Male Involvement in Maternal Health Decision-Making in Nkwanta South District, Ghana_

Abstract

BACKGROUND Worldwide, men play critical role in women‘s ability to seek health care, including reproductive health care, even though more often than not, they are ill-informed about women‘s reproductive health needs. Male participation has been shown to yield substantial influence in decisions and health outcomes in several other areas of reproductive health, including abortion and breastfeeding. However, male involvement has been found to be affected by men‘s low knowledge of women‘s reproductive health issues, culture and traditional restrictions. The study therefore looked at determinants of male participation in women‘s reproductive health needs in Nkwanta South District of the Volta Region. OBJECTIVE: This study was undertaken to determine the level of male involvement in antenatal, delivery and postnatal periods in Nkwanta South District of the Volta Region of Ghana, using a male involvement index developed during the study, as well as identify factors that promote and barriers that limit such male involvement. METHODS A cross-section study, covering 433 men aged 18 to 50 years, whose spouses were currently pregnant, had ever been pregnant, or had children, was carried out. Quantitative data for the study were obtained using structured questionnaires, while four focus group discussions and four key informant interviews were used to gather qualitative data. A male involvement index was constructed, based on ten key indicators. . The index of male participation in pregnancy, delivery, and postnatal periods was constructed by adding the scores of ten indicators of male participation for each respondent. The ten variables used had equal weight in the score. The male involvement score for each respondent ranged from 0 to 10, based on three categories, which included emotional, financial and physical supports. Linear regression was used to determine the association between background characteristics of the respondents and their involvement in maternal health. RESULTS The median age of the respondents was 37 years. More than seven out of every ten men (or 71%) had a low male involvement index, though a higher proportion (85%) claimed they accompanied their wives/partners to the clinic. The results also showed that men's knowledge of antenatal OR 0.3 95%CI (-1.422,-0.676) and delivery OR 0.2 95%CI (-1.801,-1.017), attitude towards antenatal OR 0.1 95%CI (- 2.898,-1.968), and postnatal OR 0.3 95% CI (1.781,-0.945) were the major factors that influenced male involvement in maternal health issues. The barriers that hinder male involvement in maternal health were related to cultural beliefs, socio-economic and poor health system. CONCLUSION The level of male involvement in women health decision- making was found to be generally low in Nkwanta South District. Even though men did give financial support to their partners during their maternity periods, emotional and physical support was low. Men‘s lack of knowledge of women maternal health needs, their limited roles and responsibilities in maternal health decision-making, and their attitudes were found to be shaped by cultural and gender roles. The structure of the health system also contributed to low male involvement as well. All of these were factors that contributed highly to low male involvement in maternal health matters. Despite increased knowledge of antenatal, delivery, and post-natal care, men still showed low participation in women maternal health needs.