Facilitators and barriers of male partner involvement in antenatal care at Kawempe National Referral Hospital

Abstract

Introduction: The involvement of men in maternal and child health programs and services like antenatal care, is recognized globally to give better health outcomes and improved service delivery for both men, women and children. However, in Uganda and other developing countries, male involvement in prenatal care remains low and a significant hurdle to safe motherhood in antenatal care provision. There is paucity of documented evidence of the extent of the practice, facilitators and barriers to male partner involvement in antenatal services thus no clear strategies to optimize the practice. This study thus sought to explore the facilitators and barriers of male partner involvement in antenatal care at Kawempe National Referral Hospital. Methodology: This was an explorative qualitative study conducted at Kawempe National Referral Hospital, Kampala Uganda. The data was collected using a total of 3 FGDs each comprised of 5 men who had accompanied their wives for ANC, 4 FGDs each comprised of 5 pregnant mothers who had been accompanied by their husbands, 4 FGDs comprised of pregnant mothers who had not been accompanied by their husbands, 6 key informant interviews comprised of healthcare providers responsible for education, counselling and providing ANC services and 7 telephone conducted in-depth interviews with male partners who did not accompany their spouses giving a total of 68 participants. Data analysis was done thematically using NVIVO version 12 software. Results: The facilitators of MPI were divided into three major themes that is health related facilitators, maternal facilitators and health facility facilitators. Presence of adverse events of pregnancy, availability of male-friendly services, provision of patient counseling an education and involvement in community outreach and engagement were identified as the major facilitators. The barriers to male partner involvement were also grouped into three themes that is; health facility, community related and personal barriers. Prolonged waiting time at ANC sites, fear of hospital bills, limited accessibility of ANC facilities, unfavorable conditions at work, stigmatization from other men, limited awareness and education on importance of MPI and lack of social support and role models were the major barriers identified. Conclusion: Male involvement in ANC activities is facilitated by adverse events of pregnancy, availability of male-friendly services and community outreach programs and is limited by prolonged waiting time at ANC sites, unfavorable work schedules and stigmatization from other men. Targeted health education programs, flexible ANC services, and ensuring supportive working environments is recommended to booster male involvement in ANC.