Sociodemographic Characteristics of Respondents
From table 1, 62% of respondents were aged 20 to 30 years, 11.5% were less than 20 years, and 26.1% were above 30 years. Again, 38.5% of attained education below Junior High School or Middle school, 33.0% were in Junior High School (JHS) or Middle school, while 28.4% were in Senior High School (SHS) or Vocational and above. Also, 86% were found in a one-husband one-wife marriage, while the remaining 14% were in a polygamous marriage. Respondents were into various categories of Occupation, of which 29.4% were farmers, 24.3% were housewives only, 11.9% were petty traders, and 10.6% were public servants. On ethnic lines, 98.2% were Dagaaba, while the remaining were Kassenas, Akans, and others, constituting 1.8%. In terms of religion, 87.2% were Christians, 11.9% were Muslims, and 0.9% of them practiced African Traditional Religion.
Table 1
Socio-demographic Characteristics of Respondents
Variable
|
Frequency
|
Percentage (%)
|
Age
|
|
|
<20 Years
|
25
|
11.5
|
20 -30 Years
|
136
|
62.4
|
>30 Years
|
57
|
26.1
|
Total
|
218
|
100.0
|
Level of Education
|
|
|
Below JHS/Middle School
|
84
|
38.5
|
JHS/Middle School
|
72
|
33.0
|
SHS/Vocational and Above
|
62
|
28.4
|
Total
|
218
|
100.0
|
Marital Type
|
|
|
Monogamous
|
188
|
86.2
|
Polygamous
|
30
|
13.8
|
Total
|
218
|
100.0
|
Ethnicity
|
|
|
Dagaaba
|
214
|
98.2
|
Others
|
4
|
1.8
|
Total
|
218
|
100.0
|
Religion
|
|
|
ATR
|
2
|
.9
|
Christian
|
190
|
87.2
|
Muslim
|
26
|
11.9
|
Total
|
218
|
100.0
|
Occupation
|
|
|
Farming
|
64
|
29.4
|
Housewife only
|
53
|
24.3
|
Petty trading
|
26
|
11.9
|
Public servant
|
23
|
10.6
|
Vocational
|
52
|
23.9
|
Total
|
218
|
100.0
|
Source: Field data (2020)
Prevalence of spousal Communication on health during the pregnancy
Communication is a very important ingredient in every relationship or marriage. Figure 1 indicates whether respondents often discuss their health and pregnancy with their husbands during the period of gestation. The majority of respondents (96.8%) indicated that they often discuss issues concerning their health with their husbands, while only 3.2% did not. Again, most respondents (97.2%) stated that they often discuss their pregnancy with their husbands.
Issues Couples often discuss other than health matters
In-Depth Interview were held at health facilities and communities; some participants expressed their views on issues couples often discuss other than health. A midwife opined that;
"They concentrate more on how to care for the woman in terms of getting logistics, finances, and the money to cater for the woman instead of talking about their health."
-----A midwife with five years' experience.
Barriers to spousal communication on health during pregnancy
Regarding what prevents them from having a conversation with their husbands during pregnancy, they indicated that;
"Because of my husband's kind of work (mason work), he does not have time for me to have a serious conversation with him. He normally comes late, and he is tired. Also, he is not the talkative type" [smiling]. (Pregnant woman 1)
Another respondent indicated that;
"You don't know my husband. Anytime I complain about my health or pregnancy, he will say I am lazy, and he does not like me to talk about anything that has to do with money. Talk to him, and he is inside the room. Should I call him"? (Pregnant woman 2)
Generally, village health workers/volunteer midwives and Traditional Birth Attendants recruited for In-Depth Interviews believed that there exists inadequate spousal communication during pregnancy, contrary to results from pregnant women. It is often not clear to health care providers the barriers to spousal communication during pregnancy;
"I cannot tell whether cultural or religious beliefs affect spousal Communication during Pregnancy, but I believe there are none. Lack of spousal Communication can lead to inferior psychosis, so communication is necessary during pregnancy. If the communication is well established during pregnancy, I think everything will be okay. The husband will be able to provide everything the woman needs, and there will be nothing hidden. We know that what the mother gets during pregnancy (nutrients) are what the baby gets (nutrients). If there is proper communication and the husband can take care of the woman well, it will translate into a healthy baby". (ANC In-charge with over ten years' experience).
