Male Involvement in Maternal Health Planning Key to Utilization of Skilled Birth Services in Malindi Subcounty, Kenya

Abstract

Background.In Malindi, rural populations face challenges in accessing skilled birth services. Consequently, the majority of women deliver at home and only seek help when they have complications. This paper reports part findings from a study conducted to assess health priority setting process and its implication on availability, access, and use of emergency obstetric care services in Malindi.Methods. The study utilized qualitative methods to collect data from health personnel and maternal health stakeholders including community members. Source and method triangulation was used to strengthen the credibility of study findings. Data was categorized manually into themes around issues relating to utilization of skilled birth services discussed in this paper.Findings. Various barriers to utilization of skilled birth services were cited. However, most were linked tomwenye(the husband) who decides on the place of birth for the wife.Conclusion.Husbands are very influential in regard to decisions on skilled birth service utilization in this community. Their lack of involvement in maternal health planning may contribute as a barrier to utilization of skilled care by pregnant women. There is need to address themwenyefactor in an attempt to mitigate some of the barriers cited for nonutilization of skilled birth services.

Exploring Reasons for Low Attendance of Mothers to Growth Monitoring and Promotion Program at Loka Abaya District, Southern Ethiopia: Exploratory Qualitative Study

“…A qualitative study in the Northern Ethiopia indicated that without the support of the husbands, GMP is unlikely to succeed [8]. It is indicated that husbands are very influential in regard to decisions for health service utilization in developing countries [18]. Other studies, though not directly related to GMP, also reported husbands as the primary spokespersons for their family, and their say and advice are also highly valued by mothers and children in utilizing health-care services [19, 20].…”

Determinants of attending antenatal care at least four times in rural Ghana: analysis of a cross-sectional survey

“…In some parts of Ghana, men, as the heads of their families, hold the most important roles and responsibilities, and have unlimited decision-making power [13,14]. These men make important decisions, including those concerning whether their wives seek skilled care [12–16]. Therefore, men’s education could play a critical role in improving maternal health in Ghana.…”

“…Spousal support and decisions concerning the use of maternal health services also influence women’s access to skilled care [11]. This could be attributed to the patriarchal system in place in Africa, in which men are usually the heads of households, with the power and authority to make decisions, including those concerning their wives’ use of maternal health services [12–16], for their family members [13]. Religious factors also contribute to women’s decisions regarding ANC attendance [7].…”

Community Perspectives of a 3-Delays Model Intervention: A Qualitative Evaluation of Saving Mothers, Giving Life in Zambia

“…This perception is supported by findings from SMGL's first year of implementation, which saw a 35% increase in health facility deliveries between 2012 and 2013 20 , 21 . The engagement of men and community leaders to promote behavior change for women's health is imperative in patriarchal societies, since access to care is controlled by men 29 , 30 . Interventions to change social norms should include key community members in order to achieve desired public health effects 31 – 34 .…”