In this cross-sectional survey with qualitative components (n = 389), we explored how husbands perceive delivery care in rural Malawi. Most husbands decide on maternal health care seeking, believe in antenatal care, and prefer institutional delivery. Men acknowledge that their unfaithfulness and violence can harm the pregnancy. Most husbands feel responsible for birth preparedness, but poor availability and unforeseeable transport costs hinder care seeking in pregnancy complications. Our findings suggest that innovative birth preparedness and transport interventions that involve men, as well as the extension of antenatal care (ANC) services to men, can help overcome obstacles to improving maternal health at the community level.
Self-interview methods such as audio computer-assisted self-interviewing (ACASI) are used to improve the accuracy of interview data on sensitive topics in large trials. Small field studies on sensitive topics would benefit from methodological alternatives. In a study on male involvement in antenatal HIV testing in a largely illiterate population in Malawi, we piloted picture-and audio-assisted self-interviewing (PIASI). Out of 388 participants, 96 were randomized to answer six sensitive questions using PIASI after the face-to-face interview (FTF). Participants who responded by PIASI were more likely to express accepting attitudes toward childbearing by
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