Male partners’ participation in birth preparedness and complication readiness in low- and middle-income countries: a systematic review and meta-analysis

Abstract

Background Maternal and neonatal health outcomes remain a challenge in low- and middle-income countries (LMICs) despite priority given to involving male partners in birth preparedness and complication readiness (BPCR). Men in LMICs often determine women’s access to and affordability of health services. This systematic review and meta-analysis determined the pooled magnitude of male partner’s participation in birth preparedness and complication readiness in LMICs. Methods Literature published in English language from 2004 to 2019 was retrieved from Google Scholar, PubMed, CINAHL, Scopus, and EMBASE databases. The Joanna Briggs Institute’s critical appraisal tool for prevalence and incidence studies were used. A pooled statistical meta-analysis was conducted using STATA Version 14.0. The heterogeneity and publication bias were assessed using the I2 statistics and Egger’s test. Duval and Tweedie's nonparametric trim and fill analysis using the random-effect analysis was carried out to validate publication bias and heterogeneity. The random effect model was used to estimate the summary prevalence and the corresponding 95% confidence interval (CI) of birth preparedness and complication readiness. The review protocol has been registered in PROSPERO number CRD42019140752. The PRISMA flow chart was used to show the number of articles identified, included, and excluded with justifications described. Results Thirty-seven studies with a total of 17, 148 participants were included. The pooled results showed that 42.4% of male partners participated in BPCR. Among the study participants, 54% reported having saved money for delivery, whereas 44% identified skilled birth attendants. 45.8% of male partners arranged transportation and 57.2% of study participants identified health facility as a place of birth. Only 16.1% of the male partners identified potential blood donors. Conclusions A low proportion of male partners were identified to have participated in BPCR in LMICs. This calls countries in low- and middle-income setting for action to review their health care policies, to remove the barriers and promote facilitators to male partner’s involvement in BPCR. Health systems in LMICs must design and innovate scalable strategies to improve male partner’s arrangements for a potential blood donor and transportation for complications that could arise during delivery or postpartum haemorrhage.

Husbands' Plan to Participate in Birth Preparedness and Complication Readiness in Haramaya Health and Demographic Surveillance System Site, Eastern Ethiopia: A Community-Based Cross-Sectional Study

“…Appropriate preparation for birth preparedness and complications readiness by women, male partners, families, and the community has the potential to lower these preventable risk factors. Moreover, policies, programs, and practices could focus on improving male partners' level of knowledge about complications related to pregnancy and childbirth, and the importance of preparing, and planning for childbirth ( 9 , 14 ).…”

“…In Sub-Saharan Africa like Ethiopia, despite its public health importance for birth outcomes, male participation in maternal and child health (MCH) remains low, and having a male partner (MP) present in the labor room during delivery is utterly impossible in many settings ( 9 , 11 , 16 ), even in a limited area like urban setting, where male partners have been supportive to their spouses, there are unwelcoming, intimidating, and unsupportive health systems, presenting a missed opportunity, which embarrasses their commitment ( 13 , 17 ). Similarly, researchers have reported that factors such as poor timely action by family, which leads to a great deal such as looking for a source of money and potential blood donors in case of emergency, finding for transportation, and reaching the appropriate referral facility remain a major challenge in Africa ( 14 , 18 ).…”

“…In Ethiopia, in the last decade, various studies have been conducted to assess the practice of birth preparation and complication readiness among mothers; with little attention have been given to the level of the husband's involvement in birth preparation. Moreover, although numerous factors associated with male involvement in BPCR have been identified in the various research report ( 13 , 14 , 24 , 25 ), in Ethiopia, husbands' participation in the BPCR received little policy attention ( 23 ). In addition, the majority of the previous studies were facility-based and primarily focused on emergency obstetric care and other routine services ( 26 ).…”

The role of men in antenatal care and preventing HIV transmission from mothers to infants in Gambella region, Ethiopia

“…One study showed that many men in Southern Ethiopia do not participate in birth preparedness, including ANC attendance with their partner (45%), saving money for an emergency or the delivery (30%), or making a postpartum plan (75%) [17]. A meta-analysis of studies in low-and middle-income countries indicated that almost half of male partners accompanied their wife/partner to ANC, with rates in Ethiopia ranging from 9.9-88.5% [18], with men in urban settings accompanying female partners to ANC service and institutional delivery [19,20].…”

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

“…Systematic reviews examining male partner involvement in reproductive health care include numerous studies reporting a positive association between men's active engagement in the pregnancy, birth and postnatal period in LMIC settings (22)(23)(24). However, there are three features of this body of evidence that limit its usefulness for designing interventions and policies to address maternal and infant health in East African countries: the body of evidence is fragmented in geography, focused on particular health conditions or behaviours, and male partner involvement is poorly de ned.…”