Male Involvement in Reproductive and Maternal and New Child Health: An Evaluative Qualitative Study on Facilitators and Barriers From Rural Kenya

Lusambili, Adelaide; Muriuki, Peter; Wisofschi, Stefania; Shumba, Constance; Mantel, Michaela; Obure, Jerim; Nyaga, Lucy; Mulama, Kennedy; Ngugi, Anthony; Orwa, James; Luchters, Stanley; Temmerman, Marleen

doi:10.3389/fpubh.2021.644293

Cited by 16 publications

(18 citation statements)

References 12 publications

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“…Additionally, men's views are important contextual factors in determining whether CHV-delivered interventions for women can actually increase health service use [30]. Our experience conducting focus groups with male community members prior to the intervention allowed us to address some of their concerns during implementation, and reinforces evidence that involving men can improve uptake of reproductive health services [34,36,37].…”

Section: Discussionmentioning

confidence: 82%

Acceptability and feasibility of community-based provision of urine pregnancy tests to support linkages to reproductive health services in Western Kenya: a qualitative analysis

Kibel

Thorne²,

Kerich³

et al. 2022

BMC Pregnancy Childbirth

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Background The majority of women living in rural Kenya access antenatal care (ANC) late in pregnancy, and approximately 20% have an unmet need for family planning (FP). This study aimed to determine whether training community health volunteers (CHVs) to deliver urine pregnancy testing (UPT), post-test counselling, and referral to care was an acceptable and feasible intervention to support timely initiation of ANC and uptake of FP. Methods We applied community-based participatory methods to design and implement the pilot intervention between July 2018 and May 2019. We conducted qualitative content analysis of 12 pre-intervention focus group discussions (FGDs) with women, men, and CHVs, and of 4 post-intervention FGDs with CHVs, each with 7–9 participants per FGD group. Using a pragmatic approach, we conducted inductive line-by-line coding to generate themes and subthemes describing factors that positively or negatively contributed to the intervention’s acceptability and feasibility, in terms of participants’ views and the intervention aims. Results We found that CHV-delivered point of care UPT, post-test counselling, and referral to care was an acceptable and feasible intervention to increase uptake of ANC, FP, and other reproductive healthcare services. Factors that contributed to acceptability were: (1) CHV-delivery made UPT more accessible; (2) UPT and counselling supported women and men to build knowledge and make informed choices, although not necessarily for women with unwanted pregnancies interested in abortion; (3) CHVs were generally trusted to provide counselling, and alternative counselling providers were available according to participant preference. A factor that enhanced the feasibility of CHV delivering UPT and counselling was CHV's access to appropriate supplies (e.g. carrying bags). However, factors that detracted from the feasibility of women actually accessing referral services after UPT and counselling included (1) downstream barriers like cost of travel, and (2) some male community members’ negative attitudes toward FP. Finally, improved financial, educational, and professional supports for CHVs would be needed to make the intervention acceptable and feasible in the long-term. Conclusion Training CHVs in rural western Kenya to deliver UPT, post-test counselling, and referral to care was acceptable and feasible to men, women, and CHVs in this context, and may promote early initiation of ANC and uptake of FP. Additional qualitative work is needed to explore implementation challenges, including issues related to unwanted pregnancies and abortion, the financial burden of volunteerism on CHVs, and educational and professional supports for CHVs.

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Section: Discussionmentioning

confidence: 82%

Acceptability and feasibility of community-based provision of urine pregnancy tests to support linkages to reproductive health services in Western Kenya: a qualitative analysis

Kibel

Thorne²,

Kerich³

et al. 2022

BMC Pregnancy Childbirth

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“…Our study suggested that socio-cultural factors such as stereotyping, and the feminization of family planning hinder male involvement which is also found in the study done in by Lusambili AM et al . [ 19 ] in Kenya. Our study revealed that active community involvement of health care workers will help to engage more males in family planning methods which will help further decrease maternal morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

