TY - JOUR

T1 - Understanding male involvement in antenatal care in the Kilimanjaro region of Tanzania

T2 - Barriers, facilitators, and opportunities for engagement

AU - Sao, Saumya S.

AU - Kisigo, Godfrey A.

AU - Osaki, Haika

AU - Coleman, Jessica N.

AU - Renju, Jenny

AU - Mwamba, Rimel N.

AU - Ngocho, James S.

AU - Mmbaga, Blandina T.

AU - Watt, Melissa H.

N1 - Publisher Copyright: © 2023 Elsevier B.V.

PY - 2024

Y1 - 2024

N2 - Background: Male engagement in antenatal care (ANC) has been recommended by the World Health Organization to improve maternal and newborn health outcomes, but implementation challenges remain. This study explored barriers, facilitators, and opportunities to improve male attendance and engagement in ANC. Methods: In-depth interviews were conducted individually with pregnant women and male partners attending a first ANC visit at two public health facilities in Moshi, Tanzania. Interviews examined factors influencing male ANC attendance and male experiences during the clinic visit. Interviews were recorded, transcribed verbatim, and translated from Swahili into English. Transcripts were coded thematically in NVivo. Main findings: Constructions of masculinity both positively and negatively influenced male involvement in ANC. Individual-level barriers included a fear of HIV testing, perceptions of pregnancy as the woman's responsibility, and discomfort with ANC as a predominantly female space. Structural barriers included inability to take time off from work and long clinic wait times. The primary facilitator to male involvement was the preferential care given in the ANC clinic to women who present with a male partner. Additionally, some men desired to learn about their family's health status and felt that attending ANC was a sign of respect and love for their partner. Conclusions: Opportunities exist to improve male involvement in ANC, namely training providers to engage men beyond HIV testing and counseling. Peer programs that promote men's engagement in pregnancy could prove useful to reduce apprehension around HIV testing and dispel conceptions of ANC as only a women's healthcare space.

AB - Background: Male engagement in antenatal care (ANC) has been recommended by the World Health Organization to improve maternal and newborn health outcomes, but implementation challenges remain. This study explored barriers, facilitators, and opportunities to improve male attendance and engagement in ANC. Methods: In-depth interviews were conducted individually with pregnant women and male partners attending a first ANC visit at two public health facilities in Moshi, Tanzania. Interviews examined factors influencing male ANC attendance and male experiences during the clinic visit. Interviews were recorded, transcribed verbatim, and translated from Swahili into English. Transcripts were coded thematically in NVivo. Main findings: Constructions of masculinity both positively and negatively influenced male involvement in ANC. Individual-level barriers included a fear of HIV testing, perceptions of pregnancy as the woman's responsibility, and discomfort with ANC as a predominantly female space. Structural barriers included inability to take time off from work and long clinic wait times. The primary facilitator to male involvement was the preferential care given in the ANC clinic to women who present with a male partner. Additionally, some men desired to learn about their family's health status and felt that attending ANC was a sign of respect and love for their partner. Conclusions: Opportunities exist to improve male involvement in ANC, namely training providers to engage men beyond HIV testing and counseling. Peer programs that promote men's engagement in pregnancy could prove useful to reduce apprehension around HIV testing and dispel conceptions of ANC as only a women's healthcare space.

KW - Antenatal care

KW - HIV testing and counseling (HTC)

KW - Male engagement

KW - Male reproductive health behavior

KW - Tanzania

U2 - 10.1016/j.srhc.2023.100931

DO - 10.1016/j.srhc.2023.100931

M3 - Journal article

C2 - 38039661

AN - SCOPUS:85178423586

VL - 39

JO - Sexual & Reproductive HealthCare

JF - Sexual & Reproductive HealthCare

SN - 1877-5756

M1 - 100931

ER -