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      Men’s determinant factors on antenatal care involvement and childbirth place preference in Indonesia: An analysis of the 2012 Indonesia Demographic and Health Survey (IDHS)

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          Abstract

          Objective:

          This study aimed to describe the determinant factors of men’s involvement in antenatal care and childbirth place preference in Indonesia.

          Method:

          Secondary data from the 2012 Indonesia Demographic and Health Survey was used to identify factors determining men’s presence during antenatal care and childbirth place preference. All factors were analyzed utilizing bivariate and multivariate logistic regression.

          Result:

          Men living in urban areas, having a sufficient economy, having higher educational levels, and having more interaction with mass media were more likely present during the antenatal care of their wives. Men in Sulawesi and Maluku showed lower involvement in accompanying wives during antenatal care than those in Papua. In terms of delivery place preference, men in age 15–19 and 35–49 years, living in urban areas, having a more stable economy, reading newspapers or magazines as well as watching television at least once a week, and living in Java and Nusa Tenggara, were more likely having wife giving birth in healthcare facilities.

          Conclusions:

          Type of residence, economic situations, lower educational level, and fewer interactions with mass media and electronics are essential barriers to men’s involvement in wives’ antenatal care visits and childbirth place preference in Indonesia. Particular attention should be put to Sulawesi and Maluku to enforce the men and women as those islands underutilized antenatal care services and health facilities for childbirth.

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          Involving men to improve maternal and newborn health: A systematic review of the effectiveness of interventions

          Background Emerging evidence and program experience indicate that engaging men in maternal and newborn health can have considerable health benefits for women and children in low- and middle-income countries. Previous reviews have identified male involvement as a promising intervention, but with a complex evidence base and limited direct evidence of effectiveness for mortality and morbidity outcomes. Objective To determine the effect of interventions to engage men during pregnancy, childbirth and infancy on mortality and morbidity, as well as effects on mechanisms by which male involvement is hypothesised to influence mortality and morbidity outcomes: home care practices, care-seeking, and couple relationships. Methods Using a comprehensive, highly sensitive mapping of maternal health intervention studies conducted in low- and middle-income countries between 2000 and 2012, we identified interventions that have engaged men to improve maternal and newborn health. Primary outcomes were care-seeking for essential services, mortality and morbidity, and home care practices. Secondary outcomes relating to couple relationships were extracted from included studies. Results Thirteen studies from nine countries were included. Interventions to engage men were associated with improved antenatal care attendance, skilled birth attendance, facility birth, postpartum care, birth and complications preparedness and maternal nutrition. The impact of interventions on mortality, morbidity and breastfeeding was less clear. Included interventions improved male partner support for women and increased couple communication and joint decision-making, with ambiguous effects on women’s autonomy. Conclusion Interventions to engage men in maternal and newborn health can increase care-seeking, improve home care practices, and support more equitable couple communication and decision-making for maternal and newborn health. These findings support engaging men as a health promotion strategy, although evidence gaps remain around effects on mortality and morbidity. Findings also indicate that interventions to increase male involvement should be carefully designed and implemented to mitigate potential harmful effects on couple relationship dynamics.
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            Women’s empowerment and male involvement in antenatal care: analyses of Demographic and Health Surveys (DHS) in selected African countries

            Background Increasing women’s status and male involvement are important strategies in reducing preventable maternal morbidity and mortality. While efforts to both empower women and engage men in maternal health care-seeking can work synergistically, in practice they may result in opposing processes and outcomes. This study examines whether a woman’s empowerment status, in sum and across economic, socio-familial, and legal dimensions, is associated with male partner accompaniment to antenatal care (ANC). Methods Women’s empowerment was measured based on the sum of nine empowerment items in the 2010–2011 Demographic and Health Surveys in eight sub-Saharan African countries: Burkina Faso (n = 2,490), Burundi (n = 1,042), Malawi (n = 1,353), Mozambique (n = 414), Rwanda (n = 1,211), Senegal (n = 505), Uganda (n = 428) and Zimbabwe (n = 459). In cross-sectional analyses, bivariate and multivariable logistic regressions models were used to examine the odds of male partner accompaniment to ANC between women with above-average versus below-average composite and dimensional empowerment scores. Results In the majority of countries, male accompaniment to ANC was not uncommon. However, findings were mixed. Positive associations in women’s composite empowerment and male involvement were observed in Burkina Faso (OR = 1.27, 95% CI: 1.08, 1.50) and Uganda (OR = 1.53, 95% CI: 1.00-2.35), and in the economic empowerment dimension in Burkina Faso (OR = 1.24, 95% CI: 1.05-1.47). In Malawi, significant negative associations were observed in the odds of male accompaniment to ANC and women’s composite (OR = 0.77, 95% CI: 0.62-0.97) and economic empowerment scores (OR = 0.75, 95% CI: 0.59-0.94). No significant differences were observed in Burundi, Mozambique, Rwanda, Senegal, or Zimbabwe. Conclusion Women’s empowerment can be positively or negatively associated with male antenatal accompaniment. Male involvement efforts may benefit from empowerment initiatives that promote women’s participation in social and economic spheres, provided that antenatal participation does not undermine women’s preferences or autonomy. The observation of mixed and null findings suggests that additional qualitative and longitudinal research may enhance understanding of women’s empowerment in sub-Saharan African settings.
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              Male involvement during pregnancy and childbirth: men’s perceptions, practices and experiences during the care for women who developed childbirth complications in Mulago Hospital, Uganda

