What stops men’s involvement in maternity care? A community study (Tanzania)

men’s involvement

Discussions with parents and professionals in Tanzania have identified barriers to men’s involvement in maternity care, as perceived within the community. The researchers recommend dissemination of couple-friendly knowledge and information on maternal and newborn healthcare.

Both women and men generally agreed that men’s antenatal involvement improves the quality of maternal and newborn care. This means men become better informed and more able to engage in care for their pregnant partners. However, involvement in attending facilities beyond the first appointment is generally low. Furthermore, few men work to reduce the workload of women when they are pregnant, though after the birth, men tend to get a little more involved.

32 focus groups – 16 with men and 16 with women – were organised, involving 118 couples in all. In addition, there were 34 interviews with community teachers, village health workers and healthcare providers. These all took place in the Dodoma region of Tanzania, across four districts with very wide variation in men’s involvement: Kongwa (99.9% men’s attendance), Kondoa (24% men’s attendance), Dodoma Municipality (13% men’s attendance) and Chamwino (no information on men’s attendance).

Five barriers to men’s engagement were presented in these discussions.

Gender roles. Maternal and newborn health is generally left to women except in a critical situation and except for instrumental aspects, such as transport and finance. Men attending clinics can face stereotyping and gossiping by both women and men. The low engagement of men described above is another manifestation of divided gender roles.

Fear of HIV testing. In this region of Tanzania, antenatal care is combined with HIV testing, and there is fear of stigma following a positive test.

Precarious family economics. In families with low incomes, men may not be able to afford taking any time away from work.

Lack of knowledge. Many couples are not informed of the benefits of both partners attending a clinic together, for example, the opportunity to become better informed.

Problems at health facilities. These include long waiting times, distance to health facilities, insensitive staff, lack of space and privacy at health facilities, shortage of medical supplies and demands for bribes.

This research follows a survey of men in Dodoma region by the same researchers, which was reported on Family Included, A survey of fathers in Tanzania highlights the need for good information for fathers during the perinatal period. The findings link to other recent community research with community elders in Nigeria, Male community elders can support maternal and newborn health (Nigeria).

 

Gibore NS & Bali TA (2020), Community perspectives: An exploration of potential barriers to men’s involvement in maternity care in a central Tanzanian community, PLoS ONE 15.5

Header photo: DFID. Creative Commons.