Involving men in maternity care: South Africa

Abstract

In the current context of health care in South Africa, STIs and HIV/AIDS, as well as maternal mortality, partnered deliveries, and involving men in reproductive health, including PMTCT are important issues and priorities. Very little can be achieved for either mothers or infants unless reproductive health providers realize the need and take active steps toward involving men in reproductive health services. The Reproductive Health Research Unit (RHRU) University of the Witwatersrand, in partnership with the FRONTIERS Program of the Population Council, and the KwaZulu Natal Department of Health conducted a three-year operations research study titled "Men in Maternity" (MIM) in the Ethekwini district. The study was completed in July 2003. A randomized cluster matched paired design was used with six clinics implementing the intervention and another six control clinics continuing to provide services following the current practices and guidelines of the Department of Health. Both rural and urban clinics were included.

What Works in Family Planning Interventions: A Systematic Review

“…One article of lower quality focused on increased method options (Khan et al 2004 - introducing emergency contraceptive pills into the method mix); another of lower quality focused on client provider interactions (Nawar et al 2004). Nine reported on various quality improvement approaches (high quality: Bashour et al 2008, Bolam et al 1998, Xiaoming et al 2000; medium quality: Khan et al 2008, Kunene et al 2004, Sherwood-Fabre et al 2002, Sanogo et a. 2003; low quality: Varkey et al 2004, Speizer et al 2004).…”

“…2004) out of ten revealed a significant increase in contraceptive use. Five of the seven integrated service delivery studies focused on postpartum contraceptive use (Bashour et al 2008; Bolam et al 1998; Khan et al 2008; Kunene et al 2004; Varkey et al 2004), and of these, three reported significant results (Bolam et al 1998; Khan et al 2008; Varkey et a. 2004).…”

“…The feasibility of male involvement in antenatal care (ANC) counseling sessions and the effectiveness of their involvement in postpartum contraceptive use was evaluated by two studies – one of medium quality from South Africa (Kunene et al 2004) and one of lower quality from India (Varkey et al 2004). In KwaZulu-Natal, South Africa, the study team matched facilities by size and rural/urban status and then randomly assigned six clinics as the intervention sites and six as the comparison sites.…”

“…Implementing joint couple counseling was challenging for this program because the population being served was mostly unmarried. One-third of the couples invited attended the joint counseling sessions, and communication among them was reported to improve with male partners more likely to provide support in the event of pregnancy complications; however, postpartum family planning use and overall risk behavior did not change (Kunene 2004). The other study that examined male involvement had positive effects; however, did not randomly assign sites or control for differences between the groups (Varkey et al 2004).…”

Male Involvement in PMTCT Services in Mbeya Region, Tanzania

“…However, as postulated by Nzioka (2001), an in-depth understanding of men's attitudes is crucial when intending to increase partner involvement, and it can only be obtained through malefocussed research. Studies that did try to explore male perspectives on ANC or SRH service participation include insights from eastern and southern Africa (e.g., Adeleye and Chiwuzie 2007;Kunene et al 2004;Muia et al 2000;Nzioka 2000;Peacock 2003), or from southern Asia (e.g., Mullany 2006;Saha et al 2007;Sharma 2002). Many of those studies had in common that men tended to express a general concern for their female partner's health and rather positive attitudes towards their own participation in SRH services; thus, as pointed out by Peacock (2003), they do provide room for some optimism.…”