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

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Abstract

Background

Ethiopia has recorded substantial progress in maternal health recently. However, poor utilization of maternal health care services is challenging further improvement. Although male partners are decision-makers in households, the impact of their involvement on maternal health care services has not been well studied. Thus, the objective of this study was to examine the association between male partners’ involvement in maternal health care on utilization of maternal health care services.

Methods

A community-based cross-sectional study was conducted on male/female couples with a baby less than 6 months old ( N = 210) in Addis Ababa, Ethiopia. The main independent variable of the study was male partners’ involvement in maternal health care. Two structured questionnaires were used to collect the data from men and women. Bivariate and multivariate logistic regression models were used to examine the relationship between the dependent and independent variables.

Results

Mean age in years was 28.7 (SD = 5.4) for women and 36.2 (SD = 8.8) for men. Half of the men (51.4%) have accompanied their partner to antenatal care (ANC) at least once. However, only 23.1% of them have physically entered the ANC room together. Overall involvement of male partners was poor in 34.8% of the couples (involved in two or fewer activities). After controlling for other covariates, the odds of having 1st ANC visit within the first trimester of pregnancy and skilled delivery attendant at birth were higher in women whose male partners took time to know what happened during ANC visits (AOR = 1.93; 95%CI = 1.04–3.60; AOR = 2.93; 95%CI = 1.24–5.6.90, respectively). Similarly, the odds of having at least one ANC visit, first ANC visit within twelve weeks, HIV testing, skilled birth attendant, and birth in a health facility were higher in couples with higher overall male partner involvement.

Conclusion

The study demonstrated significant associations between male partners’ involvement in maternal health care and utilization of some maternal health care services by female partners.

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Most cited references 38

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Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Nicholas J. Kassebaum, Amelia Bertozzi-Villa, Megan S Coggeshall … (2014)

The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery. We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values. 292,982 (95% UI 261,017-327,792) maternal deaths occurred in 2013, compared with 376,034 (343,483-407,574) in 1990. The global annual rate of change in the MMR was -0·3% (-1·1 to 0·6) from 1990 to 2003, and -2·7% (-3·9 to -1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0·4% (0·2-0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1-1262·8) in South Sudan to 2·4 (1·6-3·6) in Iceland. Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa. Bill & Melinda Gates Foundation. Copyright © 2014 Elsevier Ltd. All rights reserved.

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Antenatal couple counseling increases uptake of interventions to prevent HIV-1 transmission.

Carey Farquhar, James N. Kiarie, Barbra Richardson … (2004)

To determine effect of partner involvement and couple counseling on uptake of interventions to prevent HIV-1 transmission, women attending a Nairobi antenatal clinic were encouraged to return with partners for voluntary HIV-1 counseling and testing (VCT) and offered individual or couple posttest counseling. Nevirapine was provided to HIV-1-seropositive women and condoms distributed to all participants. Among 2104 women accepting testing, 308 (15%) had partners participate in VCT, of whom 116 (38%) were couple counseled. Thirty-two (10%) of 314 HIV-1-seropositive women came with partners for VCT; these women were 3-fold more likely to return for nevirapine (P = 0.02) and to report administering nevirapine at delivery (P = 0.009). Nevirapine use was reported by 88% of HIV-infected women who were couple counseled, 67% whose partners came but were not couple counseled, and 45%whose partners did not present for VCT (P for trend = 0.006). HIV-1-seropositive women receiving couple counseling were 5-fold more likely to avoid breast-feeding (P = 0.03) compared with those counseled individually. Partner notification of HIV-1-positive results was reported by 138 women (64%) and was associated with 4-fold greater likelihood of condom use (P = 0.004). Partner participation in VCT and couple counseling increased uptake of nevirapine and formula feeding. Antenatal couple counseling may be a useful strategy to promote HIV-1 prevention interventions.

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Male antenatal attendance and HIV testing are associated with decreased infant HIV infection and increased HIV-free survival.

Adam R. Aluisio, Barbra Richardson, Rose Bosire … (2011)

To investigate the relationship between male involvement in prevention of mother-to-child HIV transmission services and infant HIV acquisition and mortality, a prospective cohort study was undertaken between 1999 and 2005 in Nairobi, Kenya. HIV-infected pregnant women were enrolled and followed with their infants for 1 year with infant HIV DNA testing at birth, 1, 3, 6, 9, and 12 months postpartum. Women were encouraged to invite male partners for prevention counseling and HIV testing. Among 456 female participants, 140 partners (31%) attended the antenatal clinic. Eighty-two (19%) of 441 infants tested were HIV infected by 1 year of age. Adjusting for maternal viral load, vertical transmission risk was lower among women with partner attendance compared with those without [adjusted hazard ratio (aHR) = 0.56, 95% confidence interval (CI): 0.33 to 0.98; P = 0.042] and among women reporting versus not reporting previous partner HIV testing (aHR = 0.52, 95% CI: 0.32 to 0.84; P = 0.008). The combined risk of HIV acquisition or infant mortality was lower with male attendance (aHR = 0.55; 95% CI: 0.35 to 0.88; P = 0.012) and report of prior male HIV testing (aHR = 0.58; 95% CI: 0.34 to 0.88; P = 0.01) when adjusting for maternal viral load and breastfeeding. Including men in antenatal prevention of mother-to-child HIV transmission services with HIV testing may improve infant health outcomes.

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Author and article information

Contributors

Bedru Hussen Mohammed:

ORCID: http://orcid.org/0000-0002-1236-6187

+852 283 15248 , bedredin4444@yahoo.com , bedru@hku.hk

Janice Mary Johnston: jjohnsto@hku.hk

Dana Vackova: vackova@hku.hk

Semira Mehammed Hassen: semirbedir@gmail.com

Huso Yi: husoyi@cuhk.edu.hk

Journal

Journal ID (nlm-ta): BMC Pregnancy Childbirth

Journal ID (iso-abbrev): BMC Pregnancy Childbirth

Title: BMC Pregnancy and Childbirth

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2393

Publication date (Electronic): 14 January 2019

Publication date PMC-release: 14 January 2019

Publication date Collection: 2019

Volume: 19

Electronic Location Identifier: 28

Affiliations

[1 ]ISNI 0000000121742757, GRID grid.194645.b, School of Public Health, , The University of Hong Kong, ; Hong Kong, Hong Kong SAR

[2 ]ISNI 0000000121742757, GRID grid.194645.b, School of Nursing, , The University of Hong Kong, ; Hong Kong, Hong Kong SAR

[3 ]The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR

Author information

Bedru Hussen Mohammed http://orcid.org/0000-0002-1236-6187

Article

Publisher ID: 2176

DOI: 10.1186/s12884-019-2176-z

PMC ID: 6332901

PubMed ID: 30642280

SO-VID: fd26d31f-4167-4408-abea-6e5c2c8bee0d

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 7 August 2017

Date accepted : 3 January 2019

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100004853, Chinese University of Hong Kong;

Award ID: -

Award Recipient : Bedru Hussen Mohammed

Custom metadata

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: male partner involvement,maternal health care services,prevention of mother-to-child transmission of hiv,antenatal care,addis ababa,ethiopia

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ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: male partner involvement, maternal health care services, prevention of mother-to-child transmission of hiv, antenatal care, addis ababa, ethiopia

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

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Advocacy for Maternal and Women’s Health

Most cited references 38

Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Antenatal couple counseling increases uptake of interventions to prevent HIV-1 transmission.

Male antenatal attendance and HIV testing are associated with decreased infant HIV infection and increased HIV-free survival.

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