Effect of male partners’ behaviours and beliefs on reproductive, maternal and child health and wellbeing in East Africa: A scoping review

Abstract

Background: East African countries have high rates of maternal and child mortality and morbidity. Studies have shown that involvement of male partners in reproductive health can benefit maternal and child health. This scoping review aims to provide an overview of the evidence across East Africa that describes male partner involvement and its effect on maternal and child wellbeing in reproductive, maternal or child health. Methods: Ten databases were searched to identify quantitative data on male’s involvement in East African countries. Studies reporting qualitative data, non-East-African samples, ‘intention to use’ data or only reporting on male partner’s education or economic status were excluded. Studies were organised into five a priori categories: antenatal care (ANC), human immunodeficiency virus (HIV), breastfeeding, family planning, and intimate partner violence (IPV) with further categories developed based on studies included. Results: A total of 2787 records were identified, 644 full-texts were reviewed and 96 studies were included in this review. Data were reported on 118,967 mothers/pregnant women and 15,361 male partners (typically reported by their female partners or coparents). Most of the studies (n=83) were reported from four countries Ethiopia (n=49), Kenya (n=14), Tanzania (n=12) and Uganda (n=10). The evidence indicates that male partner involvement and support is associated with improved reproductive, maternal and child health across a wide range of outcomes. However, the studies were heterogenous, using diverse exposure and outcome measures and reporting varying effect sizes, levels of men’s involvement and types of support. As well, male partners’ lack of practical and emotional support, and engagement in violent behaviours towards partners, were associated with profound negative impacts on maternal and child health and wellbeing. Conclusions: The body of evidence, although heterogenous, provides compelling support for male involvement in reproductive health programs designed to support maternal and child health. To advance research in this field, agreement is needed on a measure of male partner 'involvement'. To optimise benefits of male partner’s involvement, developing core outcome sets and regional coordination across health conditions are recommended.