Project Lead(s): Raymond Tweheyo
In developing countries there is lack of participation by male spouses in the preparation for childbirth.
Most maternal and child health programs seek to address the health needs of women and children and ignore men, resulting in little participation by men, resulting in poor outcomes for women and children at delivery.
However, in families, men tend to be responsible for important choices relating to the allocation of household resources and women’s care-seeking behaviour, including transportation and choice of facilities during antenatal care and at delivery.
Implemented in Uganda, the project team developed a male-integrated approach for provision of antenatal care services by providing health education to male spouses to increase spousal decision-making and participation in birth preparation.
The team hypothesized this approach would lead to an increase in family-level financing (out-of-pocket payment) and a higher level of facility deliveries.
Women and male spousal views of type of service and its components were explored, packaged and tested to measure the effect on improving women’s birth preparedness, planning, quality of delivery services and facility delivery rate.
This was a prospective quasi-experimental design (pre-post intervention and comparison group) in two health sub-district communities in Uganda, with 670 couples with gestation age 3–7 months enrolled in the study.
Results from this study showed that there seemed to be a positive correlation between educating males, with an increase in birth preparedness.
The most significant improvements with male involvement were in birth preparedness actions, including saving money for transport, purchasing supplies and seeking skilled delivery.
Health education and promotion to male partners of pregnant women resulted in a significant increase in:
· Female’s birth preparedness: 78.1% from 9.8% in the intervention arm, compared to 22.3% from 31.4% in the comparison group
· Male involvement in spousal birth preparedness: 86.6% from 47.3% in the intervention arm, compared to 45.3% from 41.3% in controls
· Skilled birth attendance: 74.3% from 63.9% in the intervention arm, compared to 20.9% from 55.6% in controls.
Knowledge of the project was disseminated through conference presentations and three manuscripts on the study have been completed.
UNICEF has been involved in discussions to implement the scaled-up intervention in a total of three districts, with Makerere University School of Public Health as the research lead.