Table 1
Sociodemographic characteristics of the 135 male participants
VARIABLE | Frequency (N = 135) | Percentage (%) |
Age | | |
19 to 24 years | 12 | 8.89 |
25 to 29 years | 25 | 18.5 |
30 to 34 years | 29 | 21.5 |
>=35 years | 69 | 51.1 |
Religion | | |
Christians | 97 | 71.9 |
Moslem | 35 | 25.9 |
Others | 3 | 2.2 |
Marital status | | |
Cohabiting | 11 | 8.2 |
Married | 122 | 90.4 |
divorced | 2 | 1.5 |
Level Of Education | | |
No formal education/ | 7 | 5.2 |
Primary | 66 | 48.9 |
Secondary | 58 | 43 |
Tertiary/college | 4 | 3.0 |
Occupation | | |
Informal | 7 | 5.3 |
Civil servant | 3 | 2.2 |
Peasant | 77 | 57.0 |
Others | 48 | 35.56 |
Number of children | | |
(0–5 children) | 75 | 55.56 |
(6–10 children) | 40 | 29.63 |
(11–15 children) | 48 | 9.63 |
Above 15 children) | 77 | 5.19 |
Living with partner | | |
Yes | 133(98.5) | |
No | 2(1.5) | |
Services ever received | | |
HIV testing | 132(97.9) | |
Only 1 supplementary service | 10(7.4) | |
More than 1 supplementary service | 5 (3.7) | |
No service received at all | 120(88.9) | |
Average number of ANC | | |
At least 4 | 13(9.6) | |
3 times | 31(23) | |
1–2 times | 68(50.4) | |
none | 23(17) | |
Table 2
Knowledge and attitudes of males towards Antenatal care involvement.
Knowledge levels scores | | |
Sufficient knowledge (11–14) | 12 | 8.9 |
Moderate knowledge (6–10) | 83 | 61.5 |
No knowledge(0–5) | 40 | 29.6 |
Would use ANC | | |
Agree | 129 | 95.56 |
Disagree | 2 | 1.48 |
Neutral | 4 | 2.96 |
Find it necessary for men to be involved | | |
Agree | 129 | 95.56 |
Disagree | 4 | 2.96 |
Neutral | 2(1.5) | |
Partner feels comfortable when accompanied | | |
Agree | 126(93.3) | |
Disagree | 5(3.7) | |
Neutral | 4(3.0) | |
Table 3
VARIABLES THAT DEFINE MALE INVOLVEMENT IN ANTENATAL CARE
VARIABLE OF MALE INVOLVEMENT | YES (%) | No (%) |
I accompanied her to ANC clinic | 105(77.8) | 30(22.2) |
I provided her with transport to attend ANC | 81(62.2) | 54(37.8) |
I provided her with food and money to feed her during pregnancy | 107(79.3) | 28(10.7) |
I brought for her the necessary requirements in regards to pregnancy for example the baby’s clothes and delivery(mama)kit | 115(85.2) | 20(14.8) |
I escorted her to the ANC clinic and took part in the various activities at the ANC clinic | 69(51.1) | 66(48.9) |
Average number of ANC visits | | |
At least 4 times | 13(9.6) | |
3 times | 31(23) | |
1–2 times | 68(50.4) | |
Never attended ANC | 23(17) | |
Table 4
Sociodemographic characteristics of participants in the focus group discussions
Variable | Number, n (%) |
Age (yrs) | |
18–24 | 5(8.3) |
25–29 | 21(35) |
30–34 | 18(30) |
35–39 | 10(16.7) |
> 40 | 6(10) |
Occupation | |
Fishermen | 5(8.3) |
Peasant | 35(58.3) |
Bodaboda cyclist | 15(33.3) |
Formal | 5(8.3) |
Level of education | |
No formal/primary education | 46(76.7) |
Secondary | 12(20) |
Others | 2(3.3) |
Religion | |
Christians | 45(75) |
Muslims | 14(23.3) |
Others | 01(1.7) |
Marital status | |
Married /cohabiting | 56(93.3) |
Single/divorced | 04(6.7) |
Sociodemographic Characteristics
The study involved 135 males and all were above 18 years of age and thus considered as adults. Slightly above half of the participants were equal to or above 35years, 51.1%( 69/135) and only 8.9%( 12/135) were young men between 19 to 24 years. Majority of the participants, 71.9% (97/135) were Christians while Moslems were 25.9% (35/135). Majority, 98.5% (133/135) were currently staying with partners as wives in a heterogeneous sexual relationship. Of these, 94.4% (122/135) were officially married. Two men were divorced (1.5%). Most men had had some formal education 94.8% (128/135) with close to 45.9%( 62/135) attaining at least secondary school education and only 5.2% (7/135) had no formal education.
