Social and cultural barriers to husbands� involvement in maternal health in rural, Gambia

Abstract

IntroductionWhile many studies have documented a number of socio-cultural barriers to male involvement in maternal health, in The Gambia very little information is known about the social and cultural practices that characterized male involvement in maternal health. This study aims to explore some of the underlying social and cultural factors affecting husbands’ involvement in maternal health issues pertaining to pregnancy and delivery in rural Gambia.MethodsFive focus group discussions and six in-depth interviews were conducted among rural men and traditional birth attendants in five areas of rural Gambia. The discussion was directed to the roles of male partners in pregnancy and delivery and the difficulties they face regarding taking care of their wives. The data resulting from the discussion was audio-recorded, transcribed verbatim, and analyzed thematically.ResultsIn general, rural Gambian men and traditional birth attendants (TBAs) reported that husbands’ involvement in maternal health is highly desirable, but is influenced by many factors, such as the traditional conceptualization associated with pregnancy and delivery as women’s domain. In addition, many men do not believe that pregnancy chores warrant their efforts compared to other competing social responsibilities. This issue may be more complicated in polygamous marriages where there is rivalry among co-wives and in neighborhoods where men who help with house chores may be subjected to mockery.ConclusionThese findings suggest that husbands’ involvement in maternal health in The Gambia is influenced by the prevailing social and cultural practices of gender role and norms, which are also at the root of maternal health problems.

Prevalence of male attendance and associated factors at their partners antenatal visits among antenatal care attendees in Bale Zone, South East Ethiopia

“…The need for male involvement in reproductive health was one of the fore-front agenda during the International Conference on Population and Development (UNFPA, 1999). Male involvement is highly desirable in maternal health (Lowe, 2017). Because male attendance during ANC is an important strategies to reduce preventable maternal problems during pregnancy (Jennings et al, 2014).…”

Womens perception of male involvement during pregnancy and labour in University College Hospital, Ibadan

“…Other barriers were also assessed such as the attitude of health care workers, religion and culture but majority of the women did not perceive this as a barrier to male involvement. This therefore shows an improvement in the barriers to male involvement over the years as studies carried out by Iliyasu et al (2010), NPC snd ICF (2013) and Lowe (2017) revealed that attitude of spouses toward husband's participation in maternal care is strongly opposed to the physical presence of husbands in the labour room during delivery due to the strong cultural and religious effects, especially for Muslims. It was however, noted that Christians were more inclined to spousal participation in antenatal and post-natal care (Umeora et al, 2011 as cited in Vehvilainen-Julkunen and Emelonye, 2014).…”

“…Other factors found to hinder the actualization of this desire for males to be involved in labour include education, which has been shown in some studies as a determining factor, reporting high participation of educated men in supporting their wives during antenatal and delivery sessions than uneducated men (Vehvilainen-Julkunen and Emelonye, 2014). Other factors such as ignorance, poverty, cultural and religious practices were shown to be reasons for low spousal participation during delivery (Lowe, 2017). In Nigeria where culture and religion governs the practices of the society, there is a strong cultural belief in several parts of the country that spousal presence worsens labour pain and prolongs labour (National Population Comission, 2013).…”

Factors influencing whether or not male partners from low and middle income countries attend childbirth: a mixed methods systematic review

“…In El Salvador, women from extended families were less likely to report on male partners' attendance than women from nuclear families (33). In a qualitative study from Gambia, some men who had more than one wife reported that they did not attend childbirth for fear of instilling jealousy among their co-wives (94).…”

“…Studies from Gambia, Syria, Botswana, Malawi, Kenya, South Africa, Nigeria, and Rwanda reported that men and women in rural and semi-urban areas did not favour male partners' presence at labour and/or birth. This may have been influenced by cultural norms that regarded pregnancy and childbirth as a woman's realm and patriarchal attitudes that childbirth is an intimate event which a man should not witness (20,22,26,62,70,74,83,91,93,94). In one survey conducted in a rural Rwandan hospital, 51% of women (n=178) said that men's presence at childbirth was not culturally appropriate (37).…”