Male involvement in maternal health decision making during ANC
Males are expected to be involved in decision-making concerning matters related to maternal healthcare. Male involvement improves women's access to healthcare during pregnancy. Figure 2 explains males' involvement in women's Antenatal care (ANC). A higher majority of males (83.9%) did encourage or ask their spouses to attend ANC. However, most males (67.0%) never attended ANC with their spouses. Again, 59.2% support their spouses with transportation to ANC, while 40.8% never did.
Factors influencing male involvement in maternal health decision making during pregnancy
In this study, a bivariate analysis was employed using cross-tabulations in the SPSS version 25.0 program. Factors such as sociodemographic characteristics, spousal communications, and health characteristics were measured and analyzed to see how they impact male involvement in motherly fitness choice-making during ANC periods. Each independent variable was cross-tabulated with the dependent variable (i.e. level of males involvement in maternal health decision making during the ANC period) to investigate the association between the two variables. The χ² value tested the power of the association. The statistical significance of χ² was tested by the P-value of 0.05 as a criterion.
Age and Level of Male Involvement in maternal health decision making
As illustrated in table 2, two variables showed a strong (χ²=6.432) and a statistically significant relationship (p-value = 0.040). Women in the age group of 20-30 were more likely to have their spouses involved in maternal health decision-making during the ANC period than other women in the age group <20 years and age group >30 years.
Number of children to have and the Level of Male Involvement in maternal health decision making
It can be seen from table 2b that there is a strong (χ²=8.755) and significant (p=<0.003) association between whether or not respondents discussed with a spouse the number of children to have and the level of male involvement in motherly fitness choice-making during ANC period.
Discussion of ANC visit with spouse and Level of Male Involvement in maternal health decision making
The results show strong evidence (χ²=22.089) of a relationship between the two variables. Respondents who discussed their ANC visits with their spouses and their in-laws were more likely to score high in their male counterparts' involvement in motherly fitness decision-making during ANC. Compared to those who discussed with Health staff and their mothers, none with a statistically significant p-value of 0.000. As recorded in Table 2, the rest of the measured variables did not show significant relationships with males' taking part in motherly fitness choices during the ANC period.
Table 2
Factors influencing male involvement in maternal health decision making during pregnancy
|
Male involvement in maternal health decision making during pregnancy
|
χ² (P-value)
|
Variable
|
Low Involvement
|
High Involvement
|
|
AGE
|
<20 years
|
10 (40.0%)
|
15 (60.0%)
|
6.432 (0.040)
|
20-30 years
|
41 (30.1%)
|
95 (69.9%)
|
|
>30 years
|
28 (49.1%)
|
29 (50.9%)
|
|
Level of Education
|
|
Primary and Below
|
36 (42.9%)
|
48 (57.1%)
|
3.058 (0.217)
|
JHS/Middle School
|
25 (34.7%)
|
47 (65.3%)
|
|
SHS/Vocational and Above
|
18 (29.0%)
|
44 (71.0%)
|
|
Type of Marriage
|
|
Monogamous
|
71 (37.8%)
|
117 (62.2%)
|
1.379 (0.240)
|
Polygamous
|
8 (26.7%)
|
22 (73.3%)
|
|
Ethnicity
|
Dagaaba
|
77 (36.0%)
|
137 (64.0%)
|
0.334 (0.563)
|
Others
|
2 (50.0%)
|
2 (50.0%)
|
|
Religion
|
|
ATR
|
1 (50.0%)
|
1 (50.0%)
|
0.530 (0.767)
|
Christian
|
70 (36.8%)
|
120 (63.2%)
|
|
Moslem
|
8 (30.8%)
|
18 (69.2%)
|
|
Occupation
|
|
Farming
|
26 (40.6%)
|
38 (59.4%)
|
1.959 (0.743)
|
Housewife only
|
19 (35.8%)
|
34 (64.2%)
|
|
Petty trading
|
7 (26.9%)
|
19 (73.1%)
|
|
Public Servant
|
7 (30.4%)
|
16 (69.6%)
|
|
Vocational
|
20 (38.5%)
|
32 (61.5%)
|
|
Discussed the number of children to have
|
Yes
|
50 (45.9%)
|
59 (54.1%)
|
8.755 (0.003)
|
No
|
29 (26.6%)
|
80 (73.4%)
|
|
Discussion of your health with your spouse?
