The respondents included nine male and nine female who were purposively selected and these were; married (4 male), unmarried (2 male), pregnant (4), previously pregnant women (2), village health team members (3; one female, two male) and health workers (3; one male, two female).
The two broad themes that describe male involvement were mostly instrumentalist and included the Level of involvement and social support perspective of involvement. Sub-themes were obtained under the description of male involvement as the extent to which males were involved, including just impregnating the wife without further attachment and throughout the engagement. The subthemes/activities on the describing of male involvement as the perspective of social support included emotional support, role play in the wellbeing of mother and child, men's preparedness, and physical support. Physical support included; nutritional support, buying clothes for the expected baby, providing transportation, escorting the mother to a health facility, helping the wife with household chores as well as informative/appraisal support.The specific support activities were prioritized differently by the respondents.
Level/Extent of male involvement
Study findings show that male involvement is described by the level or extent of male involvement.The study findings provide that where the male involvement was high the pregnant mother had a healthier pregnancy, better delivery outcomes, and a healthy postnatal period. The more involved the male partner the baby is likely to be healthier and the less the male involvement the health of the mother and baby is likely to be poor.
“Of course different people understand it differently but I understand male involvement as the range from no involvement to excellent involvement.” Respondent 2 (male)
“All men don’t take care of their wives, some do while others don’t.” Respondent11 (male)
“We have had situations where some men give facilities to the woman but abandon them in other situations, you find the man is touched right from the time he learns that the wife is pregnant and he becomes happy.” Respondent 18 (female)
"For my wife even the children we have now when she is pregnant, we walk together to the hospital for antenatal care." Respondent 13(male)
There was another description of male involvement as unbothered male partners are merely interested in having sex and stop at impregnating their wives. The uninterested involvement was usually associated with poor health for the mother and the baby as compared to the contrary.
“There are some men that just go to bars without doing anything.” Respondent 9 (female)
Social support
Emotional support
Findings describe male involvement as emotional and psychological support to the pregnant mother from her partner.
Participants revealed that where there was emotional/love and or psychological support from the male partner the pregnancy, delivery and postnatal periods were likely to be healthy.
“In this community, men are different but the biggest percentage of men take care of their wives when they are pregnant because they know that giving birth is hard to even after giving birth, they give us comfort," Respondent 6 (female)
“The man should not also stress her so that the baby can be healthy.” Respondent 10 (male)
“Taking care of a woman when she's pregnant, during delivery, and after she has given birth." Respondent 4 (male)
“However, some men do not care for their wives:For our community, most of the men don't put in much effort to take care of their wives when they are pregnant and most times women just take care of themselves." Respondent 11 (male)
Roleplay in the wellbeing of mother and child
Male involvement was described as the male partner having a role to play during pregnancy, delivery, and postnatal periods.
Participants revealed that if men played their role including among others planning, providing money, love, and care the baby and mother would be healthy.
“Male involvement is a man having roles to play towards healthy child and the mother, it is having a man participate in the wellbeing of the mother and the child that is during pregnancy, labor and after delivery.” Respondent 9 (female)
“I understand it that if a woman is pregnant and you take good care of her, it helps both of you to produce a healthy baby and it also helps the mother to stay healthy.” Respondent 11(male)
Men’s preparedness
Male involvement is described as men being prepared for the outcome from the time of conception through delivery and postnatal to take care of the pregnant woman and the newborn baby.
Participants thought that if the couple was prepared and planned then the pregnancy, delivery, postnatal, and newborn baby were likely to be better.
“First of all you find out whether your wife is pregnant and make preparation to take your wife for antenatal checkups.” Respondent 3 (male)
“What I know is you have to prepare yourself if she gets pregnant,” Respondent 13 (male)
Physical support
“According to me; I think husbands should take care of mothers, providing what to eat, providing money for health care and whatever they need.” Respondent 15 (female)
Nutritional Support to the Pregnant Mothers
The study finding reveals that male involvement is described as providing nutritional support to pregnant mothers during antenatal, delivery, and postnatal periods.
Study participants felt that a well-fed mother will have good energy during pregnancy and good health will be a crucial support factor during delivery.
