Male Partner Involvement In Maternity Care In Ablekuma South District, Accra, Ghana

ABSTRACT BACKGROUND Male partner involvement has been recognised as a key factor in improving maternal health and reducing maternal mortality in settings where men play key role in decision making in the household. Aspects of reproductive health like family planning and treatment of STI have seen improvement where male involvement has been encouraged. Ghana has a high maternal mortality rate of 350/ 100,000 live births with a slow decline towards its goal of 185/ 100,000 live births by 2015. Male partner involvement is one of the strategies that can be used to accelerate the decline in maternal mortality and improve maternal health. OBJECTIVE The objective of this study, conducted in Ablekuma South District of Ghana was to determine the level of male partner involvement in maternity care and identify factors that influenced their involvement. METHODS A cross-sectional survey using interviewer-administered structured questionnaire was conducted among 422 men aged 18 years and above with children 5 years and below. The survey was complemented by 4 focus-group discussions; two female groups and two male groups. Male involvement was measured using a composite measure of 5 key points. Pearson Chi-Square was used to test association between the various factors and the level of male involvement and logistic regression analysis was carried out to determine the influence of these factors on the level of male involvement. Thematic Content Analysis of the focus-group discussions was also done. vi RESULTS The mean age of participants was 32.9 years (SD=8.2). Overall, 26.4% had high level of involvement, 55.2% had moderate level of involvement and 18.4% had low level of involvement. The period with the highest proportion of high male involvement was during labour and delivery. Younger age (18-25years vs. 26-35years: OR=0.28, 95%CI: 0.12, 0.66) and the couple living with other family members negatively impacted on the level of male involvement. On the other hand, higher level of education (Tertiary: OR=40.57, 95%CI- 3.16, 520.32; Senior Secondary: OR=7.73, 95% CI- 1.61, 37.15; Junior Secondary: OR=6.62, 95% CI: 1.35, 32.41) and the couple living together (OR= 13.12, 95%CI 6.86, 25.08) had a positive influence on the level of male involvement. Healthcare institution barriers to male partner involvement included poor staff attitudes, restrictions on male access to labour and delivery rooms and unwelcoming health facility environment. Social stigma associated with men playing what is perceived as feminine roles within the community was another barrier. CONCLUSION Male involvement in maternity care was not optimal. Improving male-friendliness of health facilities in terms of infrastructure, organisation of services and staff attitudes and education of the community especially men to sensitise them against the negative attitudes towards male participation in maternity care can improve male involvement.