|
Yes
|
75 (35.5%)
|
136 (64.5%)
|
1.368 (0.242)
|
No
|
4 (57.1%)
|
3 (42.9%)
|
|
Discussion of Pregnancy before getting pregnant?
|
Can’t remember
|
11 (32.4%)
|
23 (67.6%)
|
4.209 (0.122)
|
No
|
15 (53.6%)
|
13 (46.4%)
|
|
Yes
|
53 (34.0%)
|
103 (66.0%)
|
|
Which of the following persons do you often discuss ANC visits with?
|
Health staff
|
14 (77.8%)
|
4 (22.2%)
|
22.089 (0.000)
|
Husband/Spouse
|
50 (33.3%)
|
100 (66.7%)
|
|
In-laws
|
8 (20.5%)
|
31 (79.5%)
|
|
Mother
|
4 (57.1%)
|
3 (42.9%)
|
|
None
|
3 (75.0%)
|
1 (25.0%)
|
|
Is today your first time coming to ANC?
|
|
No
|
64 (36.0%)
|
114 (64.0%)
|
0.034 (0.854)
|
Yes
|
15 (37.5%)
|
25 (62.5%)
|
|
The outcome of your previous pregnancy?
|
|
Life birth
|
18 (33.3%)
|
36 (66.7%)
|
4.331 (0.115)
|
Still birth
|
2 (13.3%)
|
13 (86.7%)
|
|
Is this your first-time pregnancy?
|
|
No
|
61 (37.2%)
|
103 (62.8%)
|
0.262 (0.609)
|
Yes
|
18 (33.3%)
|
36 (66.7%)
|
|
Source: Field data (2020)
Logistic regression analysis
The Logistic regression analysis was done where all the independent variables were matched against the dependent variable using Binary Logistic Regression. Those independent variables which have shown statistically significant relationships with the dependent variable in the bivariate analysis were included in the multivariate model.
Results from table 3 show a NagelkerkeR-square value of 0.221, which means that 22.1% of the variation in male involvement in maternal health decision-making during antenatal periods is explained by the factors in the model, while other factors explain 77.9%. The results showed a significant relationship between the respondent's age, whether they discuss how many children to have with a spouse, who respondents discuss ANC visits with, and their male counterparts' level of involvement in maternal health decision making during the ANC. The odds of respondents in the aged >30 years group whose spouses have a high level of participation in maternal health decision making during the ANC is almost three times the odds of belonging to the <20 years group [(AOR: 2.896, 95% CI: 1.396-6.010, p=0.004)]. The odds of respondents who discussed with their spouses the number of children to have, whose spouses have a high level of involvement in maternal health decision making during antenatal is less than half times the odds of respondents who did not discuss the number of kids to have with their spouses [(AOR: 0.328, 95% CI: 0.170-0.633, p=0.001)]. Again, the odds of respondents who discussed their ANC visits with their mothers, whose spouses have a high level of involvement in maternal health decision making during ANC is about fifteen times the odds of belonging to respondent groups who discussed their ANC visits with a health staff [(AOR: 15.257, 95% CI: 1.204-193.395, p=0.035)].
Table 3
Determinants of male involvement in maternal health decision making during ANC period
Exposure variable
|
High level of male involvement in Maternal health decision making during pregnancy
|
|
|
AOR
|
95%CI
|
P-value
|
Age
|
<20 years (RC)
|
1
|
|
|
20-30 years
|
2.666
|
0.893 - 7.958
|
0.079
|
>30 years
|
2.896
|
1.396- 6.010
|
0.004
|
Discussion on the number of children to have
|
No (RC)
|
1
|
|
|
Yes
|
0.328
|
0.170- 0.633
|
0.001
|
Who do you discuss your ANC visits with?
|
Health staff (RC)
|
1
|
|
|
Husband/Spouse
|
1.148
|
0.079- 16.597
|
0.919
|
In-laws
|
8.043
|
0.707- 91.505
|
0.093
|
Mother
|
15.257
|
1.204-193.395
|
0.035
|
None
|
3.068
|
0.173-54.442
|
0.445
|
Source: field data (2020), *RC denotes Reference Category