hollub A, Nangami M, Lane KAIDS Care. 2010 Jun; 22(6):743-50.
Awasthi S, Nandan D, A.K. Mehrotra, Shankar R: Male participation in maternal care in urban slums of district Agra. Indian J Prev Soc Med 2008, 39 (3& 4):181-183.
AMERICAN ASSOCIATION FOR WORLD HEALTH (AAWH). Invest In the future: Support safe motherhood. Washington, DC, AAWH, 1998. 48 p.
Bloom SS, Gupta MD, Wypij D: Dimensions of women's autonomy and the influence on maternal health care utilization in a North Indian city. Demography 2001, 38(1):67– 78.
Braun, V. and Clarke, V.(2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3: 77-101.
Byamugisha, R., Tumwine, J.K., Semiyaga, N. and Tylleskär, T. (2010). Attitudes to routine HIV counseling and testing, and knowledge about prevention of mother to child transmission of HIV in eastern Uganda: a cross-sectional survey among antenatal attendees. Reprod Health, 10(12): 7-12.
Carter M. Husbands and maternal health matters in rural Guatemala: wives' reports on their spouses' involvement in pregnancy and birth. Soc Sci Med. 2002; 55(3): 437- 50.
Carter, M. W., & Speizer, I. (2005). Salvadoran fathers’ attendance at prenatal care, delivery, and postpartum care. Rev Panam Salud Publica, 18 (3), 149-156. http://dx.doi.org/10.1590/S1020-49892005000800001
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De Vaus, D.A. (1993) Surveys in Social Research. (3rd edn.). London, UCL Press
Dutta M, Kapilashrami MC, Tiwari VK. Knowledge, awareness and extent of male participation in key areas of reproductive and child health in an urban slum of Delhi. Health and Population, Perspectives and Issues. 2004; 27(2): 49-66
Dudgeon MR and Inhorn MC, Men’s influences on women’s reproductive health: medical anthropological perspectives, 2004, Social Science & Medicine, Vol. 59, pp. 1379–1395.
Drennan, M. Reproductive health: New perspective on Men participation. Population Reports. Series J, No. 46. Baltimore, John Hopkins University School of Public Health, Population Information Program, October 1998.
Ezeh AC: The Influence of spouses over each other's contraceptive attitudes in Ghana. Stud Fam Plann 1993, 24(3):163–174.
Fekede Asefa, Ayele Geleto, Yadeta Dessie. Male Partners Involvement in Maternal ANC Care: The View of Women Attending ANC in Hararipublic Health Institutions, Eastern Ethiopia. Science Journal of Public Health. Vol. 2, No. 3, 2014, pp. 182-188. doi: 10.11648/j.sjph.20140203.17
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Finlayson K, Downe S (2013) Why Do Women Not Use Antenatal Services in Low- and Middle-Income Countries? A Meta-Synthesis of Qualitative Studies. PLoS Med 10(1): e1001373. doi:10.1371/journal.pmed.1001373
Greene M, Mehta M, Pulerwitz J, Wulf D, MBankole A, Singh S. Involving men in reproductive health: Contributions to development; 2004.
Green, J., Willis, K., Hughes, E., Small, R., Welch, N., Gibbs, L. & Daly, J. (2007) Generating best evidence from qualitative research: the role of data analysis. The Australian and New Zealand Journal of Public Health, 31(6), pp. 545 – 550
GIOIA, D. A. & CHITTIPEDDI, K. 1991. Sensemaking and sensegiving in strategic change initiation. Strategic management journal, 12, 433-448.
Hahjahan M, Mumu S, Afroz A, Chowdhury H, Kabir R, Ahmed K: Determinants of male participation in reproductive healthcare services.
Hemmersley, M. (2008) Questioning Qualitative Inquiry: Critical Essays. London, SAGE
Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, Lopez AD, Lozano R, Murray CJL: Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5. The Lancet 2010, 375(9726):1609-23.
Iliyasu, Z., et al.. (2010). Birth preparedness, complication readiness and father’s participation in maternity care in a Northern Nigerian Community. African Journal of Reproductive Health, 14 (1), 21-32.
Jessica Davis, Stanley Luchters, Wendy Holmes (2012) Men and maternal and newborn health: benefits, harms, challenges and potential strategies for engaging men, Compass: Women's and Children's Health Knowledge Hub. Melbourne, Australia.
JHPIEGO. (2001). Maternal and Neonatal Health (MNH) Program. Birth preparedness and complication readiness. A matrix of shared responsibilities. Maternal and Neonatal Health, 23-31.
Kenya National Bureau of Statistics (KNBS) and ICF Macro. 2010. Kenya Demographic and Health Survey 2008-09. Calverton, Maryland: KNBS and ICF Macro.
