Exploratory descriptive qualitative research of factors influencing male involvement in antenatal care services at Mangochi District Hospital, Malawi

Abstract

Male involvement in antenatal care services is currently being encouraged in most Sub-Saharan countries, including Malawi, as an approach to address maternal mortality. Despite the benefits associated with men attending ANC services, in Sub-Saharan Africa, the involvement of male spouses in ANC services is low, with attendance rates ranging from 5% to 31%. About two-thirds of men in the region (61.7%) visit the clinics only once. Malawian men also rarely attend ANC services with their partners ranging from 3.2% to 19%. However, documentation on the reasons for the low male involvement in the country is scanty. The purpose of this research is to explore factors influencing male attendance in antenatal care services during pregnancy at Mangochi District Hospital, Malawi. An exploratory descriptive qualitative research design was employed to explore factors influencing the involvement of male partners in antenatal care services during pregnancy. Using purposive sampling, the research recruited 40 participants which included couples attending ANC services, pregnant women whose male spouses were not attending ANC services and staff nurses providing ANC services. Focus group discussions, in-depth interviews, and key-informant interviews were used to collect data, using semi-structured interview guides with probes. The research used thematic analysis to analyse data by emerging themes and their sub-themes. Among others, the research findings revealed that social and structural factors including men’s perceived benefits of their spouses’ ANC attendance, societal and cultural expectations, socioeconomic barriers special treatment which women receive when they are escorted by their male spouses, attitude of health care providers prior ANC preparations, distance to the antenatal clinic, time spent at ANC clinic and unfriendly facility environment are key factors influencing male partner participation in ANC. These factors either promote or hinders men from attending their spouses’ ANC visits, as they would directly and indirectly affect men’s attitudes and subjective norms towards their participation in ANC services. However, the special treatment which women receive when they are escorted by their male spouses greatly motivate men to be attending ANC services at Mangochi district hospital. The research then recommends that addressing these social and structural factors would improve pregnancy outcomes and ultimately reducing preventable maternal deaths.