The role of male partner in utilization of maternal health care services in Ethiopia: a community-based couple study

Mohammed, Bedru Hussen; Johnston, Janice M.; Vackova, D; Hassen, Semira Mehammed; Yi, Hana

doi:10.1186/s12884-019-2176-z

Cited by 67 publications

(73 citation statements)

References 40 publications

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“…In our study, both rural and urban women who were PDs for the uptake of skilled care were more likely to have partners with at least primary education. These findings are in line with findings of studies from Ethiopia and elsewhere suggesting that husband's education may lead to greater involvement in maternity care utilization, as it is men who generally have an upper hand in decision-making at the household level in a patriarchal society like Ethiopia [51][52][53][54][55][56]. Similarly, we demonstrated that all PDs for the uptake of skilled care were more likely to report exposure to media compared to non-deviants in both surveys, irrespective of their location.…”

Section: Discussionsupporting

confidence: 89%

Uptake of Skilled Maternal Healthcare in Ethiopia: A Positive Deviance Approach

Ousman

Magnus

Sundby

et al. 2020

IJERPH

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Risk factor approaches are often used when implementing programs aimed at enforcing advantageous health care behaviors. A less frequently-used strategy is to identify and capitalize on those who, despite risk factors, exhibit positive behaviors. The aim of our study was to identify positive deviant (PD) mothers for the uptake of skilled maternal services and to explore their characteristics. Data for the study came from two waves of the Ethiopian Demographic and Health Surveys conducted in 2011 and in 2016. PD mothers were defined as those reporting no formal education but with adequate use of antenatal care (ANC) and/or institutional delivery services. Two-level multilevel regression analysis was used to analyze the data. Factors associated with PD for the use of ANC services were: partner’s education status, involvement in household decision making, exposure to media, and distance to the health facility. Factors associated with PD for health facility delivery were: partner’s education, woman’s employment status, ANC visit during index pregnancy, exposure to media, and perceived challenge to reach health facility. Rural-urban and time-related differences were also identified. The positive deviance approach provides a means for local policy makers and program managers to identify factors facilitating improved health behaviour and ultimately better health outcomes while acknowledging adverse risk profiles.

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Section: Discussionsupporting

confidence: 89%

Uptake of Skilled Maternal Healthcare in Ethiopia: A Positive Deviance Approach

Ousman

Magnus

Sundby

et al. 2020

IJERPH

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“…Similar findings were reported in studies conducted in Bangladesh [20], Debrebirhan central Ethiopia [21] and Metekel, western Ethiopia [22]. In Ethiopia, it is known that most women are socioeconomically dependent on male partners who are decisionmakers in households, and influence on maternal health care services utilization [23].…”

Section: Discussionsupporting

confidence: 84%

Spatial distribution and determinants of an optimal ANC visit among pregnant women in Ethiopia: further analysis of 2016 Ethiopia demographic health survey