King, N & Horrocks, C. (2010) Interviews in Qualitative Research. London, SAGE
Kululanga et al..: Striving to promote male involvement in maternal health care in rural and urban settings in Malawi - a qualitative study. Reproductive Health 2011 8:36.
Naomi W (2005), Challenges and opportunities for male involvement in reproductive health in Cambodia, Policy Project Paper presented for review by the United Agency for International Development (USAID).
Natoli L. Report: East New Britain study of male involvement in reproductive, maternal and child health. Melbourne: Burnet Institute; 2012.
Ndyomugyenyi R, Neema S, Magnussen P (1998) The use of formal and informal services for antenatal care and malaria treatment in rural Uganda. Health Policy Plan 13: 94–102.
Nkuoh GN, Meyer DJ, Tih PM, Nkfusai J. Barriers to men's participation in antenatal and prevention of motherto-child HIV transmission care in Cameroon, Africa. J Midwifery Womens Health. 2010; 55(4): 363-9.
Ormel H, Perez 1997. Sexual and reproductive health are also men’s concerns. ‘’Strategies for their involvement.’’ Nov. 4 (2); 31-5.
Reece, M., Hollub, A., Nangami, M., and Lane. (2010). Reasons for men's involvement in PMTCT initiatives sought by their wives and other HIV-related services. AIDS Care, 6 (22): 743-750.
Retherford RD, Ramesh BM: Fertility and contraceptive use in Tamil Nadu, Andhra Pradesh, and Uttar Pradesh. NFHS Bulletin 1996, 3:1–4. International Institute for Population Sciences.
Rossman, G. B. & Rallis, S. F. (2012) Learning in the Field (3rd ed.) London, SAGE
Shattuck, D., Kerner,B., Gilles, K, Hartmann, M., Ng’ombeT, Guest G. Encouraging contraceptive uptake by motivating men to communicate about family planning: the Malawi Male Motivator project. American Journal of Public Health. 2011;101(6):1089-95. Epub 2011/04/16.
Silverman, D (2010) Doing Qualitative Research (3rd ed) London, SAGE
Simkhada B, Porter MA, Van Teijlingen ER (2010) The role of mothers-in-law in antenatal care decision-making in Nepal: a qualitative study. BMC Pregnancy Childbirth 10: 34. doi:10.1186/1471-2393-10-34
Tover J, Ross J: How increased contraceptive use has reduced maternal mortality. Maternal Child Health J 2010, 14(5):687–695.
Tsui A, McDonald-Mosely R, Burke A: Family planning and the burden of unintended pregnancies. Epidemiol Rev 2010, 32(1):152–174.
United Nations (UN). 1994. Report of the International Conference on Population and Development, Cairo, 5–13 September, 1994. New York: UN. Para. 4.27, p. 30. 10
United Nations General Assembly, Report of the Ad Hoc Committee of the Whole of the Twenty-first Special Session of the General Assembly Key actions for the further implementation of the programme of action of the International Conference on Population and Development [A/S/-21/5/Add.1]. New York, 1999:paragraph 62(c)
United Nations Population Fund (1999), implementing the reproductive health vision; progress and future challenges for UNFPA, available at www.unfpa.org accessed 20th October 2008
WHO, UNICEF, UNFPA World Bank estimates. Trends in Maternal mortality: 1990 to 2010, Geneva 2012.
WHO. Country statistics; Malawi (2010) available from :http://www.who.int/countries/mwi/en/.
Wolfinger, N. H. (2002) On writing field notes: collection strategies and background expectancies. Qualitative research, 2(1), pp. 85 – 95
World Health Organization (2001), Programme for male involvement in reproductive health available at www.who.org accessed 20th October 2008 www.unfpa.org.mx/publicaciones/PoA_en.pdf
Allendorf K: Couples' reports of women's autonomy and health‐care use in Nepal. Stud Fam Plann 2007, 38(1):35–46.
Acharya DR, Bell JS, Simkhada P, van Teijlingen ER, Regmi PR: Women’s autonomy in household decision-making: a demographic study in Nepal. Reprod Health 2010, 7–15.
Adamson, P. (2001) Deaf to Screams of Women. United Kingdom. Population Council; UNICEF
African Health Monitor (2004) A Magazine of the World Health Organization. Regional office for Africa. Volume 5. Number 1.
Assessing male spousal engagement with prevention of mother-to-child transmission (pMTCT) programs in western Kenya.Reece M, Hollub A, Nangami M, Lane KAIDS Care. 2010 Jun; 22(6):743-50.
