Determinants of Male Partner Involvement in Antenatal Care in Wakiso District, Uganda

Abstract

Aims: In spite of its associated positive outcomes for maternal and child health, male partner involvement continues to be low in Uganda. This study sought to assess determinants of male involvement (MI) in antenatal care (ANC) in a Ugandan sub-urban context as well as the proportion of male partners who are consistently involved in ANC. Place and Duration of Study: This was a descriptive cross-sectional community-based survey with both quantitative and qualitative approaches conducted in Makindye sub-county, a peri-urban area in central Uganda, between August and October 2015. Materials and Methods: Participants were selected using simple random sampling. Data were collected from 384 males aged 18 - 49 years whose wife had given birth to at least one child and below two years of age. In addition 21 key informants were also purposively selected for the qualitative strand. Results: Male involvement in ANC was found to be very low (6%) and attributed to socio-demographic factors such as education (p=0.000), marriage (p=0.001) and age (p=0.044) which were found to increase ANC involvement while lower income earnings (p =0.023) decreased MI levels. Inconsistent participation in ANC is increased by: not living together with their spouses during pregnancy (OR-3.474, p-0.012); family members living with male partners and their spouses (OR-4.122, p-0.001); family members influencing male partners’ decision to get involved in ANC (OR-5.421, p-0.001); unplanned pregnancies (OR-8.935, p-0.001); peer influence (OR-3.614, p-0.036); and limited male involvement in deciding where spouses attend ANC (4.245, p-0.009). Health worker attitude (p=0.001), waiting time (p=0.001) and cost of antenatal services (P=0.003) were significantly associated with male involvement in ANC. Conclusion: Study findings confirmed low MI in ANC with explanatory factors being social, economic and system related. Interventions need to focus on continued sensitization and dialogue especially with and among men; support income generating initiatives and address health system barriers to male involvement.