Male involvement in early antenatal care attendance in the face of male champions; case study: Mparo HCIV, Rukiga District

Abstract

Introduction: Antenatal care is one of the key health programmes that promote maternal and child health in Uganda. However, low male involvement in ANC has persisted and poses a challenge to health care provision and policy implementation despite their mobilization by male champions. Male champions in this study refer to men who were trained as social mobilisers of fellow men to embrace antenatal care. This study was conducted to examine the determinants of male involvement in early ANC attendance in the face of male champions in Mparo HCIV, Rukiga District. Methods: A cross-sectional study design was adopted using a mixed-methods approach. Data was collected from 141 respondents comprising of male partners, healthcare workers, and male champions using questionnaires, interviews, and focus group discussions. Quantitative data were analyzed using the Statistical Package for Social Scientists (SPSS) and the following were performed; descriptive statistics, Pearson chi-square tests, and binary logistic regression. On the other hand, qualitative data was analysed using thematic and content analysis techniques. Results: The study findings revealed that male champions were very key in increasing male involvement in early ANC attendance in the Mparo sub-county. It was revealed that male partner who had a perception that a pregnant woman should attend her first ANC visit in the 4-5 months of pregnancy was 1.168 times more likely to be involved in early ANC attendance than their counterparts with a perception that a pregnant woman should attend her first ANC visit from the 8 th month of pregnancy. Also, male partners who had ever tested for HIV/AIDS had higher odds of being involved in early ANC attendance (AOR=2.362) than their counterparts who had never tested for HIV/AIDS. Lastly, male partners who waited for 30-45 minutes at a health facility were 10.807 times more likely to be involved in early ANC attendance than those that waited for 1 hour or more at a health facility. The qualitative findings further indicated that male champions encouraged male partners at homes, churches, health facilities, and bars to accompany their spouses for early ANC. However, they faced several challenges including cultural beliefs that hindered male involvement in early ANC high transport costs to the health facilities, and demotivation because of lack of incentives. Conclusion: the study findings revealed that male champions, individual factors, and health facility factors had a significant association with male involvement in early ANC attendance in Mparo HCIV in Rukiga District. To this end, therefore, the study recommended; Ministry of health to increase the number of staff allocated to the ANC clinic at Mparo HCIV, expansion of voluntary HIV/AIDS counselling and testing for male partners, and facilitation of male champions in mobilizing male partners for early ANC attendance especially transportation means and allowances.