Awasthi S, Nandan D, A.K. Mehrotra, Shankar R: Male participation in maternal care in urban slums of district Agra. Indian J Prev Soc Med 2008, 39 (3& 4):181-183.
AMERICAN ASSOCIATION FOR WORLD HEALTH (AAWH). Invest In the future: Support safe motherhood. Washington, DC, AAWH, 1998. 48 p.
Bloom SS, Gupta MD, Wypij D: Dimensions of women's autonomy and the influence on maternal health care utilization in a North Indian city. Demography 2001, 38(1):67– 78.
Braun, V. and Clarke, V.(2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3: 77-101.
Byamugisha, R., Tumwine, J.K., Semiyaga, N. and Tylleskär, T. (2010). Attitudes to routine HIV counseling and testing, and knowledge about prevention of mother to child transmission of HIV in eastern Uganda: a cross-sectional survey among antenatal attendees. Reprod Health, 10(12): 7-12.
Carter M. Husbands and maternal health matters in rural Guatemala: wives' reports on their spouses' involvement in pregnancy and birth. Soc Sci Med. 2002; 55(3): 437- 50.
Carter, M. W., & Speizer, I. (2005). Salvadoran fathers’ attendance at prenatal care, delivery, and postpartum care. Rev Panam Salud Publica, 18 (3), 149-156. http://dx.doi.org/10.1590/S1020-49892005000800001
Centers for Disease Control and Prevention (CDC), The Social Ecological Model: A Framework for Prevention http://www.cdc.gov/violenceprevention/overview/social-ecologicalmodel.html (retrieved April 21, 2014).
Communication for Development (C4D) Capability Development Framework, UNICEF and 3D Change, 2009. This document is available at the following UNICEF C4D Intranet.
De Vaus, D.A. (1993) Surveys in Social Research. (3rd edn.). London, UCL Press
Dutta M, Kapilashrami MC, Tiwari VK. Knowledge, awareness and extent of male participation in key areas of reproductive and child health in an urban slum of Delhi. Health and Population, Perspectives and Issues. 2004; 27(2): 49-66
Dudgeon MR and Inhorn MC, Men’s influences on women’s reproductive health: medical anthropological perspectives, 2004, Social Science & Medicine, Vol. 59, pp. 1379–1395.
Drennan, M. Reproductive health: New perspective on Men participation. Population Reports. Series J, No. 46. Baltimore, John Hopkins University School of Public Health, Population Information Program, October 1998.
Ezeh AC: The Influence of spouses over each other's contraceptive attitudes in Ghana. Stud Fam Plann 1993, 24(3):163–174.
Fekede Asefa, Ayele Geleto, Yadeta Dessie. Male Partners Involvement in Maternal ANC Care: The View of Women Attending ANC in Hararipublic Health Institutions, Eastern Ethiopia. Science Journal of Public Health. Vol. 2, No. 3, 2014, pp. 182-188. doi: 10.11648/j.sjph.20140203.17
Fisher J, Cabral de Mello M, Patel V, Rahman A, Tran T, Holton S, Prevalence and determinants of common perinatal mental disorders in women in low- and lower- middle-income countries: a systematic review. Bull World Health Organ. 2012; 90(2): 139G-49G.
Finlayson K, Downe S (2013) Why Do Women Not Use Antenatal Services in Low- and Middle-Income Countries? A Meta-Synthesis of Qualitative Studies. PLoS Med 10(1): e1001373. doi:10.1371/journal.pmed.1001373
Greene M, Mehta M, Pulerwitz J, Wulf D, MBankole A, Singh S. Involving men in reproductive health: Contributions to development; 2004.
Green, J., Willis, K., Hughes, E., Small, R., Welch, N., Gibbs, L. & Daly, J. (2007) Generating best evidence from qualitative research: the role of data analysis. The Australian and New Zealand Journal of Public Health, 31(6), pp. 545 – 550
GIOIA, D. A. & CHITTIPEDDI, K. 1991. Sensemaking and sensegiving in strategic change initiation. Strategic management journal, 12, 433-448.
Hahjahan M, Mumu S, Afroz A, Chowdhury H, Kabir R, Ahmed K: Determinants of male participation in reproductive healthcare services.
Hemmersley, M. (2008) Questioning Qualitative Inquiry: Critical Essays. London, SAGE
Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, Lopez AD, Lozano R, Murray CJL: Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5. The Lancet 2010, 375(9726):1609-23.
Iliyasu, Z., et al.. (2010). Birth preparedness, complication readiness and father’s participation in maternity care in a Northern Nigerian Community. African Journal of Reproductive Health, 14 (1), 21-32.
Jessica Davis, Stanley Luchters, Wendy Holmes (2012) Men and maternal and newborn health: benefits, harms, challenges and potential strategies for engaging men, Compass: Women's and Children's Health Knowledge Hub. Melbourne, Australia.