Regarding the number of children, slightly above half of the respondents, 75/135(55.6%) had 0–5 children while about 5.2% (77/135) had 15 or more
children. Furthermore, 99.3% (134/135) were engaged in some form of employment with informal sector accounting for 97.1% (131/135) and only
2.2% (3/135) were formally employed. Majority 98.5% (133/135) were staying with their partners while only 1.5% (2/135) were not staying with the
partner during the pregnancy. (Table 1)
We assessed attitude of the respondents towards ANC and there was over 90% score for each parameter with 95.6%( 129/135) emphasizing that
they would agree to use ANC, 95.6% (129/135) agreeing to finding it necessary for men to get involved in ANC and 93.3%(126/135) agreeing to
partner’s comfort. Moreover men’s knowledge of ANC was relatively good with the majority, 70.4% (95/135) expressing moderate to sufficient
knowledge (scores 6–14). Significantly only 8.9% (12/135) had sufficient knowledge on ANC. Regarding the knowledge about ANC
(recommended visits, services offered, benefits to both mother and unborn child and the risks associated with absconding), they were
relatively knowledgeable with the majority 61.5% expressing moderate knowledge and 8.9% sufficient.( Table 2)
Among the participants in the focus group discussions, majority were youth and young men, with 65% accounted for by 25–34 year olds. Christians
constituted the majority at 75% and most were largely staying with a partner at 93.3%.Regarding employment status majority were in the informal
Sector, at 91.7% while still 76.7% had attained either no formal education of had attended primary level (Table 4)
Male Involvement
Several areas were assessed to determine the level of male partner involvement in the utilization of ANC services (Table 3).
Significantly, no parameter measured was below 50%.Majority of males, 85.2% (115/135) self reported participating by making sure that the necessary requirements in regards to pregnancy are available. Moreover while 77.8% reported having accompanied a partner to the ANC clinic while 22.2% did not. Among the 20 men that never accompanied their partners, 30% (6/20) did not know about ANC while 25% (5/20) did not do so because they were not staying together. The rest did not accompany partners because of being busy, 45%( 11/20).(Fig. 1)
Also, whereas the majority of males, 83% ever attended ANC only 50.4% attended 1–2 visits and as the contacts increased thereafter the percentage attending declined. Noteworthy is that only 9.6% (13/135) ever attended at least 4 ANC clinics. Moreover only 51.1% took part in the various activities at the clinic.(Table 3)
Number of services received at ANC.
The services that were provided included taking their Blood pressure, body weight, nutritional status assessment (by measuring Mid Upper arm circumference (MUAC)) and Human Immune Virus (HIV) testing. HIV serology testing was the major service offered to men, 97.9%( 132/135).Significantly, 88.9% (120/135) never had any supplementary services provided during ANC. However, 15/135 males (1.1%) received at least a supplementary service with 3.7% (5/135) receiving more than one service.(Fig. 2)
Qualitative data results.
This was done through a phenomenological approach with inductive thinking. Focus group discussions were used to explore what the males thought of ANC and the services provided and to understand the level of their participation. The participants were asked five questions which were answered as follows.
Theme1: ANC as a small room for only midwife and pregnant woman?
Whereas they were mixed answers to what men thought ANC was, majority submitted that ANC was a small room where the midwife enters with the pregnant woman and the latter is checked.
15 males described it as a small room where the midwife takes your wife and you are told to wait from outside.
“During ANC your wife is taken into a small room and the midwives tell you to wait outside,” said a 26 year old participant
However 10 males described it as a room where the midwife checks the status of the baby and the mother.
“ANC is a place where you take your wife so that the midwife can check on the status of the baby and the mother.” said 25 year old respondent
Theme 2: Anc As A Couple Serving Centre
With regards to male involvement in the ANC clinics, respondents reported that pregnant women and their spouses who were not sure of their HIV status were afraid of going together for ANC services. The respondents revealed that one of the basic services provided at the clinic during the first ANC visit was HIV counseling and testing. According to our respondents, the majority of men did not want to take HIV testing. To them, testing for HIV was soliciting problems.
15 participants said, they were afraid of testing for HIV status with their female partners.
However others appreciated it since they could get to know together and get necessary treatment.
“You are asked as a couple to test your HIV status and in case one of you is positive you are given ARVs (antiretroviral drugs)” They also reported,
During ANC you are given health education as a couple and thereafter the wife is given some tablets to take to ensure that the baby grows well.
Theme 3: Males’ Role As Providers
During the discussions, males expressed several ways in which they are involved.
“We are involved,” said 27 years old.
“Involvement! …paused..What do you call male involvement, all men are involved in one way or the other”, replied 35 year
“So we are involved”, said 29 year old
“ I ensure that the mother sleeps in a mosquito net,” said a 57 year old respondent
“ The man should buy clothes and delivery kit,” said 42 year old
“A man should escort the mother for ANC or provide transport in case you are busy, “said a 35 year old.
“Provide a balanced diet for the mother to make sure she is healthy’, said a 27 year old
Theme 4: Couple ANC attendance as determinant of family direction
Majority agreed that attendance of ANC as a couple may help foster unity and build stronger family ties although others expressed fear of the end of marriage in case during HIV testing, one turned out seropositive.
“As a couple it creates unity and my wife feels really loved when I escort her.” All said,
ANC “It is a good thing because it helps us as a couple knows the status of the baby hence prepare accordingly.”
And 12 said, “In case I test positive that could be the end of our marriage.”
It is a risky idea because of the mandatory HIV testing; we could part ways in case I turned out positive.
Theme 5: ANC as unpleasant place.
Most males decried the environment and mood at the facilities.
15 of the responses were “The mid wives are so rude, you can’t even think of going for another visit.” “You sit from 8am till 3 pm and sometimes even 5 pm”
17 of the men said, “The men are never attended to, it’s only the women, we stay idle the entire time.”
“The midwives are so rude, you can’t even think of going for another visit.” said 36 year old participant
“The men are never attended to, it’s only the women, we stay idle the entire time’’, 29 old said
We are fishermen; we work during night and sell off our catch in during day so our work schedule cannot allow us to take part consistently.
“My wife is disabled and whenever I walk with her in public I am laughed at”, said a 27 year old