Involvement of men in health, nutritional care and support of women attending antenatal clinics in urban low income areas: case of Nairobi, Kenya.

Abstract

This cross-sectional descriptive and analytical study was conducted between September and October 2005. It sought to determine male involvement in health, nutritional care and support of pregnant women attending urban low cost antenatal clinics. Approximately half a million maternal deaths each year occur in developing countries. Lack of attention to women's nutritional health and society's indifference to pregnancy are the reasons why women die from pregnancy, childbirth and peripartum related complications. The study involved 312 randomly selected mothers seeking antenatal services in three health centres (Ngara, Riruta and Langata) in Nairobi, and 34 purposively selected male partners out of the 35 who had accompanied the women. With use of structured questionnaires, data were collected on various aspects of male involvement as well as the socio-demographic characteristics of the respondents. Majority of the women interviewed and their partners were young parents in their mid twenties. The study showed that most ante~atal mothers (97.2%) and accompanying men (88.2%) supported involvement of men in health, nutritional care and support of women during pregnancy. Food provision, helping with household chores and ensuring access to healthcare when the woman is sick were the major roles respondents expected men to play. A woman's level of education was found to be significantly associated with the type of care and support expected from men. According to most antenatal mothers (54.3%), men were only participating on average in caring for and supporting pregnant women. On the other hand, almost two thirds of the accompanying men (63.5%) thought men's involvement was good. The major obstacles to male involvement were identified as financial constraints, cultural influences, men's negative attitude, and lack of knowledge on importance of involvement. To some accompanying men (15%), lack of privacy in antenatal clinics was a hindrance to men's accompanying women for joint nutrition and health counselling. The major suggested strategies to get men involved were education and sensitization of men and improvement of conditions and terms of work for men. The study concludes that both men and pregnant women support the idea of involving men, and will not pose an obstacle to any programme that may be formulated to promote male involvement. However, participation of men is hindered by financial constraints, cultural views (belief pregnancy a woman's affair and men's negative attitude), lack of information and tight work schedules. The study recommends a needs assessment to address men's fears, formulation and implementation of an education and sensitization programme that will target men, and invitation of men to the clinic for joint couple education, advice and counselling. Lastly similar studies need to be conducted in high-cost clinics and rural areas to facilitate better understanding of the issues.