Male involvement in family planning in a rural area of India

Parija

Pal

Panigrahi³

et al. 2022

Journal of Family Medicine and Primary Care

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Introduction: Family planning is one of the essential health care services to promote and ensure reproductive health. Nearly 40.2 percent of men think it as a woman’s responsibility as per the National Family Health Survey 4. Not much attention has been given to the male partners in the usage of contraceptives. So, this study was conducted to assess the male participation in family planning among married males in a rural area of Chhattisgarh. Methodology: A sample of 365 married males were interviewed through a semi-structured questionnaire at a primary health care center. Results: Only 48 (13.1%) participants were using condoms or male sterilization as a method of contraception at the time of the study. Good involvement of males in family planning was found to be (10.9%) in our study. Those who were above the poverty line and educated (graduation and above) had good involvement in family planning. The chief reason cited for not opting for male sterilization by participants was fear of physical weakness followed by family opposition. Conclusion: The socio-cultural barrier in itself demotivates men from getting involved in the family planning program. This study recommends increasing health literacy regarding family planning among men by including it in the school curriculum and through awareness activities and counseling that influences them positively and motivates them to accept contraceptive services and shared decision making. Sterilization facilities should be made accessible to them to further encourage them.

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“…The area and facilities were part of the AQCESS Project’s interventions. Detailed information on the social and economic context of Kilifi and Kisii can be found in our recent published papers from the AQCESS Project 2 3 17–21…”

Section: Methodsmentioning

confidence: 99%

Views of nurses and other healthcare workers on interventions to reduce disrespectful maternity care in rural health facilities in Kilifi and Kisii counties, Kenya: analysis of a qualitative interview study

et al. 2022

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ObjectiveThere is an abundance of evidence illuminating the factors that contribute to disrespectful maternity care in sub-Saharan Africa. However, there is limited documented evidence on how some of the key influences on the mistreatment of women could be addressed. We aimed to document the perspectives of nurses and other healthcare workers on existing and potential strategies embedded at the health facility level to promote respectful delivery of healthcare for women during delivery and on what interventions are needed to promote respectful and equitable treatment of women receiving maternity care in rural Kenya.Design, setting and participantsWe analysed relevant data from a qualitative study based on in-depth interviews with 24 healthcare workers conducted between January and March 2020, at health facilities in rural Kilifi and Kisii counties, Kenya. The facilities had participated in a project (AQCESS) to reduce maternal and child mortality and morbidity by improving the availability and the use of essential reproductive maternal and neonatal child health services. The participants were mostly nurses but included five non-nurse healthcare workers. We analysed data using NVivo V.12, guided by a reflective thematic analysis approach.ResultsHealthcare workers identified four interconnected areas that were associated with improving respectful delivery of care to women and their newborns. These include continuous training on the components of respectful maternity care through mentorships, seminars and organised training; gender-responsive services and workspaces; improved staffing levels; and adequate equipment and supplies for care.ConclusionsThese findings demonstrate some of the solutions, from the perspectives of healthcare workers, that could be implemented to improve the care that women receive during pregnancy, labour and delivery. The issues raised by healthcare workers are common in sub-Saharan African countries, indicating the need to create awareness at the policy level to highlight the challenges identified, potential solutions, and application or implementation in different contexts.

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Male Involvement in Reproductive and Maternal and New Child Health: An Evaluative Qualitative Study on Facilitators and Barriers From Rural Kenya

Cited by 16 publications

References 12 publications

Acceptability and feasibility of community-based provision of urine pregnancy tests to support linkages to reproductive health services in Western Kenya: a qualitative analysis

Acceptability and feasibility of community-based provision of urine pregnancy tests to support linkages to reproductive health services in Western Kenya: a qualitative analysis

Male involvement in family planning in a rural area of India

Views of nurses and other healthcare workers on interventions to reduce disrespectful maternity care in rural health facilities in Kilifi and Kisii counties, Kenya: analysis of a qualitative interview study

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