A systematic test of a male involvement intervention in maternity care has been carried out in Burkina Faso and published in the Bulletin of the World Health Organisation. A three-part partner/couple programme increased the proportion of women exclusively breastfeeding at 3 months, use of postpartum contraception and women’s attendance at postnatal appointments.
A randomized control divided 1144 women attending primary health centres in Bobo-Dioulasso into two groups. About half the women received normal care and the other half a three-part partner/couple programme:
- Interactive group session during pregnancy with male partners only to discuss their role. (Attended by 74% of male partners.)
- Counselling session during pregnancy for individual couples. (Attended by 64% of couples.)
- Couple counselling session immediately after the birth. (Attended by 56% of couples, though this was artificially low because some women gave birth in other health facilities.)
To assess outcomes, the researchers only asked women; they did not interview the men.
The following are the proportions of “yes” responses by women in the intervention group compared to the routine care group.
| Exclusive breastfeeding 3m postpartum | 1.38x |
| Woman’s attendance at 2+ scheduled outpatient postnatal care consultations | 1.25x |
| Contraception
Use of long-acting or permanent method of contraception 8m postpartum Use of any contraceptive or contraceptive method 8m postpartum Timely initiation of effective modern contraception Use of effective modern contraception 8 m postpartum Use of any contraceptive or contraceptive method 8m postpartum Unmet need for contraception 8m postpartum |
1.34x 1.16x 1.13x 1.12x 1.10x 0.76x |
| Good relationship adjustment 8m postpartum | 1.18x |
| Complete satisfaction with routine care | 1.10x |
The researchers discuss what mechanism might be behind the improvement, offering five suggestions.
- Better communication between spouses and shared decision-making, as has been found in other studies.
- Men better informed in a context where men are seldom exposed to advice from health workers.
- Men more willing to pay for long-acting contraceptives. Women less afraid of the husband discovering concealed contraceptive use.
- More influence by fathers over their mothers who may discourage breastfeeding.
- More frequent contact with postnatal services, reinforcing health messages.
Intervention design
Women were given letters by the health services to give to their husbands and these were followed up by phone calls to him.
Health workers received one day of training on working with men and couples, and focused particularly on women’s control of their male partner’s involvement.
Interactive group discussions for male partners
- They took place on Saturday mornings.
- The sessions focused on stories of poor communication and collaboration between man and woman and inadequate health information. With good communication and information, the stories related positive outcomes.
- Men were given the equivalent of US$1.7 to cover travel expenses to attend the event.
Pregnancy counselling sessions (one couple at a time)
- Health information: importance of antenatal and postnatal care; birth preparedness and signs of labour; danger signs for mother and newborn child; exclusive breastfeeding; healthy timing and spacing of pregnancies; contraception.
Postnatal counselling sessions (one couple at a time)
- They took place within hours of the birth.
- Health information about the postnatal period.
Daniele MAS, Ganaba R, Sarrassat S, Cousens S, Rossier C, Drabo S, Ouedraogo D & Filippi V (2018), Involving male partners in maternity care in Burkina Faso: a randomized controlled trial, Bulletin of the World Health Organisation 96
Photo: EU Civil Protection and Humanitarian Aid. Creative Commons.