Tessema

Animut

2020

BMC Pregnancy Childbirth

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Background: Antenatal care (ANC) is essential to improve maternal and newborn health and wellbeing. Antenatal care coverage is improving in Africa since over two-thirds of pregnant women have at least one ANC contact. However, to realize the complete life-saving potential that ANC guarantees for mothers and babies, at least four visits providing essential evidence-based interventions are required.. Therefore, this study was conducted to identify determinants of an optimal ANC visit and its spatial distribution in Ethiopia. Methods: This study is a secondary data analysis of the 2016 Ethiopian Demographic and Health Survey (EDHS). A total of 8025 women who had a live birth in the five years preceding the survey were included in this study. STATA 14 software and ArcGIS10.7 software were used for analysis. The generalized estimating equation (GEE) model was fitted to identify factors associated with an optimal ANC visit. Crude and Adjusted odds ratio with a 95% CI computed to assess the strength of association between explanatory and outcome variables.Results: This study revealed that rural residence (AOR = 0.59, 95%CI: 0.45-0.77),male partners educational status [secondary school (AOR = 1.33, 95%CI: 1.05-1.67)], distance to the health institutions [not a big problem (AOR = 1.21, 95%CI: 1.04-1.39)], community-level literacy (AOR = 1.07, 95%CI: 1.03-1.12), and community level service utilization (AOR = 2.67,95%CI:2.21-3.24) were significantly associated with optimal ANC visits. From the spatial analysis result, an Optimal ANC visit was observed in Addis Ababa, Tigray, Harari, and Dire Dawa regions whereas areas with no optimal ANC visit were Afar, Amhara, Oromia Benishangul, SNNP, and Somalia regions. Conclusion: Living in peripheral regions of the country and in rural areas, lower educational status of male partners and distance to health institutions were prohibiting factors for an adequate number of visits. In this study, community-level literacy and community level service utilizations were were also affect womens' ANC utilization which implies community-level interventions should be considered for improving antenatal care utilization and better health outcomes. The government should give special attention to the regions like Afar, Amhara, Oromia, Benishangul, SNNP, and Somalia which had low optimal ANC visits.

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“…Our study found that averting barriers to health facility delivery to improve maternal and child health outcomes is a collective responsibility of husbands, mothers-in-law, community members such as neighbours, local council village leaders and village extension health workers. In addition to the recent call to strengthen male partner involvement in the utilization of maternal health care services by their female partners [20,21], our study further highlights the role of other key players (significant others) in averting barriers to utilization of health facility delivery services. Similar to findings from other studies, quite often, husbands will only go as far as providing financial support for transport and money to buy birth preparedness items [22].…”

Section: Perceived Barriers To Uptake Of Health Facility Deliverysupporting

confidence: 52%

Examining the roles of significant others of women in the uptake of health facility delivery in Northern Uganda: perspectives from the health belief model.

Nyachwo

Naigino

Apolot

et al. 2019

Preprint

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Background: Health facility delivery improves maternal and child health outcomes but has not been fully achieved in countries with the poorest maternal health indicators. We identified and examined the roles of key influencers (significant others) of mother’s perceptions towards health facility delivery in Northern Uganda. Methods: This was an exploratory study conducted using in-depth interviews with eleven significant others in a mother’s life; who were purposively selected from four sub-counties of; Ogur, Agweng, Amach and Agali, as part of a larger study in Lira district, Northern Uganda. We also conducted seven key informant interviews with health workers involved in maternal and child health care. Data analysis using Atlas ti version.7.0 was conducted deductively following a thematic framework approach to analyse themes adapted from the health belief model. Results: The study identified husbands, biological mothers, mothers-in-law, fathers-in-law, brothers and co-wives as influencers of mother’s perceptions on uptake of health facility delivery. Other significant others included traditional birth attendants who were believed to have the ability to determine when the condition of a mother required the intervention of a medical expert. Community members such as local village leaders, village health extension workers and neighbours were also cited . Whereas husbands were regarded as ke y significant others of women, health workers emphasized that, husbands were not always available to support the mothers during pregnancy and child birth. The roles of significant others of women included: planning for birth, providing financial support, making decisions on where a mother will deliver from, continued counselling and psychosocial support. Conclusion: Programs aimed at increasing male involvement to improve maternal and child health outcomes should also target other influencers of women’s perceptions on health facility delivery including family and community members, to provide back-up support to mothers in the absence of their husbands.

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The role of male partner in utilization of maternal health care services in Ethiopia: a community-based couple study

Cited by 67 publications

References 40 publications

Uptake of Skilled Maternal Healthcare in Ethiopia: A Positive Deviance Approach

Uptake of Skilled Maternal Healthcare in Ethiopia: A Positive Deviance Approach

Spatial distribution and determinants of an optimal ANC visit among pregnant women in Ethiopia: further analysis of 2016 Ethiopia demographic health survey

Examining the roles of significant others of women in the uptake of health facility delivery in Northern Uganda: perspectives from the health belief model.

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