Barriers to Male Participation in Antenatal Care in Nyamagana District, Tanzania.

Kinyina, Alen (2021) Barriers to Male Participation in Antenatal Care in Nyamagana District, Tanzania. Masters thesis, The Open University of Tanzania.

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Abstract

Men participation in antenatal care has been acknowledged by World Health Organization (WHO) as a key factor in improving maternal health and reducing maternal morbidity and mortality in settings where in the household men play key role in decision making. Aspects of reproductive health like family planning and treatment of sexual transmitted infections (STI) such as syphilis and HIV have seen improved where male participation has been promoted. Tanzania has a high maternal mortality rate of 556 per 100,000 live births with a slow decline towards its goal of 140 per 100,000 live births by 2030. Male partner involvement is among the strategies that can contribute to accelerate the decline in maternal mortality and improvement of maternal health. This study investigated about the barriers to male involvement in ANC in Nyamagana district, Tanzania.The study was underpinned by a conceptual framework adapted from Vyonne conceptual framework of male involvement in antenatal care. This study utilized mixed approach of qualitative and quantitative methods. A cross-sectional survey using interviewer administered structured questionnaire was conducted among 201 male partners aged 18 years and above whose partner has delivered within 12 months’ prior the interview day.Purposive sampling technique was used to select the sample of respondents. The list of villages was used as the master frame from which 6 villages were purposely selected for the study 2 from rural, 2 from semi urban and 2 from urban to ensure good representation. Selection of eligible men respondents involved random selection of households in each selected village. The FGDs women were selected by nurse on duty at Makongoro Health center basing on the said eligibility until a group of 6-8 women is complete The survey was complemented by four focus-group discussions; two groups were postnatal mothers and a second two groups of pregnant women with at least 3 ANC visit. Both descriptive frequencies and percentages were carried out; Pearson Chi-Square was used to test association between the various factors and the level of male involvement; and inferential binary logistic regression analyses were carried out to determine the influence of these factors on the level of male involvement. For the focus group discussion results, Thematic Content Analysis was also done. 153 (76.3%) respondents reported men participation in ANC. Men with 50 years and above were less likely to report high male involvement in ANC compared to those who were aged 18–29 years (OR= 1.45, 95% CI= [0.37–1.85], p=0.04. Respondents who were living together with their partners were about two times more likely to participate in ANC compared to those who are not living with their partners (OR =2.15, 95% CI= [1.15–4.02], p=0.01). Lack of health insurance and transport means were significantly associated with poor male participation in ANC. Participants who reported long waiting time at the health facility as a barrier of male participation in ANC were less likely to report high male involvement in ANC compared to those who disagreed (OR=1.55, 95% CI = [1.36–1.83], p =0.002). The findings of this study calls for district health managers and other reproductive health stakeholders involved to strengthen efforts accelerating male friendly policy in social cultural, social economic and enabling environment at the various ANC facilities that would encourage men to participate in ANC service. Keywords: Antenatal care, maternal health, morbidity, mortality

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