Background <p>In Malawi, women experience poor maternal health outcomes. Although this is strongly linked to gender inequalities, men should not be excluded from the solution. Male partners’ engagement at home and at maternal health services has been shown to improve health outcomes for women, in part through increased and consistent utilisation of antenatal care services. Initiatives have been implemented in Malawi to increase male partner involvement, although with minimal success. This study aimed to investigate the beliefs, perceptions and experiences of the lay male community members of Chilaweni, rural Blantyre district in Southern Malawi, on the role of men during pregnancy and delivery.</p> Methods <p>A qualitative exploratory study design was selected. Flexible semi-structured interviews were used to explore participant views in depth. Participants, recruited through convenience sampling, were interviewed over four weeks at two sites in Chilaweni. Participant responses were translated from Chichewa to English. Data was transcribed clean verbatim and analysed using Braun and Clarke’s six-step approach to reflexive thematic analysis.</p> Results <p>Twenty interviews were conducted. Four main themes were identified: roles; barriers; facilitators; and topic reception. Roles in maternal healthcare included attending clinics or providing transport. However, often men felt their role was to work, presenting a barrier to engagement. This was accompanied by social embarrassment, driven by cultural beliefs surrounding men who are involved in women’s healthcare. Encouragingly, though participants recognised the benefits of participation in maternal healthcare. These are presented under the theme ‘facilitators’, with men reporting factors such as the opportunity to be tested for sexually transmitted infections as motivation to participate, as well as personal reasons, including participation being an act of love. The theme ‘topic reception’ considers participants’ awareness and approach to the topic, which was positive, serving as a promise for change in the future.</p> Conclusion <p>Overall, this study highlights key roles men feel they play during pregnancy, as well as barriers and facilitators to their engagement. Participants were receptive to the concept of male partner involvement, wanting to take part actively. This study recommends several strategies based on its findings to increase male engagement in pregnancy and childbirth in Malawi.</p>

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Exploring men’s perceptions, experiences and beliefs on their role in maternal healthcare in rural southern Malawi: a qualitative study

  • Gabriella Millard,
  • Alice Pennington,
  • Christel McMullan,
  • Ruthie Markus,
  • Grace Mkandawire,
  • Miriam van Goor,
  • Gilles de Wildt

摘要

Background

In Malawi, women experience poor maternal health outcomes. Although this is strongly linked to gender inequalities, men should not be excluded from the solution. Male partners’ engagement at home and at maternal health services has been shown to improve health outcomes for women, in part through increased and consistent utilisation of antenatal care services. Initiatives have been implemented in Malawi to increase male partner involvement, although with minimal success. This study aimed to investigate the beliefs, perceptions and experiences of the lay male community members of Chilaweni, rural Blantyre district in Southern Malawi, on the role of men during pregnancy and delivery.

Methods

A qualitative exploratory study design was selected. Flexible semi-structured interviews were used to explore participant views in depth. Participants, recruited through convenience sampling, were interviewed over four weeks at two sites in Chilaweni. Participant responses were translated from Chichewa to English. Data was transcribed clean verbatim and analysed using Braun and Clarke’s six-step approach to reflexive thematic analysis.

Results

Twenty interviews were conducted. Four main themes were identified: roles; barriers; facilitators; and topic reception. Roles in maternal healthcare included attending clinics or providing transport. However, often men felt their role was to work, presenting a barrier to engagement. This was accompanied by social embarrassment, driven by cultural beliefs surrounding men who are involved in women’s healthcare. Encouragingly, though participants recognised the benefits of participation in maternal healthcare. These are presented under the theme ‘facilitators’, with men reporting factors such as the opportunity to be tested for sexually transmitted infections as motivation to participate, as well as personal reasons, including participation being an act of love. The theme ‘topic reception’ considers participants’ awareness and approach to the topic, which was positive, serving as a promise for change in the future.

Conclusion

Overall, this study highlights key roles men feel they play during pregnancy, as well as barriers and facilitators to their engagement. Participants were receptive to the concept of male partner involvement, wanting to take part actively. This study recommends several strategies based on its findings to increase male engagement in pregnancy and childbirth in Malawi.