Good nutrition throughout the period from conception to post-delivery was associated with better outcomes for both the mother and the newborn.
“I understand it in a way that a man has to bring food that has vitamins and proteins for the pregnant wife so that when it gets to the time of delivery, she can have a normal birth.” Respondent 1 (male)
“Taking care of a woman when she’s pregnant, during delivery after she has given birth, she should eat vegetables, have a balanced diet.” Respondent 4 (male)
“After giving birth, a man should try and take care of me and provide food for me so that I can have a healthylife.” Respondent 5 (female)
Buying clothes for the expected baby
The study findings describe male involvement as buying clothes and necessities for the expectant baby in time.
Participants felt that if the man bought the clothes and necessities for the baby the pregnant mothers were happy and felt loved and cared for.
“The man can also buy baby clothes before the baby is born, even if he doesn’t have enough money it shows that he cares.” Respondent 5 (female)
“I made sure I got all requirements like clothes for the baby, buying what was required at the hospital.” Respondent 3 (male)
"Prepare baby clothes which will be used to carry in the baby at birth, for example, I have already bought baby clothes because am almost giving birth." Respondent 6 (female)
Providing transportation
Male involvement is understood as providing transport to access antenatal, delivery, and postnatal services.
Participants revealed that when the male partner provided transport whether physical or delegated made the investigation and management of the pregnancy, delivery, and postnatal better.
Findings indicate that when transport was provided any possible complications were detected early and hence a likely better outcome for the baby and mother.
"They even transport us back home, that is if you get any complications like having a cesarean section or others and if you give birth from a nearby hospital like Nyamarebe. They pick you from the hospital and take you back where they can take good care of you." Respondent 6 (female)
“Some have means of transport, they transport their wives themselves and those who don’t have, look for motorcycles to bring their wives to the health facilities.” Respondent 9 (female)
“Involving is taking care of women by taking her to the hospital for antenatal.” Respondent 16 (female)
Escorting wife to the health facility
The study findings describe male involvement as escorting your wife to the health facility for antenatal, delivery, and or postnatal care.
Participants felt that if the male partner escorted the pregnant women then they would appreciate better the issues surrounding the management of the pregnancy.
The findings however also point out that escorting a wife is not the most important part of male involvement.
“Men try to take their wives for antenatal care and at delivery time.” Respondent 7 (male)
"The husband takes care that is; escorts her to the hospital for antenatal and we as health workers when these pregnant women are brought by their husbands, we care about them by giving them a priority." Respondent 8 (female)
“Some physically come with their wives during delivery and they become attendants for these mothers who have given birth.” Respondent 9 (female)
"Men think that men's involvement in antenatal is just escorting your wife to the hospital because when we talk to them, they show you, they wanted to come." Respondent 18 (female)
Helping wife with household chores
Male involvement was described partially as helping the pregnant or postnatal woman, especially with the heavy household chores.
Participants felt that the pregnant and postnatal mother was weak and needed rest so if they were helped with household chores the mother and baby would be healthy. The mother also felt loved and cared for and this had a positive relationship with the male partner and the newborn baby.
“Other situations, you find the man is touched right from the time he learns that the wife is pregnant, he becomes happy, helps the wife in house chores.” Respondent 2 (male)
“A man should help his wife on some home chores especially those that are heavy.” Respondent 18 (female)
Informative and appraisal support
Taking the HIV test with the mother
Findings reveal that male involvement is understood as taking the HIV test together with the pregnant mother to prevent transmission of HIV to the newborn baby.
Study participants felt that taking the HIV test was critical since it could enable the health workers to take the necessary intervention to have a healthy HIV-free baby but also for the couple to know their HIV status if they did not.
Findings indicate that if the HIV status was known then the couple would have better trust for each other in the relationship.
“The other thing that we do is to teach them about HIV/AIDs and test them for HIV, so when a couple comes together, it becomes easy for us to disclose the results whether they are positive or negative.” Respondent 8 (female)
“Sometimes you might find they have HIV but they are not aware of it, but if they go together for checkups, it would help them give birth to a healthy baby.” Respondent 12 (male)
"To me, most of the men don't usually help their wives that is during antenatal on some work at home." Respondent 14(female)