JHPIEGO. (2001). Maternal and Neonatal Health (MNH) Program. Birth preparedness and complication readiness. A matrix of shared responsibilities. Maternal and Neonatal Health, 23-31.
Kenya National Bureau of Statistics (KNBS) and ICF Macro. 2010. Kenya Demographic and Health Survey 2008-09. Calverton, Maryland: KNBS and ICF Macro.
King, N & Horrocks, C. (2010) Interviews in Qualitative Research. London, SAGE
Kululanga et al..: Striving to promote male involvement in maternal health care in rural and urban settings in Malawi - a qualitative study. Reproductive Health 2011 8:36.
Naomi W (2005), Challenges and opportunities for male involvement in reproductive health in Cambodia, Policy Project Paper presented for review by the United Agency for International Development (USAID).
Natoli L. Report: East New Britain study of male involvement in reproductive, maternal and child health. Melbourne: Burnet Institute; 2012.
Ndyomugyenyi R, Neema S, Magnussen P (1998) The use of formal and informal services for antenatal care and malaria treatment in rural Uganda. Health Policy Plan 13: 94–102.
Nkuoh GN, Meyer DJ, Tih PM, Nkfusai J. Barriers to men's participation in antenatal and prevention of motherto-child HIV transmission care in Cameroon, Africa. J Midwifery Womens Health. 2010; 55(4): 363-9.
Ormel H, Perez 1997. Sexual and reproductive health are also men’s concerns. ‘’Strategies for their involvement.’’ Nov. 4 (2); 31-5.
Reece, M., Hollub, A., Nangami, M., and Lane. (2010). Reasons for men's involvement in PMTCT initiatives sought by their wives and other HIV-related services. AIDS Care, 6 (22): 743-750.
Retherford RD, Ramesh BM: Fertility and contraceptive use in Tamil Nadu, Andhra Pradesh, and Uttar Pradesh. NFHS Bulletin 1996, 3:1–4. International Institute for Population Sciences.
Rossman, G. B. & Rallis, S. F. (2012) Learning in the Field (3rd ed.) London, SAGE
Shattuck, D., Kerner,B., Gilles, K, Hartmann, M., Ng’ombeT, Guest G. Encouraging contraceptive uptake by motivating men to communicate about family planning: the Malawi Male Motivator project. American Journal of Public Health. 2011;101(6):1089-95. Epub 2011/04/16.
Silverman, D (2010) Doing Qualitative Research (3rd ed) London, SAGE
Simkhada B, Porter MA, Van Teijlingen ER (2010) The role of mothers-in-law in antenatal care decision-making in Nepal: a qualitative study. BMC Pregnancy Childbirth 10: 34. doi:10.1186/1471-2393-10-34
Tover J, Ross J: How increased contraceptive use has reduced maternal mortality. Maternal Child Health J 2010, 14(5):687–695.
Tsui A, McDonald-Mosely R, Burke A: Family planning and the burden of unintended pregnancies. Epidemiol Rev 2010, 32(1):152–174.
United Nations (UN). 1994. Report of the International Conference on Population and Development, Cairo, 5–13 September, 1994. New York: UN. Para. 4.27, p. 30. 10
United Nations General Assembly, Report of the Ad Hoc Committee of the Whole of the Twenty-first Special Session of the General Assembly Key actions for the further implementation of the programme of action of the International Conference on Population and Development [A/S/-21/5/Add.1]. New York, 1999:paragraph 62(c)
United Nations Population Fund (1999), implementing the reproductive health vision; progress and future challenges for UNFPA, available at www.unfpa.org accessed 20th October 2008
WHO, UNICEF, UNFPA World Bank estimates. Trends in Maternal mortality: 1990 to 2010, Geneva 2012.
WHO. Country statistics; Malawi (2010) available from :http://www.who.int/countries/mwi/en/.
Wolfinger, N. H. (2002) On writing field notes: collection strategies and background expectancies. Qualitative research, 2(1), pp. 85 – 95
World Health Organization (2001), Programme for male involvement in reproductive health available at www.who.org accessed 20th October 2008 www.unfpa.org.mx/publicaciones/PoA_en.pdf
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2018-10-02
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Ouma, G., Karanja, P. S., & Udu, D. (2018). FACTORS INFLUENCING MALE INVOLVEMENT IN SAFE MOTHERHOOD AMONG COMMUNITIES IN KWALE AND KILIFI IN COASTAL KENYA. Global Journal of Health Sciences, 3(3), 1 – 23. Retrieved from https://www.iprjb.org/journals/index.php/GJHS/article/view/725
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