              Background Development of appropriate interventions to increase male involvement in pregnancy and childbirth is vital to strategies for improving health outcomes of women with obstetric complications. The objective was to gain a deeper understanding of their experiences of male involvement in their partners’ healthcare during pregnancy and childbirth. The findings might inform interventions for increasing men’s involvement in reproductive health issues. Methods We conducted 16 in-depth interviews with men who came to the hospital to attend to their spouses/partners admitted to Mulago National Referral Hospital. All the spouses/partners had developed severe obstetric complications and were admitted in the high dependency unit. We sought to obtain detailed descriptions of men’s experiences, their perception of an ideal “father” and the challenges in achieving this ideal status. We also assessed perceived strategies for increasing male participation in their partners’ healthcare during pregnancy and childbirth. Data was analyzed by content analysis. Results The identified themes were: Men have different descriptions of their relationships; responsibility was an obligation; ideal fathers provide support to mothers during childbirth; the health system limits male involvement in childbirth; men have no clear roles during childbirth, and exclusion and alienation in the hospital environment. The men described qualities of the ideal father as one who was available, easily reached, accessible and considerate. Most men were willing to learn about their expected roles during childbirth and were eager to support their partners/wives/spouses during this time. However, they identified personal, relationship, family and community factors as barriers to their involvement. They found the health system unwelcoming, intimidating and unsupportive. Suggestions to improve men’s involvement include creating more awareness for fathers, male-targeted antenatal education and support, and changing provider attitudes. Conclusions This study generates information on perceived roles, expectations, experiences and challenges faced by men who wish to be involved in maternal health issues, particularly during pregnancy and childbirth. There is discord between the policy and practice on male involvement in pregnancy and childbirth. Health system factors that are critical to promoting male involvement in women’s health issues during pregnancy and childbirth need to be addressed.
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                Author and article information

                Journal
                J Public Health Res
                J Public Health Res
                PHJ
                spphj
                Journal of Public Health Research
                SAGE Publications (Sage UK: London, England )
                2279-9028
                2279-9036
                10 November 2023
                October 2023
                : 12
                : 4
                : 22799036231204318
                Affiliations
                [1 ]Department of Obstetrics and Gynecology, School of Medicine, Universitas Islam Negeri Alauddin Makassar, Makassar, Indonesia
                [2 ]Department of Parasitology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
                [3 ]Department of Obstetrics and Gynecology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
                [4 ]Clinical Nurse, La Patarai General Hospital, Barru, South Sulawesi, Indonesia
                Author notes
                [*]Azizah Nurdin, Department of Obstetrics and Gynecology, School of Medicine, Universitas Islam Negeri Alauddin Makassar, PO Box 90221, Makassar 90245, Indonesia. Email: azizah.nurdin@ 123456uin-alauddin.ac.id
                Author information
                https://orcid.org/0000-0002-2188-7144
                https://orcid.org/0000-0001-5800-8732
                Article
                10.1177_22799036231204318
                10.1177/22799036231204318
                10638868
                37953878
                a98d5f34-8416-4428-be9f-48e29b25d4c1
                © The Author(s) 2023

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 27 January 2023
                : 29 August 2023
                Categories
                Original Article
                Custom metadata
                October-December 2023
                ts1

                antenatal care,determinants factor,healthcare delivery,indonesian men

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